![]() ![]() The bandage is too tight if numbness is felt below the area of compression or there is additional pain or swelling beyond the edge of the bandage. To prevent edema and encourage fluid return, wrap the bandage starting distally (at the point farthest from the midline of the body) and progress proximally (toward the midline of the body). Ice applications should not exceed 20 to 30 minutes per application, and ice should not be applied directly to the skin.Īn elastic compression bandage can be wrapped around the injured part. Cold is most useful when applied immediately after the injury has occurred. ![]() In addition to pain relief, these changes reduce muscle spasms, inflammation, and edema. The cold induces physiologic changes in soft tissue, including vasoconstriction and a reduction in the transmission and perception of nerve pain impulses. Unless the injury is severe, prolonged rest is usually not indicated.Ĭold (cryotherapy) in several forms can be used to produce hypothermia in the involved part. Movement should be restricted and the extremity rested as soon as pain is felt. RICE ( Rest, Ice, Compression, Elevation) may decrease local inflammation and pain for most musculoskeletal injuries. Severe strains may require surgical repair of the muscle, tendon, or surrounding fascia. At the time of injury, hemarthrosis (bleeding into a joint space or cavity) or disruption of the synovial lining may occur. Alternatively, the joint structure may become unstable and result in subluxation or dislocation. A severe sprain can result in a concomitant avulsion fracture, in which the ligament pulls loose a fragment of bone. X-rays of the affected part may be taken to rule out a fracture. Mild sprains and strains are usually self-limiting, with full function returning within 3 to 6 weeks. Edema develops in the injured area because of the local inflammatory response. Pain aggravated by continued use is common. The clinical manifestations of sprains and strains are similar and include pain, edema, decreased function, and contusion. Strains may also be classified as first degree (mild or slightly pulled muscle), second degree (moderate or moderately torn muscle), and third degree (severely torn or ruptured muscle). Most strains occur in the large muscle groups, including the lower back, calf, and hamstrings. Because areas around joints are rich in nerve endings, the injury can be extremely painful.Ī strain is an excessive stretching of a muscle, its fascial sheath, or a tendon. A gap in the muscle may be apparent or palpated through the skin if the muscle is torn. A third-degree (severe) sprain is complete tearing of the ligament in association with moderate to severe swelling. A second-degree (moderate) sprain is partial disruption of the involved tissue with more swelling and tenderness. A first-degree (mild) sprain involves tears in only a few fibers, resulting in mild tenderness and minimal swelling. 3 A sprain is classified according to the degree of ligament damage. Most sprains occur in the ankle, wrist, and knee joints. These injuries tend to occur around joints and in the spinal musculature.Ī sprain is an injury to the ligamentous structures surrounding a joint, usually caused by a wrenching or twisting motion. Sprains and strains are common injuries from abnormal stretching or twisting forces that may occur during vigorous activities. If knee instability or continued injuries, reconstructive surgery may be done. Physical therapy with rehabilitation, knee brace. Traumatic tearing of ligament by deceleration forces together with pivoting or odd positions of the knee or leg. If symptoms persist, MRI to diagnose meniscus injury and possible arthroscopic surgery. ![]() Rest, ice, elevation of extremity if possible, NSAIDs. Injury to fibrocartilage of knee characterized by popping, clicking, tearing sensation, effusion, and/or swelling. If symptoms persist, surgical repair may be necessary. Protection of affected extremity by use of brace. Usually occurs as a result of inversion, eversion, shearing, or torque applied to a joint.Ĭharacterized by sudden pain, swelling, and instability. Protective brace (orthosis) may be necessary if symptoms recur. Inflammation of tendon as a result of overuse or incorrect use. If pain persists, x-ray to rule out stress fracture of tibia. Inflammation along anterior aspect of calf from periostitis caused by improper shoes, overuse, or running on hard pavement. If minor tear: Rest, NSAIDs, and gradual mobilization with ROM and strengthening exercises. Tear within muscle or tendinoligamentous structures around shoulder. ![]() Rest until symptoms decrease and then gradual ROM and strengthening exercises. Entrapment of soft tissue structures under coracoacromial arch of shoulder. ![]()
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