Sprains and strains
These are the most ordinary injuries there are: an ankle that rolls off a kerb, a hand that slips on a bar, a hamstring that goes on the very first sprint.
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Medicines commonly prescribed for Sprains and strains
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 600 mgActive substance: ibuprofenManufacturer: Industria Quimica Y Farmaceutica Vir S.A.Prescription requiredDosage form: TABLET, 400 mgActive substance: ibuprofenManufacturer: Farmalider S.A.Prescription not requiredDosage form: INJECTABLE PERFUSION, 600 mg/100 mlActive substance: ibuprofenManufacturer: B Braun Medical S.A.Prescription required
These are the most ordinary injuries there are: an ankle that rolls off a kerb, a hand that slips on a bar, a hamstring that goes on the very first sprint. The great majority heal at home, with no doctor and no imaging. But that simplicity holds two traps. The first is mistaking a fracture or a dislocation for a sprain and losing time. The second is the opposite — lying still because "a ligament is torn", and ending up with a stiff, weak joint instead of a healthy one. What follows is how to tell one from the other, and what to do day by day.
A sprained ligament and a strained muscle: which is which
Two different injuries hide behind everyday language, and it is worth telling them apart, because they heal differently.
- A sprain is damage to a ligament, the short tough band that holds bones together at a joint. The fibres tear partly; less often the ligament gives way completely. The classic examples are a rolled ankle, a jammed thumb, a knee twisted while turning, a wrist injured in a fall onto the hand.
- A strain is a tear in the fibres of a muscle itself, or of the tendon that anchors it to bone. Here the classics are different: hamstrings and calves in runners, groin muscles in footballers, the lower back when something heavy is snatched off the floor.
Joints are usually hurt by rolling and twisting; muscles by a sudden contraction while they are being stretched at the same time — a sprint start, a jump, an attempt to catch a falling weight.
What it feels like in both cases: pain that arrives at the very moment of the injury, swelling over the following hours, and bruising that may only appear on day two or three, often well below the injury itself because blood tracks downwards. Weight-bearing and movement hurt, and a muscle may answer with a painful spasm. Injuries range from a few torn fibres to a complete rupture; the difference between those is something a clinician judges, not the injured person.
This is not a dislocation, and the difference matters
In everyday speech a dislocation is lumped in with sprains and strains, but it is a different injury altogether: the surfaces of a joint have come apart and stayed out of place. It is not hard to recognise.
- The joint has changed shape: there is a step, a bulge, the limb points at an unnatural angle or looks shorter than the other one.
- Movement is virtually impossible, the joint feels locked, and any attempt to shift it causes sharp pain.
- There is often a distinct feeling that something popped out — and that feeling is accurate.
Never try to put a dislocation back yourself — not on your own, and not with the help of a coach or a friend "who knows how". Nerves and blood vessels run right beside the joint, and a rough attempt at reduction adds damage to them, or a fracture, on top of the dislocation. A displaced fracture also looks much the same, and the two cannot be told apart without an image.
What to do instead: support the limb in the position it is already in, without straightening anything, apply something cold, and get to an emergency department as quickly as you can. Avoid eating or drinking on the way, since sedation or an anaesthetic may be needed to put the joint back.
The first few days
The first two or three days decide how much swelling there will be, and therefore how hard it will be to get movement back afterwards. The order of business is simple.
- Rest and protection. Stop the activity; with a leg injury put as little weight through it as you can for a day or two; with a hand or finger use a support. This means unloading it, not immobilising it.
- Cold. An ice pack or a bag of frozen peas, always wrapped in a tea towel, for 15 to 20 minutes, every two or three hours through the first day or two. Ice never goes straight onto skin: that causes a cold burn.
- Compression. An elastic bandage from the toes or fingers upwards, firm but loose enough to slide a finger underneath. Take it off at night. If numbness, tingling, a blue tinge or more pain appears beyond the bandage, it is too tight — loosen it at once.
- Elevation. Keep the injured part above the level of your heart when sitting or lying: the leg on a pillow, the arm in a sling. This does most of its work in the first 48 hours.
Now the honest caveat, without which the list above does harm. Complete stillness does not heal anything; it gets in the way. An immobilised joint loses its range quickly, the muscle around it weakens within days, and healing tissue that is never loaded recovers less well. So rest is needed only for as long as it genuinely hurts — usually the first one to three days. As soon as movement stops being sharply painful, start moving gently: bend and straighten within a comfortable range, draw letters in the air with your foot, put as much weight through the leg as you can manage without limping. Getting moving early is not bravado, it is part of the treatment.
