Sprains, Strains, and Fractures ARE DEBILITATING WHEN IGNORED: BE CAUTIOUS

Last Saturday, our son joined his teammate for a local tournament. The match was a competition against teams in neighboring estates. When he came back, or rather, driven home, he could barely walk. Both his ankles were swollen, and he walked with a limp. However, his spirit was high for being voted the best defender of the season! It was not the first time, and I can promise you, it will not be the last. My fingers are closed, hoping that he will tire of all sprains and strains and give up on football. His case is not exceptional because sprains, strains, and fractures are common incidences. To bridge the health gap, we shall define sprains, strains, and fractures, signs and symptoms, risk factors, first aid, indications for advanced medical care, and prevention.

Sprains

A sprain is an injury that causes tearing and overstretching of groups of muscles called ligaments that connect a bone to another bone within a joint. Most of the sprains affect the joints of the ankle, knee, and wrist. The immediate effect of a strain is that it limits function and movements.

Strains

A strain is a painful injury that occurs due to stretching and tearing off muscles attached to bones. Common causes of muscle strains are overuse or fatigue. Strains occur on the lower back, behind the neck, or lower part of the thigh. It can also affect the muscles of the shoulders due to heavy lifting.

Symptoms of Sprains and Strains

• Loss of function of the affected part may be the first sign that you have a sprain or a strain. In severe cases, total immobilization may occur.
• The affected part appears tender when touched and visibly swollen at the ankle, knee, or wrist.
• There may be bruising if the sprains or strains are due to a fall or grinding on a rough surface.
•  Walking with a Limp to relieve weight on the affected joints may be evident. 
• Muscle cramps or muscle pull. 

Risk factors for sprains and strains

• To the athletes, muscle sprains and strains occur due to inadequate preparation and warm-up before a match.
• Uneven ground causes the limbs to turn or twist.
• When lifting very heavy weights, the muscles of the arms are stretched and stressed.
• Sitting in a poor position for a very long time
• Higher body mass index (BMI), Being overweight exerts pressure on joints.
• Fatigued muscles are likely to tear off easily.

First Aid for Sprains and strains

• Try and immobilize the affected part. By immobilizing, weight-bearing is relieved. Splint, braces, and crutches are all effective in relieving pressure on the affected area. Choose the most appropriate.
• Apply ice cubes on the injured part to relieve swelling. Do not apply ice cubes directly to the skin. Wrap with a cloth or towel. Place the ice cube for about 20 minutes each time. During the first 12 hours, apply the wrapped ice cubes /ice bag more frequently, observe the nature of swelling. 
• Before the strains or sprains resolve, apply ice cubes every four hours until the swelling subsides.
• Compression reduces swelling. Wrap site with a bandage, do not wrap tightly as this can cause a reduction in the blood supplied to the limp below the injury, with dire consequences.
• Raise the affected part. Elevate the injured part above the heart level to reduce pressure on the area. Rest the affected limb on pillows to rest the foot.
• Rest. Getting relieved from routine works to allow the injury time to heal.

When to seek advanced medical care

• Swelling does not subside.
• Pain is not relieved after the first aid, and a substantial amount of time has erupted since the injury.
• Numbness of extremities.
• Cannot move or bear the weight on the injured limb
• There is a rise in temperature, an indication of inflammation.

Fractures

A fracture is a loss of bone integrity leading to a full or partial breakage. The fracture can be small cracks or can have a complete breakage.

Risk factors for fractures

Advancing age– As one advance in age, there is an increase in bone loss, leading to fragile bones that are more prone to fracture. Change of gait and high risks of stripping and falling common in old age increase risks of fractures

Gender- Women get more fractures than men. Generally, women have small and weak bones. Hormonal changes at menopause increase the risks of bone loss and bone fragility, the risk for fractures.

Smoking. Studies have shown a close relationship between quality of bone density and smoking. Some of the pathways that smoking increase bone loss is through poor oxygen supply to bone tissues, slow growth of bone producing cells, and poor calcium absorption, the mineral needed for bone formation

Alcoholism. Heavy consumption of alcohol increases the risk of bone loss and fracture in later years. Another factor that increases the risk of fractures in heavy drinkers is poor diet.  

Medication. Long-term corticosteroids for inflammation affect bone density causing fragility, a precursor to fractures. 

Chronic diseases. Type 2 diabetes, rheumatoid arthritis, and some forms of cancers increase the risks of fractures in adults. Diabetes is a risk factor for bone fracture is multi-direction, complications arising from poorly controlled blood sugar leading to loss of vision, increasing the risk of fall that can cause bone fracture.                                                                                       

History of a previous fracture. When a previous fracture heals, it creates a weakness that causes recurrent future fractures due to external stresses. Studies have shown that once a fracture has occurred and healed, there is a high chance that another fracture is almost definite to occur at the same place.

Family history of hip or other types of fractures

Evidence indicates a positive relationship of a family member with hip fracture to increased risks of future fractures of close relatives.

Signs and Symptoms of bone fractures

There are different types of bone fractures. Some may be internal under the skin, while others, the fracture protrudes out of the skin. Whichever type of fractures, there are definite signs and symptoms;

• The first sign is a deformity or depression on the surface instead of a continuous alignment.
• Disability, the affected part of the bone cannot function, rendering the person immobile, particularly with fractured limbs.
• There is pain and discomfort. A broken bone that pieces the skin causes a sharp pain that gets worse with even slight movement.
• There may be obvious signs of broken bone protruding from the skin, and bleeding may be present.
• Fractures of large bones of the thigh, pelvis, or hip joints. If a large blood vessels is injured, it causes severe bleeding. In this case watch for signs of shock; progressive loss of consciousness, shallow breathing, pale lips, and low blood pressure.

First Aid of Bone Fractures on site of the accident

The goal of first aid in fracture management is to immobilize the fractured bone, stop bleeding, and plan for medical attention.     

• Ensure that you are safe, to be able to help the casualty
• Assess the level of damage to the fractured limb
• If there is broken skin and blood is oozing out, cover with a clean dressing and apply external pressure to stop the bleeding, do not put pressure on a protruding bony fragment.
• The casualty (injured person) should not move the affected limp to prevent more damage.
• Support the fractured limp by holding the joints above and below to arrest any form of movement.
• If available, place two padded supports around the injured part.
• Meanwhile, get someone to alert the emergency services who will conduct more immobilization safely and transport the injured person to the hospital.

Prevention of Sprains, strains, and fractures

Sprains, strains, and fractures are preventable, appropriate preventive measures to observe include;

• Nutrition. A well-balanced diet builds quality muscles that can withstand stress. A diet rich in calcium and vitamins is necessary for bone health.
• Physical activity. Always warms up before performing high-intensity physical activity. Also try to avoid excessive bodily contact that can lead to injuries.
• Safe work environment, clear any debris at work environment that can increase trips and falls.
• Use caution when walking on slippery or wet floors,
• Wear appropriate personal protective equipment such as gumboots. Poor-fitting equipment can cause trips and falls.
• Avoid walking on uneven ground where twists and turns are likely to occur if you must be very cautious. 
• Routine exercise supports the bone structure and muscles and improves balance.