Stretch of ligaments - Causes, symptoms and treatment. MF.

Sprain stretching is an easy degree of traumatic injury, the cause of which is a sharp movement in the joint, accompanied by a complete or partial rupture of the periarticular bag or ligamentous apparatus.

Stretching mechanism

Symptoms of sprain

A characteristic symptom of sprains is a strong movement pain. There is also swelling, dyeing of the skin in blue or purple( hematoma), tenderness in palpation. The functions of the joint are limited because of pain. With finger tapping of bones( percussion), which are involved in the formation of the affected joint, the pain is insignificant or nonexistent. More severe damage can lead to rupture of ligaments, resulting in an extensive hematoma, until the appearance of fluctuations( sensation of fluid movement during palpation of the stretch).

The sprain of the acromioclavicular joint is a consequence of a fall or a direct blow to the top of the shoulder. It is characterized by pain and increased sensitivity of the skin over the outer end of the clavicle. Pain syndrome increases with the movement of the arm across the body.

Stretching of the sternoclavicular joint can occur when falling on an elongated arm. This type of injury is characterized by pain over the place of injury. With a stronger impact on the joint, a deformation occurs at the junction of the clavicle with the sternum.

Sprains of the wrist of the wrist can occur with a sharp extension of the wrist. It is characterized by acute diffuse pain at the time of injury( most of all over the wrist joints), a very rapid( within 1 hour) swelling in the affected area, a restriction of the volume of motor movements, the inability to grasp the object with the affected arm and the instability of the joint.

Tension of the knee joints of the knee joint .The cause of its occurrence can be direct shock or twisting. It is characterized by pain that occurs at the time of injury. The pain gradually passes, while trying to move in the knee joint appears again. There is also swelling, stiffness and increased sensitivity on the inside of the joint.

The stretching of the anterior cruciate ligament occurs when an unexpectedly powerful twisting of the thigh, especially when the shin is fixed( for example, the players of the spike are immersed in the ground, and at this time the body is unfolded).It is characterized by symptoms such as acute pain and cracking at the time of the damage( a person has a feeling of "collapse" of the knee).In this case, the function of the joint is broken completely, its instability arises. After 1-2 hours, edema develops, which gradually progresses.

Ankle sprain of the ankle .Most often, it develops when you turn the foot. Also, it can be caused by landing on the foot of another person( for example, during sports games).Characteristic signs are mild pain and inability to produce motion in the joint.

Degrees of extensions

There are 3 degrees of tension of the ligamentous apparatus:

I degree - characterized by damage to a small portion of the ligament. It is characterized by poorly expressed pain. In this case, movements in the joints are practically unlimited, and the presence of edema is not necessary.
II degree of - characterized by a slight tear ligament. Characterized by puffiness, pain, frequent occurrence of a hematoma.
III degree - the most severe stretching. In this case, the bundle is broken almost completely. Characterized by acute pain, edema, pronounced hematomas. The motor function is limited due to severe pain. It is possible to form an unstable joint, which entails frequent repeated damage to it.

Degrees of sprain

First aid and diagnosis of sprains

When getting a similar injury to the site of damage, it is necessary to apply cold and, if possible, immobilize it. Then you should go to a medical institution to provide qualified assistance.

First aid for sprains

Diagnosis of ligament sprain is possible only with the help of anamnesis( the presence of trauma) and the symptoms of damage, since no x-ray examination reveals any pathologies. However, the radiograph should be made to exclude the possibility of fracture of the bones or dislocation of the joint.

It is impossible to visually accurately distinguish the sprain from fractures or dislocations, so self-medication is unacceptable, and it is necessary to consult a doctor for radiography.

