What is a sprain
Ligaments are bands of connective tissue that surround and strengthen a joint.
Their ends are attached to the mating bones. Thanks to ligaments, the joint can only bend in a certain direction. Any external force aimed at bending a joint in an unnatural direction can lead to spraining, the first signs and first aid for which will be discussed below. The connective tissue that secures the articulation of bones is highly durable and lacks elasticity. She is unable to stretch. When a tensile load is applied, fibers rupture, which, depending on the severity of the injury, can range from a small part to a complete rupture of the ligament. Therefore, in traumatology there is no concept of “sprain”; instead, the term “rupture” is used.
When an injury occurs, along with the rupture of connective tissue fibers, blood vessels usually rupture, which leads to internal hemorrhages with the formation of hematomas and the appearance of swelling.
Let's consider all aspects regarding the definition, causes, types, symptoms of sprains and first aid for this condition.
What is a compression bandage?
Compression or elastic bandage "Intex" is a tape made of latex, cotton and polyester fiber. Latex gives the tape stretchability, cotton ensures hypoallergenicity and softness , and polyester fiber makes the bandage durable and wash-resistant.
A bandage made from an elastic bandage "Intex" supports damaged muscles, relieving excess stress from them. The elastic bandage reduces swelling and stimulates blood flow in the area of injury, improving metabolism in the area of injury and accelerating the healing of damaged muscles.
How to distinguish a sprain from other joint injuries
Although the principles of emergency care for various types of sprains are the same as for other types of injuries, it is advisable to assess the severity of the injuries before visiting a traumatologist. This will allow you to take additional measures and choose the right tactics that will help avoid complications.
The easiest type of injury is a bruise. It is accompanied by rupture of blood vessels and the formation of hematomas, but the structures of the joint, bones and ligaments remain intact. Its symptoms are pain after injury, which soon decreases and is felt only when pressing on the injured area. The bruise is usually accompanied by swelling, but the range of motion of the injured limb does not decrease.
Dislocation occurs due to displacement of the articular surfaces relative to each other. It can be recognized by the unnatural position of the bone, changes in the shape of the joint, as well as sharp pain when trying to move. The victim should be given first aid for dislocations and sprains, trying not to disturb the deformed joint. Its reduction should only be done by a traumatologist, who must be contacted within the first 24 hours after the injury.
A fracture is usually characterized by sharp pain with movement, numbness at rest, and swelling in the injured area. When pressing on the injured area, acute pain is felt. The victim urgently needs to apply splints, as well as take other emergency measures used for sprains and dislocations, and then be taken to a medical facility.
Sprain and rupture of ligaments can be suspected by the direction of action of the traumatic load. For example, if during a fall your foot twisted sharply or your knee turned inward or outward, then with a high degree of probability a sprain can be assumed. Symptoms are aching pain at rest and sharp pain when moving, which only intensifies over time, and swelling may occur.
A sprain can be distinguished from a fracture by the absence of pain when pressing on the joint. Ligament rupture can be no less dangerous than a fracture. If there is severe pain and immobility, the injured person needs to call an ambulance, and if the condition is not very serious, then within one to two days after the injury you need to see a traumatologist. First aid for a sprained ligament should be provided immediately.
Causes of ankle ligament rupture
Given the characteristics of the ankle functions, ligament damage can occur in various situations. As a rule, it is caused by a fall, twisting of the foot, or a sharp turn. At this moment, the joint is stretched and the ligament tissue is torn. Common causes of joint sprains and ligament tears:
- Sports activities.
- Rolling of the foot, for example on steps or slippery roads;
- Impact to the ankle area.
The feet are subject to stress every day, but ligaments do not tear every day. It is worth highlighting a number of provoking factors in which the risk of trouble increases significantly:
- For women - high heels, on steps, on slippery paving slabs - the chances of spraining an ankle and fans of stilettos are quite high.
- Obesity – being overweight is not a reason to fall or injure yourself, but if you twist your ankle, an obese person is much more likely to suffer a torn ligament due to the significant strain.
- Endocrine disorders that reduce the elasticity of ligaments.
- Congenital pathologies of the structure of the foot and ankle.
