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All You Need To Know About Second Degree Sprain Treatment

Portea Homecare

Portea Homecare

  Domlur, Bengaluru     Feb 16, 2017

   3 min     

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This write-up gives all the clarifications and detailed explanations about the most common and minor accidental injury.
Yes, addressing the elephant in the room – Sprain.
It is essential to be well-versed with the implications of sprain because a slight twist in the ankle can result in weeks and weeks of inactivity and disturbance in every avenue of your life.
Know the sprain to dial down the pain
Commonly, doctors and medical experts are frequently faced with the conundrum between sprain, strain, dislocation or fracture.
People can easily misconceive a strain with a sprain or vice-versa. If a fracture is confused with a sprain and no immediate medical attention is taken then it can result in serious consequences. Thus, for quick healing and proper treatment, it is of utmost importance to know the nature of the injury.
Know the similarities and differences
Here’s a guide to characterize that pain in the twisted ankle or the wrist which bent, unfortunately.
Whereas in both the scenarios, i.e., in sprain and strain there is stretching and tearing of tissues of an internal organ, the cardinal disparity lies with the body part in which it occurs.
• A sprain is an injury to the ligament. When a body part is sprained the ligaments of that area is either stretched or torn. Ligaments are fibrous tissues which interlink bones to the joints. Sprains are identified by minimal swelling, localized tenderness in that area but minimal functional disability. Sprains are frequently seen in ankles and wrists, primarily joints.
• When your foot or arm is strained due to the sudden stimulus of working out and accomplishing that New Year’s resolution, you injure either the muscles or tendons. Tendons are the linking tissues which chain the muscles to the bones. Tearing and stretching of muscles and tendons are called strains. Other terms for sprains are torn-muscle, muscle-pull and ruptured tendon. The common sites of strains are hamstrings (posterior area of thighs) and lower spine.
• Dislocations and fractures are graver than sprains and strains. In dislocations, the bones in the joints get dislocated and shift from their original place. Fractures involve cracking or breaking of bones. Evidently, the gravity of ache and discomfort is higher in fractures. It is recognized by a distorted look of the injured area, inability to move at all, swelling, etc.
Categories of Sprain
Sprains are classified into three categories depending on the graveness and severity of the injury.
• A first-degree sprain is a rip off of only a few fibers of the ligament. It is the mildest form of sprain involving stretching plus little tearing and pain and swelling. Mobility is not affected to a very grave extent. Basic medical intervention may resolve the possible complications.
• A second-degree sprain is a moderate level sprain. The intensity of the injury is higher than the previous degree certainly. In this degree, all the fibers are disrupted. The patient experiences pain, swelling and inability to move the limb. Joint movements are normal. The diagnosis can be made by performing a stress test (see the picture below)

                                                         

Close-up Of Person’s Hand Holding Ice Gel Pack On Ankle


• A third-degree sprain is a complete tear of the ligament. There is swelling and protrusion over the injured ligament. Contrary to the level of degree and severity of the injury the pain comparatively is lesser. Tissues are damaged, the joints are rendered unstable, mobility is extensively impacted, and the ligament is totally ruptured. This can be diagnosed by the stress test, MRI scan, arthrography, arthroscopy, etc.
The Moderate Level of Injury
The second degree of sprain is the moderate level which is the most common sprain. While the swelling, bruising and pain are common in all the three degrees, the intensities of all these elements vary. Therefore, the ligament damage is lesser than a third degree and more than first.
Second-degree sprain is characterized by extensive stretching and partial rupture of the ligaments and other tissues.

Signs and Symptoms of Second Degree Sprain
After tripping and twisting your ankle, it is very difficult to discover the nature of sprain, considering the chaotic and painful state of physical and mental being. However, there are certain indicators and symptoms which can aid in clarifying the nature of sprain.
• The pain will not be extremely severe. You may be able to bear the medium amount of ache.
• Movements or mobility will be affected. The patient will not be rendered completely immobile, but he or she will face difficulty while prancing normally. There could a short-term immobilization.
• There would be a slightly more inflammation with pain. The ankle joint may get prone to tenderness.
• Bruising will start to surface after few days of the injury.
• In grade 2 sprain, the patient might face obstructing pain while putting the body weight over the sprained ankle.
• The joints are not affected normally in this degree. They remain stable.

