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In contrast to pulled muscles (strains), sprains involve the tearing or traumatic injury of ligaments. These are strong, fibrous structures surrounding the many joints. Common areas where sprains occur are the knees, ankles, and wrists, though almost any joint can be affected. The typical “whiplash” injury of a rear-end automobile collision is also a ligamentous sprain. In reality, the entire spine is vulnerable to this type of injury.

The general characteristics of a sprain are as follows: there is acute pain, localized in the involved joint. Swelling follows, particularly if further ambulation or joint motion is continued, and the area is often held in a dependent position. When blood vessels are torn, bruising becomes apparent within hours, frequently turning the affected joint “black and blue.”

There are several important first aid measures to be used in suspected sprains. These include the immediate immobilization of the extremity, its elevation, and the application of ice packs. All of these remedies reduce the amount of swelling and pain. They also help to control bleeding within the joint.

Pain in any joint is a message from “nature” to rest the injured member. For sprained ankles, wrists, or knees, elastic bandages, crutches, and occasionally plaster casting is used for immobilization during the healing phase. Hot and cold contrast treatments, used after the first 12 to 24 hours, aid in the resolution of these inflammatory changes. They also accelerate healing and reduce pain. Unusual persistence of pain in the involved area should alert one to the possibility of fracture, which is best diagnosed with an x-ray.

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