- The presence of old injuries and diseases of the joint.
- Sports activities – long jump, high jump, parachuting.
What you will need for first aid
To properly provide first aid in the event of a sprain, you must have in your first aid kit regular and compression bandages, painkillers, as well as a cooling pack, which can be replaced with the following available means:
- cold accumulator for thermal bag;
- pieces of ice from the freezer, tied in a bag;
- finely chopped frozen vegetables;
- bag of snow;
- a heating pad filled with cold water.
It is desirable that the cooling agent can easily take any shape for better fit to the injured area. An elastic and simple bandage, as well as a cooling pack, should always be in your home, office, or car first aid kit in order to be able to provide first aid for a sprain as soon as the need arises. In case of open wounds, you need to have sterile dressing material. Also, to immobilize the injured limb, splints may be needed, which can be replaced with any oblong-shaped objects at hand.
Briefly about the treatment method
Banding is a method of creating a pressure bandage on a swollen leg due to lymphedema.
Banding serves the purpose of maintaining the volume of the limb after a lymphatic drainage massage session and allows you to maintain the achieved result. Banding technology is quite complex. The bandage consists of several materials applied in layers to provide the necessary pressure on the swollen tissue.
With the help of a bandage, it is possible to achieve the main goal of treating lymphedema - eliminating dense progressive edema and restoring the normal volume of the limb.
Stages of assistance
Before considering what the sequence of providing pre-medical first aid for a sprain is, we note what absolutely cannot be done. After a blow, the first reflex movement is to rub the bruised area. It is better to refrain from this, since rubbing activates blood circulation, and if the vessels are damaged, then hemorrhage into the surrounding tissue will increase, which will lead to the growth of a hematoma.
The same applies to heating the damaged area. In the first two days, it is forbidden to apply warm heating pads to the injury site, take a hot bath or shower, or make warming compresses. This can be done only after 48 hours, when the threat of hemorrhage from damaged vessels has passed.
First aid steps for a sprain include resting the injured joint, cooling, and compression. Painkillers are also used if necessary. We briefly covered the stages of first aid for a sprained ligament victim, and now we will look at each of them in detail.
Peace
The first step in helping with muscle and tendon sprains is to keep the injured joint immobile. This allows you to achieve two goals - to stop the development of pathological processes caused by injury and to reduce pain.
The victim must be laid down, placing the joint in a position in which pain is minimal. In this case, it is desirable that the injured area is above the level of the heart. This reduces blood supply to the injured area. If there is a suspicion of a fracture or ligament rupture, it is recommended to immobilize the limb using splints. But this must be done after the stages of bandaging with an elastic bandage and cooling.
Splints are applied on both sides of the injured area, extending beyond it, and attached to the limb using bandages. It is necessary to place a soft cloth under the splints to avoid damaging the skin.
Compression
The next stage of first aid for an injured person with sprained muscles and ligaments is the application of a tight bandage, which, on the one hand, provides fixation of the joint, and on the other hand, slightly compresses the damaged vessels and reduces internal hemorrhage. It is best to use a compression bandage for this purpose, but if this is not available, you can make a tight bandage with a regular bandage or strips of clean fabric. If there are wounds on the skin, they must be covered with several layers of sterile dressing material before applying a tight bandage. The bandage should be tight, but in moderation, it should not interfere with blood circulation in the limb, because when a ligament is sprained, providing first aid, everything should be done to improve, and not worsen, the condition of the injured person. If, some time after applying a tight bandage, the skin of the limb turns blue or, conversely, becomes too pale, the bandage must be loosened.
Cooling
First aid for a sprain also includes applying cold to the injured area. This helps stop internal bleeding. Immediately after the injury, cold exposure should be 25–30 minutes, and then for two days, cold should be applied for ten minutes every two hours, excluding sleep time. When using cooling agents, wrap them in a cloth and make sure the dressing does not get wet, especially if there are wounds on the skin.
How to apply an elastic bandage to a thigh?
If the hip is damaged, a spica bandage is applied - a figure-of-eight bandage covering the thigh and hip joint.
