How to get a sprain. Types of stretching. How is the differential diagnosis of sprain of the ligament apparatus

If as a result of an injury ligamentous apparatus joint, a complete or partial rupture of the ligaments has occurred, then this condition will be qualified by doctors as a sprain. Human ligaments are accumulations of dense connective tissue that allow you to keep the joint in a normal position. One sudden movement can lead to injury - the ligaments will stretch more than their natural elasticity allows. Most often, ankle and elbow joints are injured in this way, but sprains can also be diagnosed in the knee joint.

The main symptoms of a sprain

The first and main symptom of the condition under consideration is sharp pain at the site of damage to the ligaments - this is due to the fact that the ligamentous apparatus includes many nerve fibers and blood vessels. But there are other symptoms of sprains that will manifest themselves to one degree or another with different stages the state in question.

1 degree sprain

If applied minor injury on the ligamentous apparatus, then the pain sensations will be mild, the human motor activity is not limited, and the swelling at the site of injury, if any, is not intense.

2 degree sprain

At this degree, moderate stretching and rupture of the fibers of the ligamentous apparatus occurs. Symptoms in this case will be as follows:

• sharp pain that limits movement;
• swelling quickly increases at the site of injury;
• spilled bruises appear at the site of injury.

Note:with 2 degrees of sprain, pathological joint mobility can also be observed.

3 degree sprain

In this case, a complete rupture of the ligaments occurs. The patient notes intense swelling and redness of the skin at the site of injury, pathological joint mobility (instability) appears. If the doctor begins to carry out load tests on the injured joint, he does not meet resistance.

Note:3 degree sprain is considered the most difficult, the treatment is carried out in a medical institution, the surgeon will conduct surgical intervention about stitching broken ligaments. The recovery period after such an injury is long - up to 6 months or more.

Many patients, having received joint grass and sprains, do not seek professional medical help - they try to cope with pain and decrease on their own. motor activity. In fact, such carelessness is fraught with complications, in some cases, in the near future, the ability of such a patient to move independently on his feet may be called into question.

Which symptoms should promptly seek medical attention:

• very severe pain in the damaged joint, which makes it impossible to make at least some movement;
• a feeling of numbness or tingling in the area of ​​\u200b\u200bthe joint or the entire limb - this indicates serious damage to the nerve fibers;
• formed at the site of injury extensive hematoma or redness - this is due to damage to the blood vessels, and against the background of severe pain, their spasm and subsequent necrosis may occur;
• against the background of a sharp pain, movement of the joint is possible, but a crunch or clicking is heard;
• there is an increase in body temperature, chills;
• complete loss of free movements in the joint or, conversely, excessive mobility (pathological) against the background of intense pain.

It is especially important to consult a doctor if, after an injury and an obvious sprain, the pain does not go away within 1-2 days, the joint mobility is not fully restored.

In general, the phenomenon in question can happen to any person during physical exercise or during careless walking. But there are a number preventive measures to help prevent sprains. For example, you need to carefully walk in shoes on high heels and play sports in special footwear. It is necessary to fight excess weight - even to a small extent creates an additional load on the joints.

Remember that only an active lifestyle strengthens the ligamentous apparatus of the joints.

If the injury to the joint has already occurred, then before applying for medical assistance you can do the following:

Note:in the first hours after a ligament injury, it is strictly forbidden to take a warm or hot bath, rub or massage the injured area. Otherwise, the inflammatory process will actively develop, and the swelling will begin to progress.

If the patient complains of severe pain, and a crunch appears in the joint when moving, then this is a reason to call a doctor. The specialist will not only examine the joint, but also prescribe anti-inflammatory and analgesic drugs. It is advisable to apply a napkin with Diclofenac or Ibuprofen ointment to the damaged joint - they will relieve swelling and relieve pain. After the pronounced pain is removed, the swelling is reduced, the patient will be prescribed physiotherapy.

Surgical treatment is prescribed only with a complete rupture of the ligaments.

If the doctor believes that the treatment of a sprain can be carried out at home, then it would be wise to use for speedy recovery and folk remedies. The most effective include:

Folk methods for the treatment of sprains can be used only after examining the joint by a surgeon - this specialist will assess the condition of the joint and determine effective treatment. And the specified methods from the category " ethnoscience In no case should they completely replace therapy - they will be only one of the components of complex therapy.

Sprain - the most frequent view injuries in people who lead an active lifestyle. The main factors leading to sprains are sudden movements and too intense stress on the joint for a long time. Ligaments can be damaged at home, on the street, during sports activities. Such injuries often occur in children and athletes.

Ligaments are elastic, but very dense bundles of connective tissues in the structure of the joint, which connect parts of the bones, hold the joint and direct its movement. They are made up of specifically directed fibers containing elastin and collagen, which provide strength to the ligaments. Despite this, the ligaments do not stretch well, and with heavy movement or exposure to an external factor, a tear occurs. individual fibers which is called stretch. Ligaments are usually stretched in large joints: knee, elbow, shoulder, ankle, as they bear the greatest load.

causes of sprain

Connections are called connective tissue, which strengthens the joint in a certain place, provides mobility and at the same time regulates its movement. When subjected to a load, the ligament stretches and then returns to its natural state. If the load exceeds the physiological possibilities of communication, tears of varying intensity appear in the fibers, from microscopic to significant. This leads to instability and loss of joint function. In connections are nerve roots and vessels that hurt and bruise when ruptured.

Causes of household injuries are falls, trips, sudden lifting of heavy objects. Women often injure their ankles due to walking in heels on very smooth floors or on uneven surfaces. In athletes, sprains are specific depending on the sport: football players, runners, skiers often stretch the ligaments in the joints of the legs, basketball players, tennis players - in the shoulder joint, wrestlers - in the joints of the hands.

