Sprains and Strains Treatment and Prevention Singapore

Sprains and strains are common injuries that can happen to anyone. Sprains and strains are the most common workplace injuries, especially those that involve the back. In 2017, the U.S. Bureau of Labor and Statistics reported that sprains and strains affected more than 34,000 workers. Sprains and strains are the most common type of sports injuries. If you have ever exercised or played a sport, you will most likely have experienced a sprain or strain.

What are Sprains and Strains?

Sprains and strains are often mentioned together but are quite different. A sprain refers to an injury to the bands of tissue (ligaments) connecting two bones together, while a strain refers to injuries to muscles or to a band of tissues that connects a muscle to your bones (tendons). Both injuries can be either acute or chronic. Mild strains and sprains usually heal on their own with ample rest and basic care, but moderate to severe strains or sprains will require medical attention and can sometimes require surgery. Minor sprains and strains usually heal in about 2 weeks, while severe sprains and strains may take up to a few months to fully heal.

Common Sprains and Strains

Sprains tend to be common in the:

Wrists
Ankles
Thumbs
Knees

Strains tend to be common in the:

Knees
Feet
Legs
Back

Acute sprains and strains usually come as a sudden injury due to a specific, isolated incident. Chronic sprains and strains on the other hand, refer to an injury that has persisted for at least three months. These chronic sprains and strains are typically caused by an overuse of the injured area.
For acute sprains and strains, they can be graded depending on their severity.

Grade I – affected area is moderately painful and swollen, with a small percentage of torn fibres. Function and strength tend to remain unaffected.
Grade II – affected area is painful and swollen, with a moderate percentage of torn fibres. Some loss of function and strength is experienced.
Grade III – A significant loss of function and strength is experienced, and the soft tissue may be completely ruptured. It is advised that you seek medical help for injuries of this severity.

Symptoms of Sprains and Strains

The two types of injuries share similar symptoms and can often be confused for one another. Common symptoms of sprains include:

Bruising
Pain around the affected joint
Loss of range of motion at the affected joint
Swelling near the affected joint
Loss of flexibility

To differentiate between the two types of injuries, you can look out for bruising or muscle spasms. If bruising is observed, it is likely to be a sprain. If you experience muscle spasms, it is likely to be a strain.

Risk Factors for Sprains and Strains

While sprains and strains are common injuries that can happen to anybody, there are factors that may increase your risk of developing sprains and strains. These include:

Being physically unfit. This means that your muscles and joints are likely to be weak and not properly conditioned. This may result in your muscles and joints failing to support your movements.
Using improper equipment or misusing equipment. Poor-fitting equipment or worn-out equipment may result in an increase in your risk of developing sprains and strains. Common examples of this would be running shoes that have worn-out soles or sports shoes that do not fit your feet correctly.
Usage of poor technique. Using poor or incorrect technique while sporting can increase your risk of sprains and strains.
Not warming up. Warming up before exercising or playing sports can help to prevent injuries as it stretches your muscles, increasing your range of motion.
Not cooling down. A proper cool down session after exercising or playing sports can help strengthen your muscles and improve joint support.
Insufficient rest. Rest is important for your muscles, tendons and ligaments to recover and avoid excessive strain. Give your body sufficient rest between days when you have to exercise and train.
Your environment. Watch out for wet, slippery, or icy surfaces when walking. These surfaces can increase your risk of a fall, which could cause a sprain or a strain.

Complications of Sprains and Strains

Sprains and strains usually do not result in serious complications. Common complications of sprains and strains include a loss of functionality of the affected area, such as a limb. Sprains and strains can have serious complications if your skin is torn or if blood vessels and nerves are damaged.
These complications include:

