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Focus on Sprains PART 1: What is a sprain and how does it heal?

By West Norwood Therapies Team, Mar 8 2017 09:00AM

Our sports massage therapist, Jenny Greig, looks at sprains and explores the healing process and how you can help yourself recover


It is common for people to suffer from minor injuries during sports, exercise and daily life, such as a twisted ankle. Sprains are a common injury that most people will have experienced. While these injuries are usually not serious, it is useful to understand the healing process in order to be able to optimise your recovery and prevent the injury from becoming worse. There are plenty of easy things that you can do to recover from a small injury such as a sprain.


A sprain is when a ligament is damaged by stretching, twisting or tearing. Ligaments are bundles of connective tissue that contain collagen fibres and cells known as fibroblasts, and they connect bone to bone to make a joint. For example the ACL (anterior cruciate ligament) in the knee which is commonly injured by twisting during sports such as football, or a twisted ankle can be a common injury when walking or running.

ACL SPRAIN:


TWISTED ANKLE:




You will know when you have a sprain as it is often very painful! The symptoms are swelling around the joint, pain, being unable to put much weight on the joint and unable to move it very well. You may also have a lot of bruising but this can take a day or two to show.


Clearly, it is important to get an x-ray if you suspect it might be broken! If the pain is severe, you can’t put any weight on it, or there are any unusual lumps, it is important to go to a minor injuries unit to get it checked. Also, if you don’t see any improvement over a few days (if the swelling does not reduce) it is important to see a doctor to rule out a fracture.


The biological processes of healing

The acute phase of injury is approximately the first 1-3 days following the injury. This is when you have a lot of pain and inflammation.


The sub-acute phase follows this, from around day 3-21. The debris from damaged cells are removed from the injury site and new collagen fibres are laid down to rebuild the damage to the ligament. These collagen fibres are soft when they are new and are vulnerable to further damage, so it is important to avoid further injury during this time.


The next phase is the remodelling phase, from day 21 up to a year, although often the injury can be healed after approximately 6 weeks. During this phase, the new collagen hardens to become stronger, and the fibres become aligned so that the ligament can regain its optimal function. When the new collagen is first laid down on the injury site, it can be disordered like scar tissue, and in the remodelling phase this is improved so the ligament is once again smooth and the fibres are in alignment.


Understanding how the ligament heals after an injury is useful in choosing the best way to treat this type of injury yourself and getting back to sport and daily life as quickly as possible, without any long-term damage or further injury. For example, gentle stretching can help to improve the range of movement of the damaged joint, and can encourage the alignment of the new collagen fibres. However it is important not to stretch these fibres too much in order not to risk increased inflammation and further injury,


Part 2 (next month’s newsletter) will discuss what you can do to help a sprain to heal, how to treat it yourself.



References

http://www.nhs.uk/Conditions/Sprains/Pages/Introduction.aspx

http://www.nhs.uk/Conditions/Sprains/Pages/Treatment.aspx

http://www.orthobullets.com/basic-science/9016/ligaments

http://www.sportsinjuryclinic.net/sport-injuries/knee-pain/acl-injury

http://physioworks.com.au/treatments-1/what-are-the-phases-of-a-soft-tissue-injury


http://www.physio-pedia.com/Soft_Tissue_Healing

http://kingsleyphysio.com/wp-content/uploads/2014/06/as1.png (image)

http://medical-helpful-info.blogspot.co.uk/2014/12/sprained-knee-injury-of-anterior.html (image)





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