Sprain in a child often occurs in the ankle joint during outdoor games, ice skating. Additional factors that contribute to stretching are overweight, poor-quality shoes and pathological changes joint structures.

Back to zmistu Designation and classification of sprains

The first signs of a sprain appear immediately in the form of severe pain. AT rare cases the victim may not feel pain and continue to move the joint, thereby stretching the ligaments even more. After a few minutes, other symptoms appear: swelling, swelling, impaired mobility of the joint, increased pain in the area of ​​damage. Excessive mobility and instability of the joint are signs of a complete detachment of the ligament.

Sprains vary in severity, there are only three of them:

• the first is damage to a small number of fibers, in which the integrity of the ligament is preserved, there is mild pain, swelling and hematoma may be completely absent;
• second - partial breaks several fibers, characterized by intense pain, swelling and subcutaneous hemorrhage, movements are limited and very painful;
• the third - there is a complete rupture of the fibers, there is severe pain, large swelling, bruising, there is no joint resistance, it may be necessary to restore the fibers surgically.

With severe injuries, stretching symptoms such as hyperemia and fever in the area of ​​injury may appear, in complex cases - general malaise, chills.

Back to ZmistuPersha Sprain Relief

Timely first aid for a sprained ligament can prevent possible complications and speed up the recovery process. So start medical measures follows as soon as possible.

Primary therapy for this disease includes the following activities:

• rest and immobility immediately after injury, the patient must be provided with a position in which the area of ​​damage is not subjected to stress;
• cold or ice cold compress it is recommended to apply to the damaged area within the first two hours, this will help relieve pain and reduce swelling;
• fixation - the damaged joint should be fixed with a compressive bandage made of an elastic bandage or an orthosis (an orthopedic product for fixing the joint);
• high position - the diseased joint should be raised and laid on a pillow, chair or other means to prevent bruising in the tissues that surround the joint;
• pain relief - on the first day, it is recommended to use painkillers for pain relief: paracetamol, nurafen, aspirin and others.

Unusually active joint mobility after injury indicates a complete rupture of one or more ligaments and requires qualified medical care. Before the doctor arrives, it is necessary to quickly put a splint on the damaged area, and if it is not at hand, fix the joint with a ruler or other means so that it is motionless.

With a minor injury, after receiving first aid, the patient can continue treatment at home and return to the hospital in about a week. ordinary life. If on the third day the pain does not decrease, the body temperature rises, redness, swelling appear in the damaged area, and a characteristic crack is heard in the joint itself, you should immediately contact a traumatologist. The doctor will order x-rays to determine the extent of damage and prescribe the necessary treatment.

If the victim cannot move the injured limb or experiences very severe pain, he must be urgently hospitalized. In case of large injuries, a plaster is applied to the diseased joint, and in special occasions may require surgery to connect the connection.

Back to zmistuTraditional methods of treatment

For mild or moderate injuries, sprain treatment is carried out on an outpatient basis after visiting a traumatologist. In case of complex stretch marks, the victim must be hospitalized, a splint made of plaster or plastic should be applied. On the first day of treatment for sprains, injuries are treated with cold and rest of the diseased joint is provided. On the third day, you can use dry warm compresses, apply an elastic bandage and gradually develop the joint.

On the first day, you can apply nonsteroidal drugs, which relieve acute pain and inflammation in the damaged joint. If the pain does not go away for more than a week, it is recommended to continue pain relief with lighter means. After removing the edema, warming ointments for sprains are used (Finalgon, Voltaren, Apizartron). To eliminate edema, gels with an extract are used. horse chestnut, for example, Aescin.

The main treatment for this disease is the absence of heavy loads. For better recovery a course of exercise therapy and physiotherapy procedures is prescribed. Exercises should begin with a light warm-up, and then gradually become more difficult. How to treat a sprain should be explained by a traumatologist. Should not be applied medications at your own discretion, this may lead to undesirable consequences.

- this is a partial damage to the ligament, micro-ruptures of individual fibers of a given anatomical structure. Usually ligaments in the region of medium, less often large joints of the extremities suffer. The injury most often occurs when the leg is twisted. Damage is manifested by pain, swelling, bruising, mild or moderately pronounced limitation of support and movements. The diagnosis is made on the basis of symptoms, MRI data and other studies. Treatment is conservative - rest. NSAIDs, cold, then heat on the affected area.

The reasons

In everyday life, sprains most often occur as a result of tripping, twisting the leg, or falling. For example, the cause of ligament damage ankle joint twisting of the leg when walking in high heels or moving on slippery surfaces (ice, hard-packed snow or too smooth floors) can become. A sprain of the wrist joint is formed when falling on the hand in the same circumstances.

In athletes, ligament injuries have their own specifics associated with the sport. Thus, skaters and skiers often have ankle joint injuries caused by a sharp internal rotation (rotation) of the foot during braking. Basketball players, volleyball players, shot throwers, and tennis players may develop sprains in the shoulder joint as a result of a sharp swing or throw. In people involved in powerlifting and bodybuilding, sometimes injuries of the ligaments of the upper limb are detected due to work with large loads, bench press or from the shoulders.

Factors contributing to damage to the ligaments in everyday life or when playing sports are overweight, uncomfortable shoes, clothing or sports equipment, as well as pathological changes in joint structures as a result of arthrosis, previously past injuries and infectious diseases. The likelihood of ligament injury also increases with congenital or acquired anomalies that violate the normal anatomical relationships and load distribution between individual segments of the limb (for example, with flat feet).

Pathoanatomy

Ligaments are elastic dense connective tissue strands that connect one bone to another. Tendons must be distinguished from ligaments, which also consist of connective tissue, but connect not several bones, but bone and muscle. Ligaments strengthen the joint and "regulate" movement. They provide both mobility of the joint and its fixation, allowing physiological movements, but keeping from non-physiological ones. Depending on the main functional purpose, there are ligaments that strengthen the joints; ligaments that guide movement; ligaments that inhibit movement.

