Sprains and Strains – Ankle – Knee – Wrist – Thumb

Ankle Sprain means that some ligaments holding the ankle bones in place are twisted, torn, ruptured. Strains means some muscles that allow the movements have been stretched, twisted or torn. Usual body parts are Ankle, Knee, Wrist and thumb.

What happens inside when ankle is sprained or strained – Every muscle or ligament has small capillaries which provide the necessary nutrients to the group of muscles or ligaments. When a muscle is stretched the capillaries also get torn. A a result of tear in the capillaries the blood starts leaking from the affected area. This leaked blood has clotting properties. The blood clot is hard and  devoid of normal fluid that remains inside the muscle. When an area is surrounded with the blood cot, the actual muscles get repaired. After the inside muscles are repaired this clot must dissolve. If this clot is given too much rest and time, this becomes very difficult to remove.

A small example will make the things more clear – When there is a tear on the skin from the outside, the tear gets healed in about 24 hours. But there is still pain when that part of the skin is stretched beyond a point. Usually there is a scar also. There is hardened skin over the tear of the skin. This is called scar tissue. The reason of the scar tissue is to give pain signals to the person who that movement beyond a particular point is avoided. Now if the this scar tissue is removed after 24 hours (some people have better healing capabilities in that case it may heal in less then 24 hours) there will be blood and the the tear will be repeated in that area. The reason of this is that the main tissue had not completely healed. After 2-3 days the scar tissue come off on its own. There is evident drying of the scar tissue. If bandage is applied to the torn skin the healing process may slow down significantly. But in case of massive tear the muscles need to be supported in the begining. The torn muscles need to be put together for proper healing of the muscles. But in that case the bandage needs to be removed as soon as the muscles become capable of holding themselves in place.

What is the difference between external tear and internal tear – The external tear is visible and after the healing is completed the scar tissue comes off on its own. Moreover the pain disappears and the normal movement of the affected skin area starts. That movement helps in removing the scar.

Internal tear – Inside there is blood and heat. That does not allow the scar tissue to dissolve on its own. Therefore the affected muscle needs to be moved after 24 to 48 hours to make that scar tissue to dissolve. But care needs to be taken not to move the affected portion too much too quickly. It may take 3 to 10 days for the scar tissue to dissolve fully. The thing that needs to be kept in kind is – there should be no movement of the affected muscles beyond the point where is starts to pain.

The options of the treatment are –

Rest – It allows the torn capillaries to be repaired. It also helps in minimising the movement of blood in the affected portion. Any excess of blood in the affected portion will increase the size of the scar tissue and hence the recovery time.

Icing – Icing also helps in reducing the blood flow to the affected portion. But too much icing may also result in inadequate scar tissue formation. Inadequate scar tissue will not allow the complete healing. basically there should be no icing after 1 hour of the injury. Very mild form of icing should be used. Instead of icing cold water may be used after 10 minutes.

Elevation – The basic idea behind elevation is also same. Reducing the blood flow to the affected portion. Not needed after 30 minutes of tear.

Compression – Is needed only when the tear is really big and the affected muscles can not hold themselves together or the person can not rest due to personal reasons of work etc. While sleeping after 1 day of tear there should be no need of compression. Too much compression will slow down the recovery drastically.