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Sprains and Strains

Sprains and strains often result from sports or exercise, but can easily result from any physical activity. Sprains result from an injury to a ligament (the connective tissue that links bones together at joints), most often in the ankle, knee, elbow, or wrist. Strains are tears in muscle tissue, commonly occurring in the muscles that support the neck, thigh, groin, and ankle.

Signs and Symptoms

Sprains and strains cause pain and swelling. You may have joint instability or disability if the injury is serious, involving a muscle or ligament tear.

What Causes It?

Sprains generally result from a twisting force applied to a joint while it is bearing weight, which causes the ligament to stretch beyond its natural limit. Muscle strains occur when the weight load on a muscle is greater than what the weakest part of the muscle can bear. Strains usually occur during activities that require a muscle to be stretched and bear weight at the same time. You are at risk for a sprain or strain if you do the following.

 

bulletExercise without warming up properly
bulletUse athletic equipment that does not fit properly
bulletParticipate in sports and activities that you are not conditioned for

 

What to Expect at Your Provider's Office

Your health care provider may take an X ray. If your injury is severe, he or she may also order an MRI. You may need to have the injured limb wrapped in an elastic bandage or put in a soft cast.

Treatment Options

Treatment Plan

Pain relievers help to reduce swelling of sprains and strains as well as relieve pain. Pain relievers should not be used to mask pain in order for you to resume an activity. For the first several days your health care provider will recommend RICE (rest, ice, compression, and elevation). Limit activity that involves the injured area for at least seven days. Ice reduces pain, bleeding, and swelling. Wrap ice in a towel, and do not apply directly to the skin. The affected area may be taped, wrapped in elastic bandage, or put in a cast depending on the severity. Elevate the affected area or joint.

Drug Therapies

Prescription

 

bulletNonsteroidal anti-inflammatory drugs—such as naproxen, reduce pain and inflammation; various side effects

 

Over the Counter

 

bulletAspirin, ibuprofen, acetaminophen—reduce pain and inflammation; various side effects

 

Complementary and Alternative Therapies

Specific nutrients and herbs may help restore the integrity of connective tissue, reduce swelling, and provide pain relief.

Nutrition

 

bulletVitamin C (1,000 to 1,500 mg three times a day) to reduce swelling and support connective tissue.
bulletBromelain (250 to 500 mg three times a day between meals) helps reduce swelling.
bulletBeta carotene (50,000 IU per day) is needed to make collagen.
bulletZinc (15 to 30 mg per day) helps you heal faster.
bulletVitamin E (400 IU/day) has antioxidant effects.
bulletAdequate protein intake is important.

 

Herbs

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

Bioflavanoids are found in dark berries and some plants. They help reduce swelling and strengthen the tissues that are affected by sprains and strains. The following may be taken in dried extract form as noted.

 

bulletQuercetin: 250 to 500 mg three times a day
bulletHawthorn (Crataegus oxyacantha): 500 mg three times a day
bulletTurmeric (Curcuma longa) makes the effect of bromelain stronger. Take 250 to 500 mg each of turmeric and bromelain, three times a day between meals.

 

The following combination of herbs reduces spasm and stimulates cirulation. Black cohosh (Cimicifuga racemosa), cramp bark (Viburnum opulus), Jamaican dogwood (Piscidia erythrina), feverfew (Tanacetum parthenium), poke root (Phytolacca americana), and valerian (Valeriana officinalis). Combine equal parts in a tea (1 cup three to four times per day), or tincture (15 drops every 15 minutes until you feel better, up to eight doses; or 20 to 30 drops four times per day).

Homeopathy

Some of the most common remedies used for this condition are listed below. Usually, the dose is 12X to 30C every one to four hours until your symptoms get better.

 

bulletArnica montana for acute injury with bruised sensation and sensitivity to pressure
bulletRhus toxicodendron for sprains and strains with great restlessness
bulletRuta graveolens for stiffness and pain from injury or chronic overuse
bulletTopical homeopathic creams containing leopard's bane (Arnica montana) or St. John's wort (Hypericum perforatum) may provide pain relief. Do not apply over broken skin.
bulletArnica oil may be applied topically for pain relief, provided the skin is not broken.

 

Physical Medicine

Castor oil pack. Apply oil directly to skin, cover with a clean soft cloth and plastic wrap. Place a heat source over the pack and let sit for 30 to 60 minutes. For best results, use for three consecutive days.

Acupuncture

Acupuncture may provide pain relief and increase local circulation.

Massage

Therapeutic massage is effective at increasing circulation and may relieve spasm in surrounding muscle groups.

Following Up

Your health care provider probably won't need to see you again unless your injury was severe or you have complications.

Special Considerations

Be careful of recurring sprains and strains. Once a muscle or tendon is injured, it is susceptible to reinjury, especially if you return to full activity too soon. Sprains and strains are easy to prevent. Basic physical fitness and strength training with proper warm-up and cool-down reduce the stress to muscles and joints.

Supporting Research

Balch JF, Balch PA. Prescription for Nutritional Healing. Garden City Park, NY: Avery Publishing Group; 1997.

Birrer RB, ed. Sports Medicine for the Primary Care Physician. Boca Raton, Fla: CRC Press; 1994.

Blumenthal M, ed. The Complete German Commission E Monographs. Boston, Mass: Integrative Medicine Communications; 1998:429.

Brown DJ. Herbal Prescriptions for Better Health. Rocklin, Calif: Prima Health; 1996.

Kibler WB, Herring S, Press J, Lee P. Functional Rehabilitation of Sports and Musculoskeletal Injuries. Gaithersburg, Md: Aspen Publishers; 1998.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:38, 326, 330.

Null G. The Clinician's Handbook of Natural Healing. New York, NY: Kensington Publishing Corp; 1997.

Olshevsky M, Noy S, Zwang M, Burger R. Manual of Natural Therapy. New York, NY: Facts on File; 1989.

Strauss RH, ed. Sports Medicine. Philadelphia, Pa: WB Saunders Company; 1991.

Ullmann D. The Consumer's Guide to Homeopathy. New York, NY: G. P. Putnam's Sons; 1995.

Zachazewski JE, Magee DJ, Quillen WS. Athletic Injuries and Rehabilitation. Philadelphia, Pa: WB Saunders Company; 1996.