What not to do
The list is short, and every item on it gets broken regularly.
- Heat in the first day or two. A hot bath, a sauna, a heat pack, warming rubs and capsicum plasters widen the blood vessels and add to the swelling and bruising. Heat has its place later, once the swelling has gone down and stiff muscles need to relax.
- Alcohol. It does exactly the same thing to blood vessels, and it dulls the pain as well — so the injury gets loaded harder than it should be, without the person noticing.
- Massaging or rubbing the injured spot. In the first days this increases bleeding into the tissue and the swelling with it. Kneading a torn muscle "to work it out" is a poor idea; massage is useful later, and away from the fresh injury.
- Pushing through severe pain. Mild discomfort on movement is acceptable; sharp pain is not.
- Going back to sport before strength has returned. Re-injuring a spot that never fully healed is the single most common story in this whole field.
When you need a doctor and an X-ray
Some findings mean home treatment is the wrong answer, because a fracture, a full ligament rupture or damage to a nerve or artery sits behind them. Seek medical help the same day if:
- you cannot put any weight on the leg or bear weight through the arm — not at all, not even a few steps, not even straight after the injury;
- the joint or limb is deformed, looks crooked or shortened, or plainly out of place;
- there is numbness, tingling or loss of sensation below the injury, or the skin has gone pale, blue or cold to the touch;
- the swelling is building fast and comes with severe, bursting pain that neither cold nor painkillers settle and that gets worse when the toes or fingers are pulled;
- you heard or felt a crack, a snap or a pop at the moment of injury;
- a knee or another large joint swelled up within an hour of the injury, or gives way, or locks;
- the pain is directly over bone — for instance over the bony knob of the ankle when you press it with a finger;
- the pain is no better after several days, or a week on things are worse rather than better;
- the injured person is a child or teenager and the tenderness is close to a joint: in a growing bone the growth plate there gives way more easily than the ligament does;
- there is an open wound, or the skin over the injury turns red and hot and a temperature develops.
If the deformity is obvious, if the limb is numb and pale, or if the person cannot move, call an ambulance — across Europe the single emergency number is 112. Otherwise making your own way to an emergency department is enough. An X-ray is not always needed: the doctor will examine the injury and decide from specific findings whether imaging adds anything.
Taking the edge off the pain
In the early days the real work is done by cold, compression and elevation; medicines are there to support them.
Paracetamol is the usual starting point. Anti-inflammatory gels and creams rubbed into the skin over the injury work about as well as tablets for this kind of injury and are barely absorbed into the bloodstream, which makes them a sensible first choice here. Anti-inflammatory tablets are for when the pain stops you moving or sleeping; take them as a short course, bearing in mind the stomach, the kidneys and the heart. A doctor or pharmacist can help you pick one, particularly if you already take other medicines.
The point of pain relief here is not comfort but movement: it lets you start using the limb early. Abolishing the pain completely is not the aim — it is what tells you where the limit of safe loading is.
Getting back to full loading
Timescales vary a great deal and no honest date can be promised, but as a rough guide: a mild injury stops interfering with everyday life within one to two weeks, running and jumping come back later, from several weeks onwards, and recovery from a serious rupture takes months.
The order is much the same in every case: first get the full range of movement back without pain, then strength, then balance and speed, and only then sport. A good practical test: if you cannot walk without a limp, it is too early to run.
It is worth saying separately why the same ankle keeps rolling year after year. An injury damages not just the ligament but the sense of where the joint is in space — the thing that lets the foot react a fraction of a second before it turns over. That sense comes back with balance work: standing on one leg, first on the floor, then with your eyes shut, then on something unstable. A few minutes a day over a couple of months noticeably lowers the risk of doing it again, and it is the most useful thing you can do once the swelling has settled. If the injury was severe or keeps recurring, do this with a physiotherapist.
What happens before the injury helps too: warming up properly, skipping a session when you are genuinely exhausted, suitable footwear, and building loads up gradually rather than in jumps.
Online consultation
A remote appointment can settle more about an injury like this than people expect. The doctor will ask exactly how it happened, will ask you to show the area and to try a few simple movements on camera, and from that will say whether home treatment is enough or whether you need to go for imaging. That is precisely the question that has people either sitting half a day in an emergency waiting room for nothing or, the other way round, walking about for two weeks on a fracture. From there the doctor can put together a plan: how many days to protect it, when to start moving, what to take for pain given the other medicines you are on, when to try running again. A follow-up call then checks that recovery is on track. For anything in the emergency section above, an online appointment is not the right route — go straight to an emergency department.
This material is for information only and does not replace medical advice.
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