Sprain

Disease Description (Causes and Symptoms)

• Definition: A sprain is a condition in which a ligament supporting a joint is stretched or partially or completely torn due to trauma. It is commonly described as “twisting” or “spraining” a joint.
• Causes: Occurs when a joint suddenly rotates beyond its normal range or is subjected to impact due to sports, falls, slipping, traffic accidents, and other causes.
• Pathophysiology: When ligament fibers are overstretched, the injury may progress from microtears (mild) → partial tears (moderate) → complete tears (severe). Depending on the extent of ligament damage, joint instability and functional impairment may occur.
• Main symptoms: Pain immediately after the injury, tenderness, swelling, bruising (bleeding), reduced joint mobility, pain with weight-bearing or use, and, in severe cases, a sensation of the joint slipping out of place (instability) or deformity.

Treatment Methods and Precautions

• Initial treatment (acute phase)
  • RICE principle: Rest, Ice (cold compresses, at 20-minute intervals), Compression (compression bandage), Elevation (raising the injured area above the heart). Recommended for the initial 48–72 hours.
  • Pain control: Use acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) (consult a doctor).
  • Bracing/immobilization: Temporary stabilization with crutches, a splint, compression bandage, brace, or similar devices.
• Imaging and diagnosis
  • If a fracture or dislocation is suspected, an X-ray is performed (to rule out a fracture). Ultrasound or MRI is recommended to assess the extent of ligament damage (especially in severe cases or cases of chronic instability).
  • Clinical examinations (tenderness location, range of joint motion, and joint instability tests) are also performed.
• Rehabilitation and recovery (subacute/recovery phase)
  • Once pain and swelling improve, begin warm compresses, joint mobility exercises, and muscle strengthening (especially the muscles around the joint and balance training).
  • Physical therapy (electrotherapy, strength and balance training, etc.) is recommended.
  • Resume activities gradually, taking into consideration the presence or absence of pain, joint stability, and the level of strength recovery.
• Surgical treatment
  • If there is a grade 3 (complete) tear or persistent joint instability despite failed conservative treatment, ligament repair or reconstruction (using an autograft or allograft) may be considered. Rehabilitation is required after surgery.
• Precautions and self-management
  • Returning to activities too excessively or too early increases the risk of reinjury.
  • Long-term joint instability or recurrent sprains increase the risk of chronic pain and osteoarthritis.
  • If you are taking anticoagulants or have a bleeding disorder, bleeding and bruising may be more severe, so inform your medical team.

Checklist Before an Outpatient Visit (Including Preparation Items and Example Questions)

• Items and records to prepare
  • Record the time the injury occurred and the circumstances at the time of injury (mechanism: whether the foot twisted, the direction of impact, etc.)
  • Location and intensity of pain (pain scale 0–10), and whether weight-bearing is possible (whether you can walk)
  • If imaging has already been performed (photographs, X-ray, ultrasound, or MRI), bring the originals or a CD
  • List of medications currently being taken (including anticoagulants) and allergy history
  • History of previous injury to the same area and treatment and rehabilitation history
• Photos/videos to show the doctor during the outpatient visit
  • Take photos if there is swelling or redness
  • Walking pattern or movements during weight-bearing (if possible)
• Useful checks during the visit
  • Fever or signs suggestive of infection (whether the wound is open or contains pus)
  • Presence or absence of neurological symptoms (numbness or tingling) or vascular abnormalities (pale or cold skin, weak pulse)

Examples of General Questions to Ask the Doctor

• What tests are needed for this injury? (X-ray, ultrasound, MRI, etc.)
• Which medications do you recommend for relieving the current pain, and what are their side effects?
• How long should I use a brace (protective support, bandage, or crutches), and how should I use it?
• When should rehabilitation begin, and what program do you recommend?
• When can I return to daily activities or exercise? (Please provide criteria and step-by-step guidance.)
• In what situations is surgery necessary? What is the prognosis if surgery is not performed?

Examples of Condition-Specific Questions

• What grade (1/2/3) is this sprain classified as, and based on the current tests, which grade does it appear to be? (Please tell me whether it is a partial or complete tear.)
• If the ligament is completely torn, is recovery possible with conservative treatment, or would you recommend early surgical reconstruction?