Spring 2003
Ask the Nurse: Sprain Pain

I hurt my ankle playing basketball. I don't know if it's a sprain or a strain, but what's the best way to treat it, and how can I tell if I should see a doctor?

Michael Pineau, RN, MS, Trauma Program Manager in Bridgeport Hospital's Level-I Trauma Center, responds:

Michael Pineau, RN, MS

Sprains and strains may feel pretty much the same—painful! But there is a difference.

If it's a strain, you've injured a muscle or a tendon—the tissue that connects muscles to bones. You may feel pain accompanied by muscle spasms or weakness, and swelling. If it's a sprain, you've stretched, torn, or separated a ligament—the tissue that connects bones to bones. You may experience pain—ranging from mild to excruciating, depending on the severity of the injury. There will also be bruising, swelling, and stiffness. And you might feel a tear or a pop in the joint at the moment of injury.

For minor sprains and strains, the classic treatment is the same, and it involves RICE:

Rest. Immediately stop doing whatever it was that caused the injury, and don't use the injured limb for 24 hours, or longer if necessary.

Ice. Apply an ice bag to the injured joint for 20 minutes several times a day.

Compression. Wrap the joint in an ace bandage to keep the swelling down.

Elevation. Keep the joint at heart level as much as possible.

Sprains and strains may sound like mild injuries, but they can be severe and can cause lasting damage. You should use your best judgement. If you're at all concerned about the amount of pain and swelling, see a physician immediately—and I urge you to err on the side of caution. Your physician may take x-rays to determine if the ankle is broken, or may order other tests or scans to determine the extent of the damage. Treatments may include anti-inflammatory medications, and/or physical therapy, or even surgery.

To prevent sports injuries, warm up before any sports activity. Do stretching exercises every day. Wear the right kind of shoes for your event, and replace them as soon as the tread or heel wears out. And know your limits—don't over-exert yourself.

Just play carefully and have a good time!