Treatment of sprains

The high regenerative capacity of the fibers of the ligaments promotes good healing of the wound surfaces of the ligaments. Treatment of sprain, in the first place, is to immobilize the affected area. In other words, it is necessary to create peace for him. In the first few hours after stretching the ligaments, cold is applied topically. Cold prevents the development of edema or reduces it, reduces pain. Bubbles or packets of ice( preferably special pharmacy) should be removed for 30 minutes every 2 to 3 hours to avoid frostbite.

For severe pain, use of non-steroidal anti-inflammatory drugs( ibuprofen, febrovid, heparin( ointment), artradol( injections), naproxen, ketorolac, etc.) is possible.

In place of damage, a bandage is applied, preferably pressing( elastic bandage), which in the medical establishment is replaced, if necessary, with gypsum.

When the swelling subsides, the physician can prescribe physioprocedures. On the third day you can use physiotherapeutic methods of treatment, such as UHF, thermal treatments( ozocerite baths), electrophoresis with analgesics, antiallergic, anti-inflammatory drugs. It can be novocaine, heparin, antibacterial drugs.

On the fifth or seventh day, you can prescribe ultrasound treatment with anti-inflammatory drugs( lazonil), biostimulants( ointment mummies), anesthetics( mobilat).

If an ankle joint is damaged with swelling, pain, and blood flow disturbances, then the hydrotherapy, such as baths, hydromassage and baths, is contraindicated. The fact is that they increase the blood flow in the place of injury, and this leads to an increase in the pain syndrome. In this case, it is advisable to use paraffin and ozocerite in the form of applications.

If the elbow joint is damaged, then heat therapy should not be used to avoid complications such as myositis and violation of joint mobility. It is better to use ice in the form of applications and isotonic movements. Later you can use electrophoresis and phonophoresis.

As a rule, treatment is outpatient. The victim remains disabled for 1-4 weeks, depending on the degree of stretching.

Rehabilitation after sprains

Rehabilitation measures begin to be carried out from the first days after the injury, in order to prevent the development of hypodynamia, and also for the purpose of prompt restoration of lost functions.

Use therapeutic exercise( LFK), massage, occupational therapy.

The tasks of LFK are:

• increasing the vitality of the affected person;
• improving the function of cardiovascular, respiratory systems;
• prophylaxis of complications;
• adaptation of all body systems to physical activity;
• increased blood and lymph circulation in the lesion zone to simulate recovery processes;
• prevention of muscle hypertrophy and joint stiffness.

Of the drugs LFK prefer therapeutic gymnastics. It consists of:

• breathing exercises( static, dynamic);
• exercises to strengthen the muscular corset( tilts, turns, half-turns);
• exercises for a healthy limb( active movements in all joints, isometric exercises).

Static exercises( limb retaining), isometric exercises, leads and leads, as well as active movements in healthy joints, are used for the injured limb, which contributes to the activation of blood circulation and recovery processes.

The load is assigned depending on the stage of rehabilitation - from easy to more complex. The increase in the load is due to an increase in the number of exercises, their dosage and the number of repetitions. Gradually add exercise for coordination and balance.

In the recovery period, there may be a problem such as limiting the amount of movement in the joint, as well as reducing the level of endurance. Proceeding from this, the main task of the recovery period is the resumption of the impaired function and the patient's working capacity.

Massage appoint for the second day after stretching. It must be done very carefully, so as not to cause pain to the injured, because in another case it can be provoked deterioration of the state of the injured area.

At the beginning of the course, massage is done only above the affected area. Suction massage( to relieve swelling) do 1-2 times a day for an average of 10 minutes. With a gradual transition to the injured site, the duration of the massage session is increased to 15 minutes.

Occupational therapy is widely used to return a person to their labor duties. For this, exercises that are as close as possible to the professional activity of the person being rehabilitated are used.

Criterion for the return of work capacity is a good amplitude of movements in the injured joint, as well as the quality of performing household tasks( self-service).

With correctly selected treatment and a course of rehabilitation measures, the forecast of any degree of stretching is favorable.

Rev.doctor of traumatologist-orthopedist Savchenko V.R.