A sprain is an injury to a ligament caused by overstretching or tearing the tough, elastic bands that connect bones and stabilize joints. Ligament damage can range from partial tears to complete ruptures, often resulting in pain, swelling, and bruising
Sprains
Sprains involve the over-extension of a joint, usually with partial rupture of the ligaments in the joint. There may also be blood vessel, nerve or tendon damage. Like a fracture, severe ligament damage may require subsequent immobilization in a plaster cast.
Signs and Symptoms of a Sprain
- Sudden pain in the joint
- Loss of power and ability to put weight through the joint
- Bruising
- Swelling
- Area becomes tender (painful to press on)
Types of Sprains
Sprains come in different types and can affect various parts of our body.
Classification by Severity:
Sprains can generally be categorised into three levels of severity:
- Mild (Grade 1): This type of sprain is caused by a slight stretching or tiny tears in the ligament. If you’ve twisted your leg and are experiencing mild pain and swelling, you might have a grade 1 sprain. Despite the discomfort, the joint typically remains stable and functional.
- Moderate (Grade 2): A grade 2 sprain indicates a partial tear in the ligament. The symptoms are more pronounced than in grade 1, with increased pain and swelling. You might also notice some instability in the joint, making it difficult to walk if it’s a leg sprain or grasp objects if it’s a wrist sprain.
- Severe (Grade 3): This is the most serious form of sprain involving a complete tear or rupture of the ligament. The joint becomes unstable and it can be extremely painful, often requiring medical intervention which could include surgery.
When to Seek Emergency Help
Seek professional medical care if any of the following apply:
- You cannot bear weight or use the joint (walking, gripping)
- The joint feels unstable or “gives out” when you try to move it
- Severe swelling, deformity, or loss of sensation occurs in the limb
- Signs of infection develop (red streaks, warmth, fever) at the injury site
First Aid Steps (R.I.C.E. Method)
- Rest
- Avoid using the injured joint for at least 48–72 hours.
- Use crutches, a sling, or buddy-taping for support as needed.
- Ice
- Apply a cold pack wrapped in a thin towel for 15–20 minutes.
- Repeat every 2–3 hours for the first 48 hours to limit swelling.
- Compression
- Wrap the area with an elastic bandage or use a supportive brace.
- Ensure it’s snug but not so tight that it causes numbness or tingling.
- Elevation
- Keep the injured limb raised above heart level whenever possible.
- Elevation aids fluid drainage and further reduces swelling.
After the initial 48 hours, gentle movement and range-of-motion exercises may be introduced to prevent stiffness.
Follow Up
- Continue RICE for 24 to 48 hours, or until the person sees a doctor.
- The doctor may want to do X-rays or an MRI to diagnose a severe sprain or strain or rule out a broken bone.
- The doctor may need to immobilize the limb or joint with a splint, cast, or other device until healing is complete. Physical therapy can often be helpful to bring an injured joint back to normal.
- In severe cases, surgery may be needed.
Do’s and Don’ts
| Do | Don’t |
|---|---|
| Follow R.I.C.E. promptly and consistently | Apply ice directly to skin or for more than 20 minutes |
| Use over-the-counter NSAIDs (ibuprofen, naproxen) for pain | Wrap bandages so tightly that circulation is cut off |
| Begin gentle joint motion as pain allows after 2–3 days | Return to full activity without restoring strength |
| Seek physical therapy for persistent weakness or instability | Ignore increasing pain or recurrent “giving way” of the joint |
Prevention & Rehabilitation
Restoring strength and stability is critical before resuming sports or strenuous activities. A physical therapist can prescribe:
- Proprioception exercises (balance drills)
- Strength training for surrounding muscles
- Functional drills mimicking sport-specific movements
Proper rehabilitation reduces the risk of reinjury and promotes full recovery
REFERENCES
- Sprains and strains. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/sports-injuries.
- Physical therapy guide to ankle sprain. American Physical Therapy Association. https://www.choosept.com/guide/physical-therapy-guide-ankle-sprain.
- WebMD Editorial Contributors, Sprains and Strains Treatment, September 19, 2024, https://www.webmd.com/first-aid/sprains-and-strains-treatment
- John Furst, Sprain First Aid, Updated February 6, 2023, https://www.firstaidforfree.com/first-aid-for-sprains-and-strains/
- Melanson, S. W., & Shuman, V. L. (2025). Acute ankle sprain. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459212/
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