Scientific associate of the newspaper “My Health“. “Ankle sprain”, June 24, 2006, issue No. 6
Lambros S. Hadjimichael, Cert. MTD


Sprain: the instant pain of the articular bone surfaces and the automatic restoration to the correct anatomical position with injury of the articular elements,

Articular elements: are the muscles, tendons, ligaments, articular sac, blood vessels and nerves,

Collagen fibers: tissue with inelastic protein and strong force in traction effort,

Distinction of Sprain from Muscle Fraction: Muscle fracture involves muscle injury, which results in partial or total rupture of muscle fibers, where sprain involves ligament injury. In many cases they coexist, since the muscles are the first line of defense of the joint and the ligaments are the next.

Sprain classification

Grade I, simple ligament dilatation, is characterized, as a minor injury. It breaks down a small number of collagen fibers, Grade II, partial rupture of the ligament, where it is more severe than that grade 1 and rupture of several fibers occurs from 1/3 to 2/3 of the ligament.

Grade III, total ligament rupture, where this ligament injury is severe . It is characterized by complete rupture of all collagen fibers, one or more ligaments or 2/3 of the joint.

Causes and symptoms of sprains

In grade I sprains, are usually caused by abrupt movements. Movements are not very violent and with a medium load to  the area pain increases, especially during movement. There is slight swelling and hematoma. The joint can be charged. Ιn grade II sprains, causes and symptoms are similar to those in grade I, but with stronger intensity and violence. The joint is sensitive and painful. It coexists with severe swelling and hematoma and causes a feeling of instability during gait in grade III sprains, the causes and symptoms are high pressure and strain, sudden and violent blows from external factors and relapses in injuries that did not have a full recovery. The area is painful. The joint cannot move normally or receive load. During walk there is a feeling of instability and loss of support. There is severe swelling to the area and can be accompanied by dislocation of the joint. Also, there is difficulty in assessing whether it is a total rupture of the joint or fracture and requires immediate immobilization of the joint and surgical rehabilitation..

Aggravating factors

The aggravating factors are:

a. Poor coordination or specificity in the area. It is usually the result of poor functioning of the musculoskeletal system or poor treatment of a previous injury in the same area. B. Hardship. Tired muscles do not give good support to the area, while “unnatural” movements are caused that can lead to injury to the muscles or joints of the joint. Lack of warm-up before strenuous physical activity. The warm-up prepares the muscular system to meet the increased demands while increasing the range of motion of the joints.

Restoration of sprains

In grade I sprains, an elastic bandage is applied for 2-3 weeks, in grade II sprains, the plaster is immobilized for 4-6 weeks, and in grade III sprains, the treatment is usually surgical, ie suturing the joint and plaster for 6-8 weeks. In all three cases, physical therapy is considered necessary in order to completely heal the injury.

First aid

The sprain requires an When sprain occurs assessment is required in order to assess the extent of the injury and classify it. However, in all cases the following protocol should be followed:

  1. Immobilization of the area to protect against greater injury.
  2. Rest of the affected area avoiding activities that may cause pain, increase swelling or discomfort.
  3. Ice application to reduce pain, swelling, inflammation and micro-bleeding in the injured area. Ice can be applied for the first 48 to 72 hours after the injury, for 10-15 minutes, ice application for more than 20 minutes, it can cause injury to the skin (burn) or nerves in the area. The application is done every two to three hours, during the day. In some cases, ice application may cause an increase of the pain, thus re-evaluation of the instructions. It is forbidden to apply hot in the area due to vasodilation which causes greater hematoma in the area with increased swelling, so additional problems,
  4. Dressing should be applied by a professional in order to reduce edema.
  5. Elevation of the affected area to reduce swelling.

When should medical attention be sought?

Emergency medical care is required in cases where:

  1. Characteristic sound occurred during injury.
  2. There is severe swelling, hematoma and joint instability.
  3. Inability to support the affected area.

We need to keep in mind that untimely or incorrect treatment can lead to chronic pain or severe joint strain and we should always have a medical examination.

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