Most people can return to their usual activities within 6 weeks.

In the event of a moderate or severe sprain, it is not uncommon for there to be sequelae, such as ankle pain or instability. The risk of recurrence is also higher.

Acute phase

During the 3 days (72 hours) following the trauma, treatment forsprain is based on the principle RGCE (rest, ice, compression, elevation). The goal of this treatment is to stop the bleeding typical of moderate and severe sprains.

RGCÉ

• Repos. If the pain is severe, the injured limb should be rested, but not for more than 48 to 72 hours. In the vast majority of cases, a longer period of rest is undesirable, as use of the joint promotes healing. Pain is the best guide: just put on the weight you can endure without too much pain and gradually increase that weight. If necessary, use crutches to reduce pain during walking in the case of a sprained knee or ankle. In some cases, it is better to immobilize the joint (see below).
• Ice. Apply ice as soon as possible to minimize swelling (see tips below). Ice relieves pain, reduces inflammation, and decreases swelling by constricting blood vessels. It can also decrease the bleeding if there has been a torn ligament.
• Compression. Wrap the affected area with an elastic bandage to reduce swelling and bruising and to support injured ligaments. Do not squeeze too hard so as not to cut off the blood circulation.
• Elevation. Keep the injured limb in an elevated position. The injured limb must be elevated 10 cm higher than the heart (sitting with the foot on a stool is not effective). If possible, maintain the elevation for 2 to 3 hours each day, until the pain and swelling subsides. The elevation helps blood flow back to the veins and limits the buildup of inflammatory fluid around the injured area.

pharmaceuticals

Acetaminophen-type pain relievers (Tylenol®, Atasol®) can help relieve pain. pain. Medication anti-inflammatory, like ibuprofen (Advil®, Motrin®), are conventionally used in the acute phase (for 2 or 3 days), in addition to compression and the application of ice. They help relieve pain. However, there is no evidence that they speed healing. The inflammatory reaction is also part of the tissue repair process. People who take anti-inflammatory drugs should be careful about their effects on the stomach, which can be major (stomach pain, digestive bleeding, ulcers, etc.). Follow the dosage carefully.

Immobilization

If the elbow or shoulder is affected, support the arm with a scarfMore avoid immobilizing it for more than 2 or 3 days, because these joints become stiff very quickly. A sprain moderate or severe may require the use of orthosis so as not to aggravate the lesion. The doctor can prescribe one. The orthosis limits movement in the axis of the injured ligaments, but allows other movements. They are available for all types of joints. According to a meta-analysis, the use of a ankle brace laced would allow quicker resorption of swelling in the ankle in the short term than elastic bandage or “taping”⁶. In the event of a serious sprain, immobilization can be considered using a plaster for ten days¹.

surgery

It is sometimes considered in the event ofsprain severe, especially in people who use the damaged joint intensively, such as athletes, or with persistent joint instability.

Rehabilitation period

The resumption of usual activities is gradual. From exercices proprioception, exercise with elastic bands and on balance boards promote recovery and reduce the risk of recurrence. They help the ligaments to regain their full capacity, reduce stiffness and strengthen the muscles which have often been atrophied by the limitation of activities. A rehabilitation therapist (physiotherapist or sports physiotherapist) is able to suggest such adapted exercises, to be practiced at home.

Treatments physiotherapy (massages, ultrasounds, mobilizations, etc.) can be part of the treatment, but are usually not essential for a good recovery.