Bleeding. Some sprains and strains can result in bleeding under the skin, forming bruises.
Blood vessel damage. While this is a rare occurrence, a severe sprain can sometimes be a dislocation of a joint that has slipped back into place on its own. The dislocation may damage your artery, affecting blood supply to your limb. Symptoms of disrupted blood supply may not surface until several hours after the injury. If left untreated, blood vessel damage can lead to a loss of the injured limb.
Nerve damage. Nerves can be damaged by physical trauma that has caused your sprain or strain. Nerve damage results in a feeling of numbness or tingling in the injured area. Depending on the severity of the nerve damage, it may take weeks, months or even years for it to heal on its own. If the nerves are torn, they will require surgery. Some nerve injuries never recover on their own.
Severe sprains can cause instability in your joints. This can increase your risk of developing osteoarthritis, which can potentially lead to disability.
Compartment syndrome. Sprains and strains can cause swelling. In rare cases where the swelling is severe enough, it can lead to compartment syndrome. Compartment syndrome occurs when swelling is so severe that it cuts off blood supply to the injured limb, potentially damaging and killing tissues in the limb which may result in amputation.

Diagnosing Sprains and Strains

To diagnose sprains and strains, your doctor will usually carry out a physical examination and ask you about your injury. This is necessary to rule out any other possible causes of your symptoms. A physical examination checks for:

Damage to blood vessels
Damage to nerves
Loss of range of motion
Problems in the joints

If this is insufficient to form a conclusion, your doctor may request an X-ray, which will help to check for fractures. If needed, further imaging tests such as a magnetic resonance imaging test or computed tomography can be used.

Preventing Sprains and Strains

While sprains and strains can be unavoidable, there are steps in which you can take to lower your risks of sustaining injuries.

Conduct proper warm-up and stretching before exercising. Warming up and stretching will give your joints ample preparation for physical activity, which will reduce the risk of injury.
Exercise regularly. Exercise regularly with moderate activity, with sufficient rest in between your exercises. This will condition your body to be strong enough to deal with the physical strain of exercising.
Pay attention to your surroundings while exercising. Look out for slippery surfaces, obstructions, or anything that can cause danger or injury.
Take breaks in between your exercises. Repetitive motions can strain your muscles greatly. To avoid overstraining your muscles, take breaks during your exercises when you can to stretch your muscles.
Proper use of equipment. Investing in good equipment for sports or exercise and using them properly will help to reduce your risks of injury greatly. There is protective equipment designed specifically for certain sports that come with a higher risk of injury, and this equipment should be used properly with the correct fitting.

Treatment for Sprains and Strains

There are various treatment methods for sprains and strains that will depend on how severe your injury is.

RICE Treatment

For mild to moderate sprains and strains, you can make use of the RICE treatment method to relieve pain and improve symptoms.

Rest

Immediately halt all physical activity so that your injury is protected from additional strain. It is recommended that you rest for 24 to 48 hours.

Ice

Applying a cold pack or ice cubes wrapped in a cloth or towel to the affected area can help to relieve pain and swelling. This can be done from 15 to 20 minutes each time and can be repeated every two hours.

Compression

Using an elastic bandage, you can compress your injury by wrapping it firmly. Ensure that you do not wrap it too tightly, as this can cut off blood flow. Compressing your injury can help to reduce swelling.

Elevation

Elevating your injury at heart level or above can help to improve blood circulation from the affected area to your heart. This reduces pain and swelling.

Do note that the RICE treatment is meant to be used as first aid and should not be used past the first two days after your injury, unless specifically instructed to do so by a doctor. Prolonged use of RICE treatment could prevent your body from starting the healing process for your injury.

Pain Medication

Pain medication may be prescribed to manage your pain symptoms caused by a sprain or strain. These may include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)
Aspirin
Naproxen
Ibuprofen
Acetaminophen
Pain-relief creams

Immobilisation

In severe cases of strains and sprains, your limb may need to be immobilised with the use of a cast to prevent further injury and allow it to heal.

Surgery

Sprains and strains that cause your tendons, ligaments, or muscles to tear may require surgery so that these tissues can be repaired.

Physiotherapy and Rehabilitation

Physiotherapy is a treatment method suitable for sprains and strains. The treatment will depend on the severity of your sprain or strain. Physiotherapy aims to improve symptoms and restore function so that you can restore your quality of life.
For sprains, physiotherapy will aim to reduce swelling and alleviate pain. Therapy used will include:

Exercises to strengthen and stretch the muscles near the affected joint
Joint mobilisation techniques performed by a trained therapist for your injured joint
Heat/ice treatment or electrical stimulation

For strains, physiotherapy will aim to prevent the build-up of scar tissues and promote healing for your injured muscles. Therapy used will include:

Exercises to strengthen and stretch your strained and surrounding muscles
Soft tissue mobilisation that breaks up fibrous tissue and scar tissue
Heat/ice treatment when necessary to alleviate swelling and pain.

