Joint Sprain: What is a Sprain?
Sprains and strains are common injuries that share similar signs and symptoms, but involve different parts of your body.
A sprain is an overstretching and/or tear of a ligament (fibrous band of connective tissue that joins bone to bone). Every joint in the body is stabilized and supported by a ligament or ligaments. They help control range of motion and enable us to complete simple tasks such as walking and running. The most common location for a sprain is in your ankle.
A strain is a stretching or tearing of muscle or tendon. A tendon is a fibrous cord of tissue that connects muscles to bones. Strains often occur in the lower back and in the hamstring muscle in the back of your thigh.
What are the signs of a sprain?
While the intensity varies, pain, bruising, swelling, limited ability to move the affected joint, and inflammation are common to all three categories of sprains: mild, moderate, and severe. You may feel a tearing or hear a ‘pop’ sound in the joint.
What causes sprains?
A sprain is caused by direct or indirect trauma (a fall, a blow to the body, etc.) that knocks a joint out of position, and overstretches, and, in severe cases, ruptures the supporting ligaments. This injury occurs when a person lands on an outstretched arm; slides into a base; jumps up and lands on the side of the foot; or runs on an uneven surface.
Physical therapy for sprains [of various types and degrees] will involve measures to reduce pain and inflammation, promote and encourage the physiological healing process, restoration of normal anatomic mobility and the restoration of optimum muscular strength for normal function, joint stability and prevention of recurrence.
The foot twists, rolls or turns beyond its normal motions. You can sprain your ankle if the foot is planted unevenly on a surface, or pushed beyond the normal force of stepping. Approximately 25,000 people each day suffer the pain of an ankle sprain. (source American Academy of Orthopaedic Surgeons) The foot/ankle complex is primarily comprised of ligaments holding the bones together. There are 7 ankle related sprains; high ankle, lateral, inversion, eversion, syndesmosis, anterior talofibular ligament, and anterior inferior tibiofibular ligament sprains! Sports related to high risk ankle sprains, are ones that require sudden, forceful and high velocity changes in direction, like football, soccer, basketball and baseball.
There are 4 major ligaments in the knee:
- Anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) bridge the inside of the knee joint, forming an “X” pattern that stabilizes the knee against front-to-back and back-to-front forces. A sudden stop; a twist, pivot or change in direction at the joint; extreme overstraightening (hyperextension); or a direct impact to the outside of the knee or lower leg. Knee sprain injuries are seen among athletes in football, basketball, soccer, rugby, wrestling, gymnastics and skiing. ACL injuries can be severe, requiring physical therapy and/or surgery for adequate correction.
- Medial collateral ligament (MCL) supports the knee along the inner side of the leg. Like the ACL, the MCL can be torn by a direct sideways blow to the outside of the knee or lower leg, the kind of blow that can happen in football, soccer, hockey and rugby. The MCL can be injured by a severe knee twist during skiing or wrestling, particularly when a fall twists the lower leg outwards, away from the upper leg.
- Lateral collateral ligament (LCL) supports the outer side of the knee. It is the least likely knee ligament to be sprained because most LCL injuries are caused by a blow to the inside of the knee, and that area usually is shielded by the opposite leg. More than any other group, competitive athletes have a very high risk of knee sprains and other types of knee problems.
Two of the four ligaments that connect the thighbone (femur) to the shinbone (tibia) are the posterior cruciate ligament (PCL) and the anterior cruciate ligament (ACL). The PCL and ACL cross one another in the middle of the knee as they join these leg bones together.
A hyperextended knee occurs when the knee is bent backward, often as a result of landing wrong after a jump. A hyperextended knee can damage ligaments, cartilage and other stabilizing structures in the knee.
Young children have softer bones because they’re still growing, so a hyperextended knee can result in a chip of bone being pulled away from the main bone when the ligaments stretch too far. In older children and adults, forceful hyperextension may tear one of the knee ligaments, particularly the anterior cruciate ligament (ACL).
A knee injury severe enough to cause swelling, pain or instability should be evaluated by a doctor immediately. Even if the injury doesn’t need surgical repair, physical therapy may be needed to help reduce pain and swelling, promote healing and restore leg strength and stability.
Wrist sprain can result from a fall onto an outstretched hand; the force impact bends the wrist back toward your forearm, overstretching the ligaments that connect the wrist and hand bones. Wrist sprains are common with basketball, baseball, gymnasts, divers, skiers (especially when they fall while still holding a pole), skaters, skateboarders, and inline skaters.
Injury to three joints of the fingers; ‘jamming’ the finger into an opponent or being hit on the tip of the finger by a ball, or bending the finger backward (hyperextended). Often overlooked as ‘just a finger’, finger injuries can be very painful and lead to chronic ailments (trigger finger) and dysfunction if not treated correctly.