When stretched, the ligament experiences a load that exceeds its strength and elasticity. As a result, part of the fibers is torn. The damaged ligament partially or completely loses the ability to perform its functions, the joint becomes unstable. There are many ligaments in the tissue small vessels and nerve endings, so when stretched, hemorrhages and severe pain occur. During the first three days, increasing edema is observed, with multiple ruptures of the fibers, the affected area acquires an "elephant" appearance - the contours of the joint are completely smoothed out, the edema spreads to the underlying sections (for example, to the foot in case of damage to the ligaments of the ankle joint). Perhaps a local increase in temperature, cyanosis and hyperemia.

Classification

In traumatology and orthopedics, there are three degrees of sprain:

• 1 degree- ruptures of individual fibers of the ligament while maintaining its mechanical integrity and continuity. Edema is expressed slightly, hemorrhages are absent. Support and movements are somewhat limited, pain is moderate.
• 2 degree– there are multiple ruptures of the fibers, partial damage to the capsule is possible. Moderate edema is noted, bruising is often detected. Movements are limited, painful, support is difficult. There may be some instability of the joint.
• 3 degree- a complete break. Accompanied by severe pain, significant swelling and severe bruising. Movements are sharply limited, support is usually impossible. When attempting passive movements, instability of the joint is revealed.

In case of damage to the ligaments of 1-2 degrees, in the vast majority of cases, it is required conservative treatment. Self-healing occurs in a few weeks. With complete ruptures, despite the high regenerative abilities of the ligaments, self-recovery does not always occur, and surgical intervention may be required. In this case, the probability of self-healing depends on the localization of the ligament, associated traumatic injuries, the timeliness and adequacy of conservative therapy.

Sprain symptoms

At the time of injury there is a sharp pain. When a significant part of the fibers is torn, a characteristic cotton is sometimes heard. Then there is a growing edema, with severe injuries, hematomas and subcutaneous hemorrhages are formed. The pain is disturbing, which sharply increases when you try to turn the limb in the direction in which it was turned at the time of injury. The degree of violation of the support and movements depends on the severity of the injury - from a slight limitation with a slight stretching to an impossibility with severe tears and complete ruptures.

Examination reveals edema. Minor stretching is accompanied by the formation of local swelling in the area of ​​the ligament. For injuries medium degree the severity of the edema extends to the entire joint. In severe injuries, pronounced swelling is observed, spreading not only to the joint itself, but also to the distal part of the limb, due to edema, the joint completely ceases to be contoured. Hemorrhages and hematomas occur mainly with moderate and severe injuries.

Palpation of the injured area is sharply painful, a local increase in skin temperature is determined. Crepitus is absent. With mild and moderate injuries, passive movements are limited due to pain, with severe injuries, excessive mobility is detected, which has certain differences from pathological mobility due to a fracture. With fractures, pathological mobility occurs in the area of ​​the fracture, that is, where it should not normally be at all. When ligaments are damaged, movements are made where they should (in the joint), but their amplitude is greater than normal.

Diagnostics

Diagnosis is based on symptoms and, if available, MRI, joint ultrasound, or arthroscopy. Ligaments are soft tissue formations, they are not visible on radiographs, therefore, radiography can only be used to exclude a fracture, since fractures and sprains are accompanied by very similar symptoms and sometimes combined with each other. In addition, during the differential diagnosis with fractures, characteristic clinical signs are taken into account.

With sprains, unlike fractures, there is no pain when pressure is applied to the bone (with the exception of pressure in the area of ​​the damaged ligament). At the moment of injury, a pop is heard, not a bone crunch. At rest, as a rule, there is no pronounced pain syndrome that disrupts sleep and rest of the patient. On palpation, crepitus is not determined, and the deformity is formed mainly due to edema, and not due to the displacement of fragments.

Unlike fractures, in which damage to the ligamentous apparatus of the joint is observed only in some cases, dislocation is always accompanied by rupture or sprain of the ligaments. Dislocations are also ruled out on the basis of radiography and the absence of typical clinical signs. With sprain, unlike dislocation, there is never a sharp and gross deformation of the joint, shortening of the limb and springy resistance when trying to passive movements.

Sprain treatment

In case of injuries of 1 and 2 degrees, outpatient treatment is carried out in the emergency room. Grade 3 injuries usually require hospitalization in the trauma department. Patients are advised to rest, elevated position of the limb. During the first day, cold is applied to the injured area (a heating pad or a plastic bag with ice wrapped in a towel). Starting from the third day, dry heat is used. For mild sprains, an elastic bandage is applied while walking or a caliper (special orthopedic bandage) is put on. At rest, the restraints are removed so as not to interfere with blood circulation in the affected area. In severe injuries, immobilization is carried out using a plaster or plastic splint.

Patients with sprains, especially in the first three days, are contraindicated thermal treatments: warm compresses, hot baths, sauna or bath. You should not drink alcohol or massage, as this contributes to the growth of edema and increased bruising. On the initial stage it is not recommended to make movements in the damaged joint, as this can provoke additional micro-ruptures of the ligament fibers and slow down the rate of its recovery. Massage and physical exercises are shown only in the recovery period.

In the first days after an injury, non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen, etc.) can be used if necessary to eliminate pain and reduce inflammation. If intense pain persists for a week or more, you should consult a doctor to recommend other, more safe ways pain relief, since long-term use of NSAIDs can cause gastritis or stomach ulcers. Along with NSAIDs for oral administration, safer external agents from the same group can be used.

At the recovery stage, patients are referred for exercise therapy. Exercises at first include only light warm-up movements, then the complex gradually expands. In this case, the general principle is the absence of pain during exercise. It should be remembered that too long complete rest, as well as too early movements in the joint, can adversely affect the duration recovery period Therefore, physiotherapy exercises should be practiced in strict accordance with the recommendations of the doctor and exercise therapy instructor.