Diagnosis for the Grade 2 Sprain
A detailed history, eliciting the exact mechanism of the injury, often indicates the likely ligament injured.
The examination helps in finding the accurate location and severity of the sprain which later can be proved and confirmed by investigations.

The Clinical Examination for Second Degree Sprain
A localized swelling, tenderness and ecchymosis over a ligament indicate injury to that ligament. Usually, a hemarthrosis (bleeding between the joints) is noticed within two hours of the injury. It may be absent sometimes because following a complete tear of a ligament, the blood seeps out of the joint through the rent in the ligament. Thus, it seems that no haemarthrosis has taken place.

The Stress Test
This is a very useful test in diagnosing a sprain and judging the gravity of the injury. It reveals the abnormal looseness in the joints of the affected area.
The ligament in question is put to stress by a maneuver. When a ligament is pressurized, the pain will be invoked in a grade 2 sprain at the site of the tear.
This will help the doctor in attaining a clear sight of the sprain.

Important Investigations
A plain x-ray of the joint is usually preferred. Sometimes, a chip of the bone may be seen in the region of attachment of the ligament to the bone.
An X-ray taken while the ligament is being stressed (stress x-ray) may document an abnormal opening up of the joint. This occurs in third-degree sprain.
In moderate degree, the joints are not affected usually. It is determined by the intensity of pain.

Treatment for Grade 2 Sprain

                                                                                     

Primarily a second-degree sprain is treated by little mobilization or complete short term cessation of movements for at least four to six weeks. It is followed by steady and gradual mobilization.
It is strictly advised to resume complete weight bearing after three months of the injury.
Usage of functional rehabilitation crutches while walking is also advised.
For relief from the pain, the medications which are commonly prescribed are acetaminophen, ibuprofen or aspirin.
Application of ice packs and cold massage therapy are also a part of the treatment.
The foot is elevated to dial down and reduce the swelling and protrusion.

Is it an Emergency Ward injury?
The answer would depend on the amount of pain caused to the patient. If his movements are barred completely, then it is advisable to get yourself in the Emergency Room.
Many times due to neglect and delay, the condition may worsen. Thus, it is safe to get a doctor’s opinion.
Normally for sprains, people skip seeking medical attention due to its regular occurrence. But it could elevate the complications and delay your recovery period.
The Recovery Process
A second-degree sprain usually takes a couple of months maximum to heal completely.
The treatment involves short-term immobilization of the limbs. This is necessary because the tissues and ligaments which are sprained take time to repair again. Excessive movements like walking may delay this recovery phase. Thus, it is advised to stay put.
Regular physiotherapy and cold massage therapy are advised to reduce the swelling and pain.
Sprains are a regular occurrence in an athlete’s life. Thus for sports people, it is advised to return back to their turf after six weeks maximum.

Importance of Proper Treatment and Care
Stressing on the lax attitude of the masses when it comes to ankle sprains, this mentality needs to be tackled because studies have revealed that 70% of the people who suffer from ankle sprains face repetitive occurrence of sprains in the future as well.
In extreme cases, the condition may worsen up to Chronic Ankle Instability (CAI).
Researchers have proven that people who develop CAI are more prone to develop post-traumatic ankle osteoarthritis.
There are more than 50% of the population who do not seek medical attention for ankle sprains.

Tests after treatment to measure the progress
• Lateral hop test (see fig.)
• Single leg stance test
• Heel rocker test
• Ankle joint dorsiflexion
• Test for joint laxity
• Stair run test

                                                               

Now, call a physio home and get treated in the comfort of your home. Also, there are ample benefits of physiotherapy at home. To avail Portea’s in-home physiotherapy treatment or know more about the service, call 1800-121-2323 or visit www.portea.com.

REFERENCES AND IMAGE COURTESY:

  1. http://www.injurymassagetherapist.co.uk/Pages/sprainedankle.aspx
  2. https://www.researchgate.net/figure/274088846_fig9_Fig-8-A-H-Lateral-hop-test-Patient-first-stands-on-uninjured-leg-and-takes-3

 

Tags:  Sprain , Exercise, dislocation, fracture, Physiotherapy, ,

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