Similar to a finger sprain, stubbing your toe into something, stopping suddenly when running or landing awkwardly from a jump, thus ‘jamming’ your toe into your shoe. These occur commonly in sports such as football, soccer, rugby, basketball and running.
Shoulder Sprain; Dislocation, ect.
A shoulder sprain is a tear of shoulder ligaments, the tough bands of fibrous tissue that connect bones to one another inside or around the shoulder joint. Although most people think of the shoulder as a single joint between the upper arm bone (humerus) and the torso, the shoulder [often referred to as the shoulder girdle complex] actually has several smaller joints outside the arm bone’s socket. Ligaments connect the four bones that are important to the shoulder’s function. These bones include:
- The triangular shoulder blade, called the scapula
- The bony knob at the top of the scapula, called the acromion
- The collarbone, called the clavicle
- The breastbone, called the sternum
A sprain that tears ligaments in the shoulder most often occurs at the joint between the acromion and collarbone, called the acromioclavicular joint. This injury sometimes is called a shoulder separation. Less often, a shoulder sprain involves the joint between the breastbone and collarbone, called the sternoclavicular joint. This joint is within an inch of the midline of the chest. Many people would not guess that it’s part of the shoulder.
Acromioclavicular Joint Sprain
The acromioclavicular joint is supported by the acromioclavicular ligament and the coracoclavicular ligament at the outside end of the collarbone near the shoulder. They bind the shoulder blade and collarbone tightly together. It takes a lot of force to tear these ligaments. The most common causes of this type of shoulder sprain are either a strong, direct blow to the front or top part of the shoulder or trauma from a fall, especially during athletic training or competition. A shoulder sprain also can be caused when a person collides with an object, such as a goal post or a tree (when skiing). Shoulder sprains are common among athletes who participate in high-velocity or contact sports such as alpine skiing, jet skiing, football, rugby and wrestling.
Depending on the severity of the ligament damage, acromioclavicular sprains usually are classified into three grades:
- Grade I – The acromioclavicular ligament is partially torn but its companion ligament, the coracoclavicular, is uninjured, so the acromioclavicular joint remains tightly joined.
- Grade II – The acromioclavicular ligament is completely torn and the coracoclavicular ligament is partially torn. In this case, the collarbone typically angles slightly out of place.
- Grade III – Both the acromioclavicular ligament and the coracoclavicular ligament are completely torn, and the collarbone separation is obvious.
Some doctors classify the most severe acromioclavicular injuries into even higher grades or types, from IV to VI. With each higher grade, the collarbone is more displaced away from its normal position and the shoulder is more severely deformed.
Sternoclavicular Joint Sprain
The sternoclavicular joint is located where the inner end of the collarbone meets the breastbone. Because the sternoclavicular joint is even more tightly connected than the acromioclavicular joint, sternoclavicular injuries occur very rarely, only about one-fourth as often as acromioclavicular injuries. When the sternocavicular joint is sprained, it is often when a driver’s chest strikes the steering wheel during an auto accident, or when a person is crushed by an object. In athletes, sternoclavicular sprains sometimes are seen among football players and rugby players after a direct kick to the breastbone or some sideways tackles that impacts the back or side of the shoulder.
Sternoclavicular sprains are graded from I to III:
- Grade I – The tears in the joint ligaments are mild and microscopic. The sternoclavicular joint remains tightly connected.
- Grade II – Ligaments between the collarbone and breastbone are visibly torn, but ligaments between the collarbone and ribs remain intact, so the joint is slightly deformed, but retains some connection.
- Grade III – All ligaments sustain severe damage, so the sternoclavicular joint is separated or deformed, and the collarbone is clearly displaced from its normal position.
Back or Sacroiliac Sprain
Sacroiliitis (say-kroe-il-e-I-tis) is an inflammation of one or both of your sacroiliac joints – the places where your lower spine and pelvis connect. Sacroiliitis can cause pain in your buttocks or lower back, and may even extend down one or both legs. The pain associated with sacroiliitis is often aggravated by prolonged standing or by stair climbing.
Sacroiliitis can be difficult to diagnose, because it may be mistaken for other causes of low back pain. It’s been linked to a group of diseases that cause inflammatory arthritis of the spine. Treatment of sacroiliitis may involve a combination of rest, physical therapy and medications.
The sacroiliac joints link your pelvis and lower spine. They’re made up of the sacrum – the bony structure above your tailbone and below your lower vertebrae – and the top part (ilium) of your pelvis. There are sacroiliac joints in both the right and left sides of your lower back. Strong ligaments hold these joints in place. The sacroiliac joints support the weight of your upper body when you stand.