How to deal with a sprain? You need to know these 4 points as soon as possible!

In life, we may suffer sprains due to strenuous exercise, improper posture when carrying or holding weights, or accidental falls, pulling, and excessive twisting. It may even happen while walking, going up and down stairs, etc. But what to do after a sprain is the most critical. Once a sprain occurs, if the situation is not particularly serious or medical treatment is inconvenient, many people will choose to deal with it themselves. Compared with the method of "applying medicated wine for massage", which requires a certain amount of practical experience, the "a towel + a basin of water" method is simpler and easier. However, if you think about it carefully, you will find that there seems to be both cold and hot compresses after a joint sprain, but which one is correct is blurred for a moment.

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After a joint sprain, should we apply heat or cold? To understand this question, we must first know what changes have taken place in our body after a joint sprain.

01. What is a sprain?

Sprain refers to injuries to the muscles, tendons, ligaments, blood vessels, etc. in the joints of the limbs or the body. The main manifestations are pain in the injured area, poor joint movement, followed by swelling. Although there is no fracture, dislocation, or skin damage in the injured area, the skin is red or cyanotic. It often occurs in the joints of the waist, ankle, knee, shoulder, elbow, hip, etc. After the sprain, if the patient has symptoms such as limited movement, obvious pain, suspected deformity, or even bone friction, he should seek medical attention in time. Since the signs of sprain are very similar to those of fractures, they must be examined by medical professionals to be confirmed. How to deal with it urgently, read on~~~

Stop movement: Stop activity immediately after injury to keep the injured part still and reduce further damage.

Ice: It is best to apply ice to the injured area as soon as possible within a few minutes after the injury. This can relieve pain and swelling, reduce the possibility of adhesion, and speed up healing. When applying ice, put a towel under the ice to prevent damage to the skin or ice water from penetrating into the joint. Apply ice for 30 minutes.

Compression: To further prevent swelling, crush the ice into a plastic bag and wrap it with an elastic bandage. Keep it on for 30 minutes, then unwrap it for 5-15 minutes and wrap it again. Leave the toes or limbs exposed to ensure adequate circulation. If the toes turn purple, unwrap the bandage and wrap it gently. This compression bandage can be used for 24 hours, but it depends on the condition of the joint.

Elevation: Elevate the injured joint to prevent fluid from seeping into the joint and surrounding tissues. During the first 24 to 48 hours of healing, swelling and pain will subside and the joint will be able to move properly. Place the joint in hot water and slowly move the joint in all directions, but do not exceed a certain range.

Drug treatment: Pain can be treated with oral nonsteroidal anti-inflammatory drugs, such as ibuprofen, diclofenac sodium, lexolofen sodium, etc. You can also use external medicines that can promote blood circulation, dissipate blood stasis, reduce swelling and relieve pain, such as Yunnan Baiyao aerosol, diclofenac sodium ointment, and traditional Chinese medicine external application preparations that reduce swelling and relieve pain. Traditional Chinese medicine bone setting and massage combined with acupuncture therapy can also achieve good therapeutic effects.

02. Will rubbing, hot compressing, and applying medicated oil aggravate the condition?

In the early stage after a sprained ankle, the surrounding soft tissue is often in a state of exudation and congestion. If the method of promoting blood circulation and removing blood stasis is used in the early stage, it will promote the continued bleeding of the tissue and aggravate the swelling. Therefore, hot compresses and medicated oils are inappropriate. Similarly, rubbing and rotating the injured ankle joint, such as massage, will also aggravate the continued bleeding of the injured soft tissue and lead to aggravated local swelling.

In addition, do not rush to take off your shoes after a sprained ankle, especially tight boots, as this may cause secondary injury.

03. Pay attention to the following 4 stages

Joints are important structures that connect two parts of the human skeleton. They are responsible for the transmission and buffering of human forces and the fulcrum of bone movement. When a joint is sprained, the first thing to be injured is the soft tissue around the joint. Strictly speaking, joint sprains mainly refer to ligament injuries. Of course, some injuries may also be accompanied by tendon, joint capsule, cartilage damage, and even fractures. Once the human body is injured, the self-repair program is also activated. The human body's response to injury is mainly divided into the following four stages.