Applying a spica bandage for a sprained quadriceps femoris muscle
To treat a quadriceps muscle strain, both an ascending bandage (the bandage is applied from bottom to top) and a descending bandage (the bandage is applied from top to bottom) are used. The elastic bandage should cover the area below and above the sprain. 1. When applying an ascending bandage, secure the bandage just above the knee - so that the first turn of the bandage is folded over the second turn of the bandage and pressed with the third - this technique allows you to firmly secure the bandage. 2. When applying a descending bandage, secure the bandage with 1-2 turns around the abdomen. 3. Apply the bandage so tightly that the tape overlaps 2/3 of the width of the bandage. 4. Cross the turns of the bandage along one line: up for an ascending spica bandage, down for a descending one. 5. Having finished bandaging, secure the bandage using the clip that is included with the Intex elastic bandage.
Applying a spica bandage for stretching the lateral thigh muscle
If the lateral thigh muscle is damaged, an ascending spica bandage is applied. 1. Fasten the bandage just above the knee, so that the first turn of the bandage is folded over the second turn of the bandage and pressed with the third - this technique allows you to secure the bandage firmly. 2. Apply an elastic bandage to the thigh, pulling the tape from the lateral side of the thigh to the medial side. This promotes inward rotation of the leg and relieves pain. 3. Apply the bandage so tightly that the tape overlaps 2/3 of the width of the bandage. 4. Bandage the leg to the groin and continue the bandage to the stomach. 5. Secure the bandage with 2-3 turns of the bandage around the abdomen. 6. Having finished bandaging, secure the bandage using the clip that is included with the Intex elastic bandage.
Applying a spica bandage for stretching the medial thigh muscle
If the medial thigh muscle is damaged, an ascending spica bandage is applied. 1. Fasten the bandage just above the knee, so that the first turn of the bandage is folded over the second turn of the bandage and pressed with the third - this technique allows you to secure the bandage firmly. 2. Apply an elastic bandage to the thigh, stretching the tape from the medial side of the thigh to the lateral side. This promotes flexion and outward rotation of the leg and relieves pain. 3. Apply the bandage so tightly that the tape overlaps 2/3 of the width of the bandage. 4. Bandage the leg to the groin and continue the bandage to the stomach. 5. Secure the bandage with 2-3 turns of the bandage around the abdomen. 6. Having finished bandaging, secure the bandage using the clip that is included with the Intex elastic bandage.
Rehabilitation period
Rehabilitation after surgery will take some time. For the first three weeks, physical activity is possible only with crutches; the load on the operated leg is excluded. Then for another three weeks the patient walks independently, but his ankle is fixed in a special hard boot. By checking the condition of the operated ligaments, the doctor determines the time when the rigid fixation can be removed, an elastic brace can be left in place, and the patient can be allowed to flex and straighten the leg in the foot.
Another rehabilitation option is faster and more technologically advanced. It does not involve the use of crutches. In this case, the surgical technique involves installing special micro-fixators of braces subcutaneously.
During the rehabilitation period, proper rehabilitation therapy, physical therapy, and physiotherapeutic procedures are extremely important.
Where to have ankle ligament surgery done in Moscow?
The main hospital in Moscow, the Central Clinical Hospital of the Russian Academy of Sciences, invites patients who have injured their ankles and need immediate help and an accurate diagnosis of the condition. We also work with old injuries, when physiotherapeutic treatment has not helped, and there is instability of the joint - come for a consultation with an orthopedic surgeon to learn more about surgical methods to solve the problem. Ligament plastic surgery will protect the joint, provide it with stability, and return full normal motor activity - without pain and restrictions!
Diagnosis of ankle ligament rupture
In order to prescribe the correct treatment or decide on the need for ankle ligament surgery, the doctor must make sure that it is a tissue rupture. First of all, the patient is examined. The orthopedist takes the shin of the injured leg with one hand and tries to move the foot to the side with the other. If the lateral ligaments are torn, excessive mobility of the foot will be evident.
Next, the patient is sent for an X-ray examination. The picture must be taken in two projections. It is possible to diagnose a ligament rupture on an x-ray only if we are talking about the third degree of pathology. If the picture is unclear, the orthopedist may order a stress x-ray or arthrography to understand the condition of the joint capsule.