Forecast and prevention

The prognosis for sprains is favorable. Grade 1 injuries usually heal without residual effects. With grade 2 and 3 sprains in some patients in remote period tingling is observed and chronic pain in the joint. This may be due to both the formation of small nodules and the involvement of nerve endings in the process of scarring of the fibers. It must be remembered that the restoration of the ligament occurs due to the formation of scars, which means that in the future this ligament will be less resistant to damage. To prevent re-injury during sports, special calipers should be used.

Over the past century, the number of domestic, professional and sports injuries has almost doubled. Many researchers attribute this to the active growth of the industrial sector and the extremely rapidly developing industrialization. The leading place in the list of injuries is occupied by sprain - not a particularly dangerous, but rather unpleasant ailment that people regularly face. different ages and gender. That is why it is necessary to know how to act in emergency and help the victim in the first minutes after receiving such damage. Do not forget that properly carried out therapeutic measures will help reduce the risk of complications several times.

What is sprain

Stretching - view traumatic injury, in which the integrity of the ligamentous apparatus of the joint is slightly violated. This pathology is widespread throughout the world and has been observed in almost every person at least once in a lifetime. If the injury occurs at least twice within six months, then such an injury is called chronic.

Unlike a tear, a stretch does not form two separate sections of the ligament. As well as pain and swelling are much less pronounced.

Degrees of damage

Classification of injury by degree:

1. First: about 20% of the ligament surface is damaged. Pain and swelling are mild and disappear in a few hours.
2. Second: from 20 to 50% of the ligament is injured. A hematoma and a massive accumulation of fluid form in the stretch area. Symptoms go away after a few days.
3. Third: 50 to 80% of the ligament is damaged, but it is not considered torn. This degree is characterized by the formation of intense pain syndrome, as well as the inability to use the limb.

The degree of sprain is determined by the size of its damage

Why sprains occur

The main causes of injury include:

• intense physical activity;
• frequent falls;
• insufficient warming up of the body before training or lifting weights;
• traffic accidents;
• a small amount of collagen fibers in the connective tissue;
• jerky movements.

The main clinical manifestations of the disease

Immediately after the injury, the patient complains of intense pain. It intensifies when trying to use the affected limb and subsides slightly at rest. After a few minutes, a hematoma begins to form in the area of ​​injury, which has a purple-cyanotic hue, the skin turns red and stretches. Due to inflammatory edema, the limb increases in size compared to a healthy one, as a result of which the patient experiences severe discomfort. The hand or foot becomes hot, and the general body temperature may also rise as a reaction of the body to a stressful stimulus.

During his work in the Department of Traumatology, the author saw several cases when patients with a pronounced third-degree sprain calmly stepped on the injured limb without experiencing any discomfort. This was due either to a rather high threshold of sensitivity, or severe alcohol intoxication. That is why the absence of pain does not exclude the diagnosis of sprain.

First aid for an injured person

If you happen to be an accidental witness to an injury, you should not be scared and lost again: competent actions will help to avoid the development of many unpleasant complications. The main thing to remember is that it is strictly forbidden to try to set the sprained ligament, and it is also recommended not to load the injured limb.

Working in the Department of Traumatology, the author often faced the consequences of improperly rendered assistance. The girl, who sprained her ankle while walking in heels, was put on a tight pressure bandage by eyewitnesses of the injury, twisting her foot in the other direction. This led to the development of severe edema and severe pain, and the first degree sprain almost turned into a rupture. The patient was examined by a doctor, she underwent all the necessary manipulations, due to which complications were avoided. That is why it is so important to know how to behave in such a situation, as well as immediately call an ambulance.

Applying ice helps reduce swelling and pain

First aid algorithm:

1. Reassure the victim. To do this, you can give him a few glasses of clean non-carbonated water to drink.
2. Remove the injured limb from clothing and shoes. This avoids the absorption of tissues with the further development of edema.
3. If you have light painkillers (Ketorol, Diclofenac, Nise), offer them to the victim. Before that, you should find out if he has allergies.
4. Put ice or any other cold object on the stretch area. In this case, it is necessary to use a fabric lining so as not to provoke frostbite in the victim.
5. Elevate the limb to improve blood circulation. To do this, you can use a roller from clothes.

How is the differential diagnosis of sprain of the ligament apparatus

Most often, patients confuse sprain with another common injury, which is also characterized by the presence of swelling, hematoma, and impaired motor function- with fracture. To exclude this diagnosis, the victim immediately after he gets to the hospital, an x-ray of the diseased limb is performed. With a fracture, you can see a clear line on the pictures that separates the sections of the bone from each other, while only soft tissues, which are not visible with this method of research. To confirm the diagnosis, doctors use ultrasound diagnostics- study of the joint cavity and ligamentous apparatus using a wave that is reflected from tissues with different lengths and creates an image on the screen. Thus it is possible to discover inflammatory edema and heterogeneity of the ligament itself.

Ultrasound can confirm the diagnosis of a sprain

Treatment of various degrees of sprain

With such an injury, you should immediately go to the hospital. Although the initial degree of sprain can be treated at home, doctors strongly recommend clarifying the diagnosis. All methods are divided into conservative ( pharmaceuticals, physiotherapy, proper nutrition, massage and therapeutic Physical Culture), as well as operational (restoration of tissue integrity).

During the period of therapy and rehabilitation, it is imperative to abandon active loads. At the same time, it is forbidden to walk, swim, and also train in gym until the injured limb is completely healed.