1. Ice compress during the coagulation period is beneficial for hemostasis and pain relief

Injury can cause different degrees of rupture of small blood vessels under the skin, leading to bleeding, which is why we often see bruises after sprains. The human body's response to bleeding is mainly in the following two ways: one is the contraction of small blood vessels to stop bleeding, and the other is to start platelet aggregation and coagulation pathways to form tiny blood clots to block the rupture of blood vessels. Therefore, in this period, we usually use ice compresses to promote blood vessel contraction and reduce bleeding. At the same time, ice compresses also have a certain analgesic effect.

On the contrary, if you apply hot compresses or use medicinal wine that promotes blood circulation and removes blood stasis during this period, the small blood vessels will expand, increasing bleeding and pain. Therefore, in the early stages of a sprain, ice compresses should be applied instead of hot compresses. It is usually recommended to apply ice compresses within 24-72 hours after the injury, for 15-30 minutes each time, 3-4 times a day. If a local pressure bandage is applied to the injured joint at the same time, it can further compress and stop bleeding and reduce local swelling in the later stage - the inflammatory stage. Therefore, it is a good choice to always have a roll of elastic bandage in your home first aid kit.

2. Apply pressure bandage to reduce swelling during the inflammatory period

After the blood vessels contract in the early stage of injury, with the release of some cytokines, the blood vessels expand instead, and various inflammatory cells gradually migrate to the injured area. After the cells are damaged, toxins are released, and the permeability of blood vessels and cells increases, causing tissue swelling. Use elastic bandages to apply appropriate pressure to the injured area to reduce swelling. Of course, the pressure should be appropriate. If the pressure bandage is too tight, it will affect blood circulation, which is also inappropriate.

3. Hot compress should be applied during the granulation period

Usually, the granulation tissue will start to crawl on the skin when it grows into granular granulation tissue on the third day. The speed and specific time of the granulation tissue crawling on the skin depends on the degree of injury, nutritional status and physical fitness of the individual. During this period, fibroblasts are generated and migrate to the wound to form granulation tissue, fill the injured cracks, repair the synthesis of collagen fibers in the tissue, and new capillaries begin to form. During this period, we can start hot compress.

4 Scar formation period lasts for several months and tissue repair

This stage is a continuation of the previous stage and can last for several months. Various types of collagen fibers continue to be synthesized during this stage, and the composition is adjusted and rearranged to achieve the transformation of the scar. It is worth noting that the repaired tissue rarely recovers to its original strength and elasticity. The stress conditions at the scar often affect the composition and arrangement of collagen fibers. Excessive force or prolonged braking time may cause abnormal arrangement of collagen fibers, affecting repair, making it even more difficult for the ligament strength and elasticity to recover to their original level.

In the early stages of injury, proper immobilization (such as using elastic bandages or protective gear, or even plaster fixation) not only helps relieve pain and prevent further injury, but also helps repair tissues. After the acute phase, external immobilization measures can be removed, and appropriate activities can be performed to accelerate the regeneration of collagen fibers and the recovery of muscles and joints.

In summary, after a joint sprain, different treatment measures should be taken according to the changes in the body at different stages. If you understand the body's reaction after the above injury, you can better understand the POLICE principle for treating ankle sprains, namely protection (P-protect), appropriate weight bearing (OL-optimal loading), ice (I-ice), compression bandage (C-compression), and elevation of the affected limb (E-elevation). This principle is not only applicable to ankle sprains, but also to other joint sprains.

Minor injuries and bumps are inevitable in life. Although they will not endanger life safety, the first-time treatment and subsequent care during the recuperation period directly affect the recovery of the affected area. Relying on vague impressions and acting rashly will not only be of no help to recovery, but may even go in the opposite direction and cause more serious injuries. Paying more attention to medical popularization and accumulating correct knowledge can better solve problems at critical moments.

Source: Chongqing Tianji Network Co., Ltd.

Source: Science Popularization China, Xi'an International Medical Center North Campus, Shanghai Songjiang

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