Treating sprains and strains

Most mild to moderate sprains and strains can often be treated at home using self-care techniques. Painkillers can also be used to ease pain.

Self-care techniques after a minor sprain or strain include:

• PRICE therapy
• avoiding HARM

These are described in more detail below.

PRICE therapy

PRICE stands for protection, rest, ice, compression and elevation.

• Protection – protect the injured area from further injury, by using a support or, in the case of an ankle injury, wearing shoes that enclose and support your feet, such as lace-ups.
• Rest – stop the activity that caused the injury, and rest the injured joint or muscle. Avoid activity for the first 48 to 72 hours after injuring yourself. Your GP may recommend you use crutches.
• Ice – for the first 48 to 72 hours after the injury, apply ice wrapped in a damp towel to the injured area for 15 to 20 minutes every two to three hours during the day. Do not leave the ice on while you are asleep, and do not allow the ice to touch your skin directly because it could cause a cold burn.
• Compression – compress or bandage the injured area to limit any swelling and movement that could damage it further. You can use a crepe bandage or a simple elastic bandage available from a pharmacy. It should be wrapped snugly around the affected area but not so tightly that it restricts blood flow. Remove the bandage before you go to sleep.
• Elevation – keep the injured area raised and supported on a pillow to help reduce swelling. If your leg is injured, avoid having long periods of time where your leg is not raised.

Avoiding HARM

For the first 72 hours after a sprain or muscle strain you should avoid HARM. This means that you should avoid:

• Heat – such as hot baths, saunas or heat packs (applying a controlled amount of heat to affected joints)
• Alcohol – drinking alcohol will increase bleeding and swelling and decrease healing
• Running – or any other form of exercise that could cause more damage
• Massage – which may increase bleeding and swelling

Moving sprained joints

Most healthcare professionals recommend you should not stop using a sprained joint because the injury will heal quicker if you begin to move the joint as soon as you are able to.

Your GP will be able to teach you a range of exercises that will help you to improve the function of the joint.

An exception may be made in cases of severe ankle sprains. Studies have found people whose ankle joint was immobilised for 10 days with a short cast recovered normal ankle function quicker than those who were treated using exercise soon after the injury occurred.

Immobilising strained muscles

The advice for muscle strains can be different. Depending on your injury, you may be advised to keep your injured muscle still for the first few days. Your doctor may arrange for a brace, cast or splint to help keep it as still as possible.

The aim of immobilising the muscle is to allow it to start healing so you can move it without tearing or pulling it again in the same place. After a few days you will probably be advised to start using the muscle again.

Treating pain

Paracetamol is usually recommended for painful sprains or strains. If this does not help, a stronger painkiller, such as codeine, only available on prescription, may be required.

Oral non-steroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen can also help reduce swelling and inflammation. However, NSAIDs should only be considered 48 hours after the injury has occurred because they affect the healing process.

Your GP may also prescribe an NSAID cream or gel, such as ibuprofen or ketoprofen, to help treat pain. You should gently apply the cream or gel to the injured area and wash your hands immediately afterwards.

Ketoprofen can make your skin sensitive to light (photophobia). Avoid exposing areas of your skin to which you have applied cream or gel to direct sunlight or artificial sources of light, such as sunlamps or sun beds.

Follow up

Your GP may ask to see you after a few days to assess how well your injury is healing.

It is also recommended you contact your GP if:

• your sprain or strain does not improve as expected – for example, you still find walking difficult
• your symptoms get worse, such as increased pain or swelling

Recovery

The length of time it takes to recover from a sprain or strain depends on how severe it is. 

Generally, after an ankle sprain you will probably be able to walk one to two weeks after the injury. You may be able to use your ankle fully after six to eight weeks and you will probably be able to return to sporting activities after eight to 12 weeks.

In cases of muscle strains, the time it can take to return to sporting activities can range widely, from two weeks to six months.