Medical therapy for sprains

The following remedies are used to treat an injury:

1. Local anti-inflammatory drugs in the form of ointments, solutions and gels that help relieve soft tissue swelling are applied at least twice a day. The most famous include: Dimexide, Menovazin, Voltaren, Fastum gel, Finalgon, Kapsikam. To reduce the size of the hematoma, Heparin ointment and Troxevasin are used.
2. Injections of Diclofenac, Ketorolac, Tramal, Tramadol, Ibuprofen and Ketotifen, which eliminate inflammation and relieve pain in the area of ​​damage. Due to the precise introduction into soft tissues, they begin to act much faster than ointments.
3. Painkillers that help relieve discomfort and block conduction nerve impulses from the area of ​​injury to the brain.
4. Calcium preparations and vitamins from group B, which improve regeneration processes. Means can reduce the healing time by several times.

Photo Gallery: Pharmaceuticals Used in Stretching

Fastum gel relieves inflammatory tissue edema, having local action Troxevasin reduces the severity of hematoma several times Ketorol has a pronounced analgesic effect

Surgical treatment of the injury

If a conservative therapy does not bring the expected results within two to three weeks, doctors decide on the need for surgical intervention. Most often, this situation occurs with a third-degree sprain, when most of the ligamentous apparatus is damaged.

In the elderly, the regeneration processes can be slightly slowed down, their duration exceeds three weeks. This should be taken into account when scheduling a patient for surgery.

The main contraindications for surgical treatment ailments serve:

• terminal states (liver and kidney failure, recent stroke, coma, heart attack);
• allergy to anesthetic drugs;
• less three months back transferred abdominal operation;
• age over 95;
• alcohol or drug intoxication.

Surgical intervention is carried out under the general or spinal anesthesia. The doctor sequentially dissects the skin, fatty tissue and muscles with a scalpel, exposing the joint. Next, he finds damaged areas of the ligament and, with the help of special strong threads sews them together to prevent further tearing. A cast is applied to the injured limb, which must be worn for two to five weeks.

After connecting the ends of the damaged ligament, their healing is faster

Folk remedies as auxiliary methods

For those who prefer to deal with sprains at home, there are long-tried natural recipes. However, do not forget that their use is permissible only at the first stage of stretching, since such injuries can heal without medical assistance.

To the benefits folk therapy relate:

• low cost of raw materials;
• the ability to independently collect materials;
• ease of preparation;
• admissibility of use in pregnant and lactating women, as well as in pediatric practice.

Disadvantages of natural remedies:

• inability to calculate the dose of the substance;
• unproven effectiveness in comparison with medicines;
• occurrence allergic reactions(angioedema, rash, urticaria, anaphylactic shock).

The most popular methods of treatment with folk remedies:

1. Apply an iodine mesh to the area of ​​injury using cotton swab. In this case, the skin should be dry and clean, the use of soapy solutions is prohibited. The size of the mesh is determined by the location of the damage, and the distance between the squares should not exceed 1 centimeter. Iodine relieves puffiness well. It is recommended to update the drawing once every two days, and the grid can be used for no more than a week.
2. Dilute 96% alcohol in proportion with water 1:3. After that, soak gauze in the liquid, wring it out and put it on the injury site, covering it with a towel on top. Alcohol has a mild warming effect, dilates blood vessels and improves blood circulation. You can keep the compress up to half an hour. You need to apply the method for seven days until the desired effect is achieved.
3. In a saucepan with a liter of hot water, add 250 grams of salt, mix thoroughly. After the solution has cooled to room temperature, place the affected limb in it for 5-10 minutes. Such treatment allows you to remove the inflammatory edema, and also prevents the development of infection in the area of ​​injury. It is recommended to use the saline solution no more than once a week.
4. Scald three large leaves of burdock with boiling water and apply to the damaged area for fifteen to twenty minutes. This plant relieves pain well and reduces discomfort during limb movements. Treatment can be carried out daily.
5. Grind five leaves of plantain, one hundred grams of lavender and one large cabbage leaf with a blender to a state of gruel. Wrap it in a layer of thin gauze, then put it on the stretch. You can fix it on top with a bandage and leave it for several hours. During this time, there will be a decrease in the size of the hematoma, and the former mobility will return to the arm or leg. It is recommended to use this method within ten days.

Photo gallery: folk remedies for stretching

Iodine mesh reduces inflammation Plantain relieves soft tissue swelling Burdock promotes better damage regeneration

Physiotherapy

Physiotherapy helps to reduce swelling and pain, promotes the speedy resorption of hematomas, accelerates the healing process of tissues, and restores the tone of skeletal muscles.

Physiotherapy can be started no earlier than on the third day from the moment of injury. This is due to the fact that during the first three days a hematoma forms in the area of ​​damage, so procedures that improve peripheral blood flow can cause an increase in bruising in size.

Table: physiotherapy in the treatment of an ailment

Photo gallery: stretching physiotherapy

Paraffin therapy improves regeneration UHF therapy improves blood circulation in tissues Magnetic stretch therapy reduces pain

Massage and therapeutic physical culture for recovery

After prolonged inactivity, muscles and ligaments need regular training and stimulation. A well-chosen massage will help improve blood flow in the area of ​​damage, as well as restore your limbs to their former sensitivity. Doctors recommend visiting a specialist or regularly going to the clinic, but if you do not have such an opportunity, it is easy to carry out the procedure at home.

Before starting the massage, be sure to warm your hands, remove long manicures, remove rings and bracelets so as not to damage the skin. With movements from the fingertips to the base of the joint, begin to rub the limb until it warms up. After that, you can move on to patting and pinching, which stimulate blood flow to the damaged area. The duration of the procedure should not exceed ten to fifteen minutes.

Video: wrist massage

Stretching exercises

Therapeutic gymnastics, in turn, prevents muscular atrophy and the formation of various contractures that violate the physiological mobility of the limb. You need to practice every day for several months to achieve optimal results. However, do not forget that if there are sharp discomfort, it is better to stop physical activity so as not to inflict more pain on yourself. serious injury.

