Minor Sprains and Strains

Introduction

A sprain is an injury involving the overstretching or tearing of ligaments and/or the joint capsule.

In contrast, a strain occurs when muscle fibers or tendons are damaged due to overstretching or tearing.



PRICE Therapy

Minor sprains and strains can usually be managed at home using PRICE therapy for the first 48 to 72 hours.

  • The primary goal is to minimize swelling.
  • If swelling is not controlled, the resulting pressure can limit mobility, lead to long-term muscle atrophy (wasting), and delay the overall recovery process.

Protection

  • Protect the affected area from further trauma, for example, by using a brace or support.

Rest

  • Avoid strenuous exercise and reduce daily physical activity.
  • Use aids like crutches or a walking stick for lower limb injuries, or a sling for shoulder injuries, to offload weight.

Ice

  • Ice packs reduce the metabolic needs of the tissues, reduce blood flow and result in less tissue damage and swelling.
  • Apply an ice pack to the affected area for 15-20 minutes every 2-3 hours.
  • Always wrap the ice pack in a towel so that it does not directly touch the skin and cause an ice burn.

Compression

  • Use elastic compression bandages during the day to physically limit swelling.

Elevation

  • Keep the injured area raised above the level of the heart whenever possible.
  • This reduces blood flow into the damaged area by the effect of gravity.



Management

Over-the-counter analgesics, such as paracetamol and NSAIDs, can help manage pain.

  • However, the contemporary PEACE & LOVE protocol suggests avoiding anti-inflammatory medications, as they may negatively impact long-term tissue healing. It even challenges the traditional use of ice in soft-tissue injury management.

Peace and Love Protocol

To ensure a fast recovery, avoid HARM (Heat, Alcohol, Running/exercise, and Massage) for the first couple of days.

  • While the application of heat (such as heat packs and hot-water bottle) can be effective in reducing pain, it should never be applied immediately after an injury.
  • Heat dilates blood vessels, which increases blood flow and worsens swelling - the exact opposite of the desired effect during the acute phase.
  • Once the initial swelling has subsided (usually after 48-72 hours), heat can be used to relax muscles and improve circulation.
  • Heat is also highly effective for chronic conditions, such as ongoing back pain.

Once the pain no longer prevents movement, begin gentle mobilization.

  • Early movement, strengthening and coordination exercises are vital for both sprains and strains to prevent stiffness.
  • A return to full activity should be gradual.

Consult a healthcare professional after 5 days if there is

  • Lack of expected improvement (e.g. difficulty walking or bearing weight).
  • Worsening symptoms (such as increased pain or swelling).



Prevention

The risk of injury can be minimized through a consistent physical conditioning program that includes sport-specific stretching and strengthening exercises.



Summary

While common in professional sports, ethyl chloride (cold spray) serves only as a temporary "cryo-analgesic".

  • It numbs the area for 30-60 seconds to allow a trainer to assess the injury without the patient being in extreme distress.
  • An athlete should only return to play if the injury is superficial.
  • Pushing through a serious injury is highly discouraged as it will exacerbate the damage.
  • If a sprain or strain is severe, a referral to a GP or specialist is essential to assess the extent of the ligament or muscle tear.



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