Overview

A sprain is a stretching or tearing of ligaments — the tough bands of fibrous tissue that connect two bones together in your joints. The most common location for a sprain is in your ankle.

Initial treatment includes rest, ice, compression and elevation. Mild sprains can be successfully treated at home. Severe sprains sometimes require surgery to repair torn ligaments.

The difference between a sprain and a strain is that a sprain injures the bands of tissue that connect two bones together, while a strain involves an injury to a muscle or to the band of tissue that attaches a muscle to a bone.

Video: Ankle sprain

Most ankle sprains involve injuries to the three ligaments on the outside of your ankle. Ligaments are tough bands of tissue that stabilize joints and help prevent excessive movement. An ankle sprain occurs when you roll, twist or turn your ankle in an awkward way. This can stretch or tear the ligaments that help hold your ankle bones together.

Symptoms

Signs and symptoms will vary, depending on the severity of the injury, and may include:

  • Pain
  • Swelling
  • Bruising
  • Limited ability to move the affected joint
  • Hearing or feeling a "pop" in your joint at the time of injury

When to see the doctor

Mild sprains can be treated at home. But the injuries that cause sprains can also cause serious injuries, such as fractures. You should see a doctor if you:

  • Can't move or bear weight on the affected joint
  • Have pain directly over the bones of an injured joint
  • Have numbness in any part of the injured area

Causes

A sprain occurs when you overextend or tear a ligament while severely stressing a joint. Sprains often occur in the following circumstances:

  • Ankle — Walking or exercising on an uneven surface, landing awkwardly from a jump
  • Knee — Pivoting during an athletic activity
  • Wrist — Landing on an outstretched hand during a fall
  • Thumb — Skiing injury or overextension when playing racquet sports, such as tennis

Children have areas of softer tissue, called growth plates, near the ends of their bones. The ligaments around a joint are often stronger than these growth plates, so children are more likely to experience a fracture than a sprain.

Risk factors

Factors contributing to sprains include:

  • Environmental conditions. Slippery or uneven surfaces can make you more prone to injury.
  • Fatigue. Tired muscles are less likely to provide good support for your joints. When you're tired, you're also more likely to succumb to forces that could stress a joint.
  • Poor equipment. Ill-fitting or poorly maintained footwear or other sporting equipment can contribute to your risk of a sprain.

Prevention

Regular stretching and strengthening exercises for your sport, fitness or work activity, as part of an overall physical conditioning program, can help to minimize your risk of sprains. Try to be in shape to play your sport; don't play your sport to get in shape. If you have a physically demanding occupation, regular conditioning can help prevent injuries.

You can protect your joints in the long term by working to strengthen and condition the muscles around the joint that has been injured. The best brace you can give yourself is your own "muscle brace." Ask your doctor about appropriate conditioning and stability exercises. Also, use footwear that offers support and protection.

Dec. 22, 2018
References
  1. Sprains and strains. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/sprains-and-strains/advanced. Accessed April 27, 2018.
  2. Walls RM, et al., eds. General principles of orthopedic injuries. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed April 27, 2018.
  3. Safran MR, et al. Sprain. In: Instructions for Sports Medicine Patients. 2nd ed. Philadelphia, Pa.: Elsevier Saunders; 2012. https://www.clinicalkey.com. Accessed April 27, 2018.
  4. Sprains, strains and other soft-tissue injuries. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/sprains-strains-and-other-soft-tissue-injuries. Accessed April 27, 2018.
  5. AskMayoExpert. Ankle sprain. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
  6. Maughan KL. Ankle sprain. https://www.uptodate.com/contents/search. Accessed April 30, 2018.