What exercises can be used:

1. Carefully perform flexion and extension swings with a limb. If you are unable to complete this movement due to pain or resistance, you should help yourself with your good arm or leg. It is necessary to repeat the exercise at least two times.
2. When spraining the ligaments of the wrist joint, use a special expander or a small elastic ball. Squeezing it several times in a row, you will feel how the limb begins to strain. The number of repetitions is from ten to twenty-five.
3. From a sitting position on the gym mat, stretch both legs forward. Next, try to reach your fingertips with your palms. This exercise allows you to stretch the shoulder, elbow and knee joints at the same time. You need to repeat at least ten times.

Video: ankle sprain exercises

After an injury, it is necessary to provide the body with building material: proteins, fats and carbohydrates are involved in the formation of new cells and tissues. That is why it is so important to properly organize the diet of a patient with a sprain. Doctors advise during the period of treatment and recovery to divide all food into six meals, while the mass of one serving should not exceed three hundred grams. Calories should not be raised more than 4000: this can contribute to the set excess weight. All dishes should be served boiled, baked or stewed, you can fry in a small amount of olive oil.

If you do not eat meat and dairy products, as well as any animal proteins, you must definitely make sure that your diet provides for the replenishment of all useful micro and macro elements. To do this, you can purchase the necessary funds at the pharmacy.

What foods should be excluded from your diet:

• glazed curds;
• home salting;
• chips, crackers, snacks;
• sausage and wieners;
• noodles, cereals, instant puree;
• shop sweets: chocolate, marmalade, marshmallows, marshmallows, waffles, various pastries with fat cream;
• fast food and semi-finished products;
• mayonnaise;
• carbonated drinks;
• packaged juices;
• energy;
• coffee.

Photo gallery: junk food

Energetic drinks slow down metabolism Fast food - a source of trans fats and fast carbohydrates Chips contain a lot of salt

Healthy foods

What to eat every day:

• fresh vegetables and fruits;
• berries;
• cereals and various cereals;
• lean meat and fish;
• seafood (lobster, mussels, shrimp);
• milk;
• cottage cheese and yogurt without additives;
• kefir, fermented baked milk, snowball, bifidok;
• hard pasta;
• homemade fruit drinks and freshly squeezed juices;
• peas and legumes (chickpeas, lentils).

Photo gallery: healthy food for the body

Vegetables and fruits are rich in vitamins
Cottage cheese contains a lot of calcium Meat - best source animal protein

Predictions and consequences of sprains

Like any other injury, this ailment takes time to heal. With the first degree of damage, the ligaments are restored within two to five days, while the second degree can take a person out of their usual rhythm of life for up to four weeks. In third stage stretching, regeneration takes two to six months. Do not forget that the older the person, the slower the recovery of soft tissues proceeds. This is directly related to inhibited metabolic processes and lower levels of collagen in the body. Also, during infectious diseases, the body spends most energy to fight the microbe: as a result, the ligaments are restored more slowly than in a healthy person.

It is especially important not to load the injured limb during the rehabilitation period. In his practice, the author of the article came across a patient who received an ankle joint a week before an important competition. Doctors strictly forbade him to train and lean on the injured leg. However, the young man did not wait for the soft tissues to recover, and began active physical activity. Unfortunately, during his running exercises, the injury worsened: instead of spraining the ligaments of the ankle joint, a tear formed. As a result, the patient was urgently taken by the ambulance service to the traumatology department and operated on, a plaster was put on his leg. The athlete not only missed important competitions, but was also suspended from subsequent training for four months.

Possible complications of sprains:

1. The accession of infection and the development of inflammatory and purulent changes in soft tissues. Due to weakness immune system during the recovery period, the body is especially vulnerable: even a recent cold or caries can become a source of serious problems. Phlegmon and abscess are accumulations of purulent masses in the area of ​​the joint and ligamentous apparatus that disrupt the function of the limb. Treatment is carried out only by opening in a hospital. And also the patient will need to take antibiotics for a long time.
2. Formation of a contracture. At the site of sprain, if the distance between the areas of the damaged area is quite large, the connective tissue grows. It forms dense and elastic strands that deform the affected limb, as a result of which it cannot bend or unbend normally. Most often, this pathology develops with chronic stretching of the ligamentous apparatus. The only way Once and for all, the problem is eliminated by the operation, during which the scar is excised.
3. Atrophy muscle tissue areas of damage. If a person constantly protects the injured limb and tries in every possible way to reduce the load on it even after a long period after the injury has healed, this leads to thinning and weakening of the muscles. An arm or leg can lose weight and significantly decrease in volume, which creates not only an external cosmetic defect, but also brings great amount inconvenience at home. To restore muscle mass, you need to eat right and exercise regularly.
4. Loss or decrease in tissue sensitivity. When injured, the neurovascular bundles in the same area often suffer. As a result, a person feels much weaker the effect of pain, cold or any other stimulus. Treatment is with physiotherapy or surgery.

Photo gallery: sprain complications

Muscle atrophy may appear after a sprain. Phlegmon of the lower leg is a consequence of infection entering the area of ​​injury. Contraction of the fingers often occurs after a sprain of the wrist joint.

How to protect yourself and your loved ones from the onset of the disease

Unfortunately, in an age of high industrial development and a large number of vehicles, it becomes much easier to get injured than it was fifty years ago. Every day, a person exposes himself and his health to a huge risk, without even realizing it. And also for last years the direction of medicine has changed a lot: if earlier doctors thought that it was much better to give large quantity funds for treatment, prevention is now the dominant link in world practice. That is why, starting from the school bench, people are taught to provide first aid for any injury, as well as to behave correctly in a stressful situation.

