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Friday, April 2, 2010

First Aid for Sprains and Strains

Sometimes in rodeo injuries happen. We hate to see an injury to any kid but especially to our own.  Today’s article is how to make them go away as fast as possible.

Sometimes what we do for them often makes them worse. That’s particularly true of sprains and strains. The problem is everyone thinks they already know what to do.

How often have you received a ton of advice on how to treat it?  Like you should put heat on it or you should ice it or hold it above your head.  Almost everyone has the idea.  But the details are important.

Sprain vs. Strain: Do You Know the Difference?

What’s the difference between a sprain and a strain?

A sprain is a ligament injury. Ligaments are the tough, fibrous tissues that connect bone to bone. They literally hold your joints together. When they are damaged, we call that a sprain.

In contrast, a strain is an injury to a muscle or tendon. You already know what muscles are. Tendons are the tough, fibrous tissues that connect muscle to bone. When either a muscle or a tendon is damaged, that is a strain.

There are three different classifications for sprains and strains:
·         Grade 1. This kind of injury happens when the fiber (ligament, muscle, or tendon) is stretched a bit beyond its normal limits and sustains some minor damage.
·         Grade 2. This kind of sprain involves a partial tear of the fiber.
·         Grade 3. This kind of sprain involves a complete rupture or tear of the fiber. Severe damage may require surgical repair.

All sprains and strains recover best when treated immediately.  You also need to be able to distinguish between those you can treat yourself and those that will need medical attention.

Signs and Symptoms

The signs and symptoms of sprains and strains overlap significantly.

Common signs of a sprain include swelling, bruising, and decreased joint mobility. If the ligament ruptures, you may actually hear a “popping” sound. Symptoms of a sprain include pain and difficulty using the affected extremity.

The signs of a strain are very similar. They include discoloration and bruising. Generally strains are accompanied by less swelling than sprains, but that obviously depends more on the severity of the injury than on the type. Symptoms include local pain and stiffness.

If you suspect that you have suffered a sprain or a strain and you are experiencing severe pain or functional impairment, you should probably consult a doctor.  If, on the other hand, your injury is not severe, you can treat it yourself by remembering the following simple mnemonic.

The RICE Method

RICE stands for Rest, Ice, Compression, and Elevation. It is the best form of treatment for most sprains and strains. Though it may sound like common sense, you need to make sure that you are doing each step correctly.  That will ensure your child is healed quickly and ready to go to the next rodeo.

1. Rest
The biggest mistake that most people make with sprains or strains is to try to “walk them off.” That’s fine for cramps. For sprains and strains, however, additional force usually means additional injury. Buts lots of us continue hobbling through our activities and then apply ice only much later that night, if at all.

Then it is too late. The first 24-48 hours after an injury are when ice, compression, and elevation will make the most difference. If you don’t start resting immediately, not only do you run the risk of hurting yourself even more.

The other mistake that people make is resting too much or too long after an injury. Prolonged immobilization causes joints to stiffen up and muscles to waste away. That means you can’t “baby” an injury, either.

Instead, you should rest only until you are pain-free -- within one to three days for most injuries. Then try to ease back into your normal routine. Listen to your body. Stop if it hurts, but do as much as you can handle. Strength and flexibility fall into the use-it-or-lose-it category. Appropriate rest will speed your recovery.

 2. Ice
As funny as it may sound, most people also ice incorrectly. You should ice immediately after an injury to minimize swelling and ease pain. Swelling is the real problem. Ice keeps swelling down because cold constricts blood vessels, which slows the arrival of inflammatory molecules. It also numbs the nerves at the site of injury to reduce pain.

Don’t wait. Ice right away.

You should never apply ice directly to the skin for an extended period of time. There are two better options. You can place a thin layer like a towel between the ice and your skin. Or you can perform an “ice massage.” To do that, just move the ice over the injured area as if you were rubbing it. Either way, don’t leave the ice in place without a barrier.

You also shouldn’t ice for more than 15-20 minutes at a time. Though your injury may still hurt at the end of that time, further icing won’t do any good. In fact, it may hurt.  Instead, wait an hour or so. Then check the area again. If it feels warm to the touch, you can ice it for another 15-20 minutes. You can then repeat that process as many times as you like.

The ideal ice pack is a Ziploc bag filled about three-quarters full with ice and a little bit of water. The water helps the ice pack conform to your body. You can also use packages of frozen vegetables.

For those who prefer hot to cold, heating does have its place. It is a great way to loosen up stiff muscles and joints. It relaxes tissues and stimulates blood flow. You can use heat before exercising (also for 15-20 minutes at a time), but you should never heat after an injury, as it will exacerbate swelling. (You should also never heat while you sleep.) A simple rule of thumb is to heat before, ice after.

3. Compression
The mistake that most people make with compression is one of omission. Compression helps to immobilize an injury and provide support. When combined with ice, it also helps to minimize swelling and pain.

To compress an injury, wrap an Ace bandage around the site. Try to overlap about half the width of the bandage on each pass until you completely cover the injury. You want it to be snug, but make sure that you don’t cut off circulation. If you start to get cold, blue, tingly, or numb, it’s too tight. Undo the bandage and rewrap it a bit looser.

You should use compression bandages at least as long as you are icing the injury. (You don’t have to take it off every 15-20 minutes, though.) Even after you stop icing, you can continue to use compression for support. Just don’t let the bandage keep you inactive for too long. Remember to rest only as long as you need to.

4. Elevation
Finally, elevate the site of your injury above the level of your heart. Just like cold compression, elevation works to decrease swelling. Elevation also prevents fluid from pooling. Keep the injury elevated at least as long as you are icing it.

The RICE method is the most effective possible treatment for most sprains and strains. As you can see, all four steps work in concert to treat sprains and strains.

Injuries happen, even to professional athletes and often at the most unfortunate times. If your child suffers from a sprain or strain, just remember to rest, ice, compress, and elevate.

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