Sprains, Strains and Fractures: What’s What and Where to Go

Sprains, strains and fractures can occur at any time of year. Whether it is running in summer sports or slipping on ice in the winter, these injuries are never out of season. While these injuries can be painful and definitely slow us up for a bit, their care is not difficult and, when given the proper attention, there are usually no long-term effects.

What is the difference?

While these injuries most commonly involve our extremities, sprains, strains, and fractures can occur anywhere in the body where there are ligaments, muscles, tendons, or bones. Definitions of these injuries are specific to the portions injured:

  • Sprains involve a stretching and tearing of a ligament, such as those composing the ankle.
  • Strains involve a stretching and tearing of a tendon or a muscle, such as the thigh muscle.
  • Fractures involve the breaking of a bone, whether hairline, complete, or displaced.

How do I know if it is broken?

Unless you are Superman and have X-ray vision, you really don’t know if your arm is strained, sprained, or broken during the acute phase (unless it is pointed in a very awkward angle!). That is because the symptoms of all three injuries look exactly the same at onset:

  • Localized pain
  • Swelling
  • Bruising
  • Difficulty with movement

X-rays are the only definitive method to establish a working diagnosis. That being said, the diagnosis should not inhibit the rapid care for these injuries.

How is it treated?

During the first 48 hours, the treatment for each of these maladies is exactly the same, with the only exception being a displaced fracture. Strains, sprains, and fractures are all treated by the acronym we know as RICE. RICE stands for:

Rest—You cannot expect a sprained ankle to feel better if you continue to run on it. The injured part must be babied a bit to be given time to heal.

Ice—Cold contracts and will help slow down the flood of fluid to the area, which leads to the dramatic swelling in these injuries. Ice is the number one combatant to keep swelling to a minimum.

Compression is accomplished through devices like ace wraps and splints. By ‘putting the squeeze’ on the affected area, swelling is once again limited, lessening the impact of the injury and speeding the healing process.

Elevation—Gravity can be our friend or our enemy with these injuries, depending on how we treat it. Keeping the extremity higher than the level of the heart will once again slow down the influx of fluids, lessening swelling. If we allow the injured to dangle below the level of the heart for any length of time, it will blow up like a balloon, making the injury more painful and leading to a longer recovery time.

Seeking treatment for these injuries can be handled in almost any setting with the exception of displaced fractures. Displaced fractures are broken bones that are not only fractured, but markedly ‘out of line’. The limb will have an odd appearance or be off set at an unnatural angle. Those injuries must be treated emergently due to the potential of circulation issues.

Emergency Rooms and Urgent Care facilities who have the capability to sedate patients and reduce the fracture back into position are where the patient should head. In less suspicious cases, that is, injuries most likely to be sprains and strains, Urgent Care settings and your own personal physician are very appropriate avenues for treatment.

Click here to learn more about ProMedica’s Urgent Care and the type of care provided.

Diane Simon
Diane Simon, RN, CEN is the Trauma Coordinator/Registrar for ProMedica Defiance Regional Hospital.