The author of the article, together with his colleagues, participated in the organization of sanitary and educational work among professional athletes. The study group included persons aged 18 to 35 who engaged in fairly serious daily activities. physical activity and regularly faced with such an injury as sprain of the ligamentous apparatus. To begin with, the doctors simulated the situation of receiving such damage, after which people were asked to provide first aid to the victim, using their knowledge. Unfortunately, as it became clear during the experiment, about 20% of athletes made rather gross mistakes, which could subsequently lead to serious complications. Further, traumatologists showed how to properly help the victim with a sprain, sequentially analyzing the stages of action. After that, a control test was conducted, during which all athletes showed excellent results. This experiment shows the importance and necessity of preventive measures.

Personal injury protection rules:

1. Before playing sports and training, be sure to warm up. Our muscles and ligaments need to be warmed up: during their inactivity, they lose their elasticity, and microscopic ruptures occur during exercise. A few minutes before training, rub your hands and feet: starting from your fingertips, walk all over your body with smooth massage movements. After that, you can stretch: from a sitting position, try to get your ankles, and also throw your elbows behind your back and try to clasp your wrists. This will help prepare the body for subsequent physical exertion.

   Stretching helps prepare the body for exercise.

2. Refuse to wear uncomfortable and squeezing shoes. Many women prefer to go out in heels: in this case, the foot takes an unnatural position, and high stilettos can cause injury. If you have a long and difficult event ahead of you, it is better to choose flat shoes that will fit you exactly. When doing running training, doctors recommend choosing sneakers with good fixation of the ankle joint in order to avoid sprains.
3. Exercise regularly. It has long been proven that a sedentary and inactive lifestyle leads to the development of such serious diseases as diabetes, hypertension, alimentary obesity, hypercholesterolemia. Training allows you to strengthen the muscular and ligamentous framework of the body, as a result of which it becomes more resistant to everyday stress and stress. Optimal quantity sports activities per week - at least three. If you have a busy work schedule and cannot find time to visit the gym, it is recommended that you train at home. To do this, you will need comfortable clothes and shoes, as well as a gym mat and small dumbbells. Fans of an active lifestyle can additionally do yoga, aerobics, swimming, gymnastics, dancing or wrestling.
4. When lifting heavy things, try to lower yourself to the same level as them. This contributes to the proper distribution of the load between the shoulder girdle and back muscles, and will also help to avoid sprains. If possible, try not to carry bulky items alone, or use mechanized devices for this.

   Proper lifting of weights evenly distributes the load

5. AT winter time years, when snow and ice mostly lie on the street, use special shoe clips. They are sold in any sports store and are rubber pads with spikes that are on the plantar surface. Such a mount practically does not spoil appearance boots or boots, but at the same time allows you to maintain grip on a slippery surface, reducing the risk of developing numerous pathologies.
6. Do not abuse the reception alcoholic beverages. According to the statistics of doctors of the trauma department, most patients are injured while under the influence of ethyl alcohol. It is known that alcohol not only causes addiction and the formation of serious dependence, but also contributes to the disruption of the activity of many organs and systems. In a drunk person, coordination of movements suffers quite a lot, as a result of which he cannot adequately assess the distance to an object or surface, which is often accompanied by the acquisition of various kinds of injuries. Doctors strongly advise not to drink more than one glass of red wine per day.

   Avoiding alcohol helps reduce the risk of injury

Ligament sprain is a serious injury that should be treated immediately. If a minor damage can drag on on their own without harm to the body, then larger ones can cause a lot of inconvenience to a person. That is why doctors strongly recommend not to be limited to first aid, but to go to the nearest emergency room. Recovery after stretching is quite lengthy: you should not expect stunning results from your body in just a few days. A properly selected course of therapy will help you return to your usual rhythm of life.

Ligaments are called bundles of connective tissue fibers that hold the bones of the joints of the supporting apparatus of the body in predetermined positions. At the same time, the ligamentous apparatus allows the joints to be quite mobile, but only within specified limits, other movements are completely limited.

By their structure, ligamentous fibers are very strong, elastic and practically do not stretch, therefore, when they talk about sprains, in fact, they mean something completely different - their partial rupture. Depending on the severity of the injury, there may be a rupture of a small number of superficial fibers or a significant number of deep ones, and in especially severe situations, a complete rupture of the entire bundle of ligaments may even occur. In the latter case, the joint completely loses its stability, and this can lead to even more serious injuries - infringement of muscles, nerve endings, and even bone fractures.

Causes of sprains

For the most part, such injuries are typical for athletes, children and people leading an overly active lifestyle, in which the following situations are possible in the joints;

• Random unnatural movement of the joint;
• Strong shock or side loads during falls;
• Lifting weights that exceed reasonable limits;

Of all sports, football, gymnastics, tennis and weightlifting are considered the most traumatic.

In addition to the obvious reasons, there are a number of factors that greatly increase the risk of developing sprains and even torn ligaments:

• Excess normal weight body;
• Congenital pathologies anatomical structure joints - instability or vice versa, unnatural mobility, different length limbs, high arch, etc.;
• Chronic joint inflammation;
• Pathologies of muscles and inflammation of nerve endings.

And yet, the vast majority of sprains are associated with increased activity Therefore, such injuries are more often observed in athletes.

Sprain classification

Types of sprains can be conditionally divided into two groups - according to the localization of the focus of injury and the degree of its severity. The latter is usually divided into three degrees:

• First- the rupture occurs on a small external section of the ligamentous bundle with a slight limitation of the mobility of the joint itself. Such stretching causes moderate swelling and, soon, the situation improves, even without treatment;
• Second- subject to rupture a large number of fibers, and already on inner layers beam. Often, such injuries are aggravated by damage to the articular bag and even muscle fibers. In this case, the manifestations of injury are more significant - noticeable swelling, hematomas, limitation of joint mobility and severe pain, and in severe cases, its instability may occur;
• Third- the most severe injury in which a complete rupture of the ligament occurs, leading to joint instability. It is manifested by severe pain, bruising, extensive swelling and impossibility of movement.

