A sprain is an injury that damages a ligament. A ligament is a firm, fibrous band of tissue. It connects two bones across a joint. There are ligaments crossing all of the joints in the body. Grade 1 and 2 sprains damage only the internal structure of a ligament. The ligament remains intact. Grade 1 is less severe than grade 2. Grade 3 sprains result in complete tears of the involved ligament. Grade 3 sprains are sometimes called torn or ruptured ligaments.
Sprain: Grade 2
A sprain occurs when an external force pushes two bones of a joint apart. If the force continues, the ligament holding the joint together has to give. Most of the time, it gives only partially and is sprained. Sprains occur most often during a sport related activity. They can also happen from accidents in everyday actions.
Forces that may cause a sprain include:
- A fall
- Contact with another person (especially in sports)
- A misstep
The most common joints involved include:
- Shoulder (acromioclavicular joint)
Factors that increase your chance for ligament sprains include:
Sports with high speeds and risk of collision, such as:
- Pain immediately after the sprain—without treatment, the pain becomes worse over the next 24 hours
- A "popping" sound
- Local swelling, often within minutes
- Bruising (black and blue)
- Trouble moving the joint
- Increased pain when putting pressure on the injured area
The doctor will ask about your symptoms and how the injury occurred. The doctor will also examine the injured joint for:
- Damage to the ligament
Tests may include:
Treatment will depend on the joint involved and the extent of the injury. The need for medical help is determined by the amount of pain and swelling. A lack of function in the joint will need medical attention. Treatment may include:
Stop doing the activity. Protect the joint.
If the leg is involved, elevation will help. Compression of the area with an elastic bandage helps to control swelling. Do not pull the elastic bandage tight. Release the bandage if fingers or toes become numb.
Ice and Heat
Apply ice to the area for 15 minutes, 4-6 times a day for the first 36 hours. Do not apply heat until you are ready to start being more active. Check with your doctor before applying heat. It may increase swelling.
As sprains begin to recover, rehab exercises are often helpful. These will help to strengthen muscles and increase range of motion. Medical help is often needed at this stage. It is very important to strengthen the muscle to which a tendon is attached. That muscle is protection against further injury.
It may be difficult to avoid sprains. Joints are at risk during athletic activities. Proper technique can help avoid awkward motions and missteps.
Thorough professional rehab of a sprained joint may reduce the risk of a later resprain. Rehab should be done with a certified athletic trainer or physical therapist. To avoid spraining a previously sprained joint, you may also wear a brace or tape the injured joint. See a healthcare professional for advice on braces and taping.
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
American Orthopaedic Society for Sports Medicine website. Available at: http://www.sportsmed.org .
Human Tendons. Human Kinetics; 1997.
Last reviewed January 2009 by
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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