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Sprains, Strains And Contusions

Apr 1, 2010
2010 / April 2010

Sprains, strains and contusions can happen to anyone — even highly trained and conditioned Olympic athletes. (Case in point: a painful shin contusion that almost prevented skier Lindsey Vonn from winning a gold medal in Vancouver.) These injuries occur wherever muscles, tendons and ligaments are present and can be temporarily disabling until they heal.

Ligaments, the fibrous bands that connect bones to one another at a joint, are normally tough in order to withstand the twisting and turning motion of our joints. They help to keep joints stable, strong and aligned correctly. When ligaments are torn or stretched beyond their limit, the resulting injury is called a sprain.

Sprains can occur from overuse of a joint, flexing or extending or twisting it beyond its normal range of motion. Any unusual force across a joint causes a sudden increase of tension or pull on a ligament and can cause it to snap. Athletes and weekend competitors are prone to these injuries, but they also can occur as a result of accidents and slips and falls.

Sprains usually cause pain, swelling and bruising in the joint and can be accompanied by muscle pain or spasm. There may be noticeable deformity due to swelling and loss of function or stability of the joint.

A strain is the tearing of muscle fibers. The majority of muscle strains occur because the muscle has been stretched beyond its limits or was forced to contract too forcefully. In mild muscle strain, only a few fibers are torn, with the muscle remaining intact and strong. In severe strain, the muscle may be torn and unable to function properly. There may be a decrease in muscle strength or a complete loss of muscle function. Sometimes people hear a “pop” in the muscle at the time of injury. There may be a dent in the normal outline of the muscle.

Muscle strain is a risk during contact sports such as football and in sports that require sudden starts such as tennis and basketball. You can also strain a muscle lifting your luggage or stepping off the curb at the airport.

A contusion, or bruise, is a crush injury to tissues beneath the skin caused by a blow of sufficient force: The greater the impact, the greater the tissue damage. If the blow is over a bony area, the bone itself may be bruised. Contusions can be sports-related but also result from blunt trauma to muscle or bone due to a fall or accident.

A contusion results in varying amounts of swelling and disability, depending on the force and location of the blow. Damage to tissue cells and capillaries results in characteristic “black-and-blue” discoloration. Because of gravity, the bruise may appear below the actual sight of the blow. The bone can also be contused, with swelling occurring between the covering of the bone and the bone itself. Due to limited circulation, swelling reduces very slowly and the contusion remains tender for an extended time.

When there is a lot of damage, large amounts of blood and waste products may collect in a pool instead of dispersing throughout the tissue. This is called a hematoma, which commonly forms following a severe contusion over a relatively flat muscular area such as the thigh.

If you experience an injury while traveling, contact your hotel concierge. The hotel may have a physician on retainer, or be able to recommend a physician to examine and treat you. You may need X-rays, a CT scan or MRI to make sure there is no fracture or torn cartilage. Over-the-counter non-steroidal anti-inflammatory medications such as ibuprofen or acetaminophen can reduce pain and swelling.

You are more likely to experience a sprain or strain if your muscles are fatigued or not in good shape, or if you do not warm up before a sport or activity. Avoid injury by warming up and stretching before physical activity and regularly exercising to strengthen muscles around your joints. Try to avoid sudden increases in intensity in your exercise program. Wear comfortable support shoes that fit your feet and suit your sports activity. Protective equipment such as pads, wrist guards or wrist splints can also help prevent injuries.

Recovery depends on the location and severity of the injury, taking a few weeks to a few months. If the sprain or strain is severe, surgery may be necessary. As your condition begins to improve, you can gradually increase activity using the injured area. Your physician may recommend physical therapy to increase your range of motion and strength. If you are not improving, contact your physician. For more information, visit www.nlm.nih.gov/medlineplus.
The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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