It is very important not to confuse a sprain with a dislocated joint, and for this you should pay attention to the differences. So, dislocation is characterized by signs that are not present with sprains:

• If a external form injured joint is markedly different from its healthy couple- there is a dislocation;
• On palpation, displacement can be detected articular head and feel the articular cavity;
• The injured limb assumes an unnatural position - it is minimally painful. This is due to displacement of bones and contraction of muscle fibers;
• The slightest movement causes very intense pain in the joint, up to the development of pain shock.

If with a sprain of the first degree of severity, even medical treatment is not always required, then in the second, this is already necessary. In addition, after removing the edema, you need a course of restorative physiotherapy, physiotherapy exercises and restoration of muscle tone.

With proper treatment, it is possible to cope with such an injury within 2 to 4 weeks, but as for the injury of the 3rd degree of severity, in this case one cannot do without surgery. Restoration of the integrity of the ligamentous apparatus is required, followed by a long recovery period.

Types of "professional" sprains

Long-term significant loads of a certain direction often lead to the appearance of typical sprains in athletes. There are 7 main such syndromes:

• tennis elbow. Regular heavy loads elbow joint lead to chronic micro-ruptures of his ligaments, which is expressed by increased pain when raising the arm up and swelling;
• Baseball player's elbow. A state completely similar to the previous one;
• friction syndrome. Basically, it is inherent in marathon runners. Long running, as a result of constant friction, can cause inflammatory processes in knee joints and pain in its outer surface;
• golfer's elbow. Forearm flexor injuries and inner surface joint;
• Swimmer's knee. Violations of the articular apparatus of the knee due to the regular high load on it, especially when swimming breaststroke. Expressed by pain and swelling;
• Jumper's knee. The syndrome is caused by stretching thigh muscles and ligaments of the hip and knee. Presents with patellar tendonitis and patella, slight swelling and pain on movement;
• Cleaved Shin. Overstrain of her muscles leads to the syndrome, as a result of which microtears, swelling and soreness occur.

It is worth considering that not only athletes are susceptible to such injuries - any person who regularly overstrains a certain joint will eventually encounter such problems, so it is worth maintaining the load level within reasonable limits.

The most common types of household sprains

Here is a list of them in order of frequency of occurrence:

Ankle ligament injury. Such injuries are observed more often than others, especially among skiers. They occur when the leg is twisted or with a strong blow. The joint swells, pain and stiffness of mobility develop.

Knee ligament injury. The main reason is a direct blow or strong lateral pressure on the cup. Already at the moment of injury, pain occurs - stabbing and intense, which in a calm position of the joint passes and returns with any of its movements. Edema develops, and mobility is markedly reduced.

Ligament injury of the wrist joint. Stretching can cause a jerky movement of the hand, but more often, this occurs when falling on the outstretched palm. The pain is immediate and very sharp. Develops within an hour severe swelling limiting the mobility of the joint, and intense pain during any movement does not allow the usual grasping reflexes.

Anterior sacral ligament injury. The main reason is the torsional stress on the hip, which often occurs in football and baseball players. Stretching leads to the development of edema, and severe pain makes it almost impossible to move the slightest movement in the joint.

Injury to the ligaments of the sternoclavicular joint and acromion. The reason is high loads during a fall with support on an outstretched arm, and sometimes a blow to the plane of the shoulder can lead to stretching. The pain occurs immediately and noticeably intensifies when you try to raise your hand up. characteristic feature such stretching - hypersensitivity of the skin in the injured area and hyperemia.

As you can see, with all sprains, the symptoms are generally similar - pain, swelling, difficulty in movement. In case of significant injuries, bruises are added, which, when completely ruptured, are very noticeable and are supplemented by the accumulation of internal fluid in the damaged area.

Treatment

At the first symptoms of sprain, you should immediately begin to provide first aid, otherwise the condition may worsen significantly and become chronic. First of all you need:

• Provide the victim with a comfortable position and immobilize the joint with a tight bandage. It is best to use an elastic bandage, but if you do not have one, a regular scarf or scarf will do. If the pain is very intense, it is worth fixing the joint with a splint;
• With noticeable swelling, especially if a hematoma forms, it is advisable to raise the affected limb. This will reduce blood flow and slow down the development of edema. Not bad at sore spot organize a cold compress - a towel with ice or soaked in cold water;
• To relieve pain, you can use any analgesic, but it is better to use anti-inflammatory and analgesic ointments, for example, Diclofenac or Ibuprofen.

After these events, the victim must be taken to a professional traumatologist.

Complications after sprains

Like any other injury, a sprain does not go away without a trace, especially if it is of a high degree of severity. Often, after treatment, the following complications are observed:

• The formation of nodules at the site of fusion of fibers, which, when moving, rub against each other, causing tissue irritation and often lead to chronic inflammation accompanied by aching pains;
• The appearance of the effect of chronic, repeated stretching in the same place;
• Damage to nerve endings and blood vessels. It causes stabbing pains, numbness of the tissue area and even disruption of the normal blood supply to the joint.

The latter is fortunately rare.

Chronic sprains are especially dangerous - over time they lead to joint deformity, its degeneration and reduced mobility. Do not forget that in such situations the patient is bothered by chronic aching pain and other discomforts.

In order not to bring to such a state, sprains should be treated in time, even minor ones, and it is even better not to allow them at all. For this, it is enough to observe simple recommendations traumatologists:

• When playing sports, you need to use professional equipment, comfortable shoes are especially important;
• Do not exceed reasonable loads. It is worth increasing them gradually and only after preliminary warming up of the muscles;
• Do not refuse full rehabilitation in the treatment of any injuries.

And, of course, you should take care of maintaining a normal body weight and a balanced diet. It must contain enough vitamins, minerals and protein.