A trained physiotherapist will be able to assess your progress throughout the rehabilitation process and progressively increase the intensity of your exercises while ensuring that you carry them out safely without risk of aggravating your injury.
In addition, your physiotherapist can offer various other types of treatments that can be used in conjunction with your physiotherapy for optimal results. These include treatment methods such as dry needling and deep tissue massage.

Physiotherapy Deep Tissue Massage

A deep tissue massage targets the deeper layers of your muscle to relieve and treat muscle and tendon pain, stiffness, and injuries. This makes it ideal for treating sprains and strains, alleviating symptoms of pain and improving the range of motion of the affected area. In addition, a deep tissue massage can help to boost blood circulation, which speeds up the recovery process of your injured tissues.

Physiotherapy Manual Therapy and Exercises

Soft Tissue Mobilisation: Soft tissue mobilisation techniques, such as massage, myofascial release, and trigger point therapy, are used to reduce muscle tension, break down scar tissue, and improve circulation in the injured tissues.
Joint Mobilisation: Gentle joint mobilisation techniques may be applied to improve joint mobility, reduce stiffness, and restore normal joint mechanics in the affected area.
Range of Motion Exercises: Passive and active range of motion exercises help restore flexibility and mobility in the injured joint or muscle.
Strengthening Exercises: Progressive strengthening exercises target the muscles surrounding the injured area to improve strength, stability, and function. Resistance bands, weights, and functional exercises may be incorporated to progressively challenge the muscles.
Proprioception and Balance Training: Proprioceptive exercises, such as balance and stability exercises, help improve proprioception (awareness of body position) and neuromuscular control to reduce the risk of re-injury.
Core Strengthening: Strengthening exercises for the core muscles (abdominals, lower back, hips) help improve stability and biomechanics, which can alleviate strain on the injured area and promote optimal movement patterns.

Physio Electrotherapy

Electrotherapy may be used to provide pain relief, reduce inflammation, and facilitate tissue healing.

TCM for Sprains and Strains

Traditional Chinese Medicine (TCM) offers various treatments for sprains and strains, aiming to reduce pain, inflammation, and promote healing of the injured tissues.

TCM Acupuncture

Acupuncture involves inserting thin needles into specific acupuncture points along meridians (energy pathways) associated with the affected area. In the case of sprains and strains, acupuncture can help stimulate circulation, reduce inflammation, and alleviate pain. Acupuncture points commonly targeted for sprains and strains include those along the Bladder, Gallbladder, and Liver meridians.

TCM Herbal Medicine

Herbal remedies are often prescribed in TCM to address the underlying imbalances contributing to sprains and strains. Herbal formulas may include a combination of herbs with analgesic, anti-inflammatory, and tissue-repairing properties. Common herbs used for sprains and strains include Radix Angelicae Sinensis (Dang Gui), Radix Paeoniae Alba (Bai Shao), and Rhizoma Curcumae (Jiang Huang).

TCM Cupping Therapy

Cupping involves placing cups on the skin to create suction, which helps increase blood flow, reduce muscle tension, and promote healing. Cupping therapy can be beneficial for relieving pain and swelling associated with sprains and strains. Both stationary and moving cupping techniques may be used to target the affected area.

TCM Gua Sha

Gua Sha is a technique that involves scraping the skin with a massage tool to promote blood circulation and alleviate pain. Gua Sha therapy can help reduce inflammation, release muscle tension, and improve range of motion in the injured area.

TCM Moxibustion

Moxibustion involves burning dried mugwort (Artemisia vulgaris) near acupuncture points to stimulate circulation and promote healing. Moxibustion can be applied to acupuncture points located around the injured area to enhance the therapeutic effects of acupuncture treatment for sprains and strains.

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