The
body moves because of the action of muscles on the skeleton.
The bones of the skeleton are held together, at the joints,
by ligaments. Injury to the ligaments (sprain) and muscles (strain)
are very common, particularly as sporting injuries. Each joint
has a normal range of movement for which the ligaments allow.
If the joint is extended beyond its normal range of movement
the ligaments become stretched, sometimes torn, and with a more
severe injury, ruptured. In a simple sprain there is usually
stretching and, perhaps, some tearing. Sprains are particularly
common around the knees, ankles, wrists and fingers. There is
pain, tenderness, often swelling, and, sometimes, bruising.
In severe sprains of the ankle, for example, it is impossible,
on examination, to say whether there is a fracture of a bone
and X-rays will be necessary. Ligament injuries tend to take
a long time to get better and recurrent ligament injuries can
seriously reduce the stability of a joint. It is common, for
example, for people with a sprained ankle to "go over" on it during the recovery period. Muscles work by contracting, shortening, and pulling on a bone like a lever. They have capacity to do a certain amount of work. If the demand on the muscle is too much - lifting a very heavy weight, for example - then the muscle works beyond capacity and is damaged, muscle fibres are torn and there is, sometimes, bleeding into the muscle. The muscle is strained, or "pulled". The muscle will hurt, there is localised tenderness, sometimes there is swelling and bruising. Complete rupture of a muscle can happen, but is uncommon. Muscle strains are common in the arms, legs and back and tend to get better quite quickly, usually much quicker than injuries to ligaments.
Once injured, the part should be rested immediately. Although function is still preserved (unlike with most fractures of bones) continued use will be painful and make the situation worse. Local application of an ice pack helps reduce swelling - a convenient ice pack is a packet of frozen peas in a damp cloth. The injured joint or muscle should be supported by sling, bandages etc. Bandages should not be too tight as further swelling might make them tighter still and cut off the blood supply to the injured part. It is usually advised that the injured part be elevated to reduce swelling. Pain killers are often necessary and the NSAIDS ( non-steroidal anti-inflammatory drugs) are often useful in this context. Local applications of NSAID gel, or rubifacients (linaments, sprays, creams available at the pharmacy) may relieve pain.. The injury, unless slight, should be seen by a doctor, in case there is a fracture present. Physiotherapy, ultrasound etc. might all be helpful. In some cases of ruptured ligaments, surgical repair may be necessary. Sports medicine has now become a popular speciality and sporting injury clinics, which particularly deal with the kinds of problems above, are found in most centres of population. |
