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Overview of Sprains and Other Soft Tissue Injuries
Key Points
Compartment syndrome and injuries that disrupt arterial supply threaten limb viability and may ultimately threaten life; these problems are very rare with sprains and strains. Check for fractures and dislocations, and consider spontaneously reduced dislocations, as well as ligament, tendon, and muscle injuries; sometimes part of this evaluation is deferred until fracture is excluded. Consider referred pain and examine the joints above and below the injured area, particularly if physical findings are normal in a joint that patients identify as painful (eg, shoulder pain in patients with a sternoclavicular joint injury). X-rays are not necessary for many injuries, including ankle sprains. MRI can be used to diagnose soft-tissue injuries. Immediately treat serious associated injuries and splint unstable injuries, and as soon as possible, treat pain. Treat most minor injuries with PRICE (protection, rest, ice, compression, elevation). Provide patients with explicit, written instructions about cast care. Encourage patients, especially older patients, to do the recommended exercises to maintain range of motion and muscle strength. 