Sprain Management
Initial Management
- A person with a painful extremity injury that limits use should avoid activities that cause pain and seek medical attention 2
- Exercise therapy should be started as soon as possible to recover joint functionality 1
- Functional support (preferably a brace) is recommended over immobilization 1
- NSAIDs may be used to reduce pain and swelling in the acute phase 1
- Cold therapy (ice) can be applied for pain and swelling, limited to 20-30 minutes per application without direct contact on the skin 2
- RICE (Rest, Ice, Compression, Elevation) alone is not recommended as a treatment modality for sprains 1
Functional Support Options
- Braces are preferred over other types of functional support for optimal outcomes 1
- A compression wrap may be considered after an acute sprain to promote comfort, but should be applied without compromising circulation 2
Exercise Therapy Protocol
- Supervised exercises focusing on proprioception, strength, coordination, and function are strongly recommended 1
- For recurrent sprains, exercise therapy should be incorporated into regular training activities 1
Return to Activity
- Functional treatment allows patients to return to sports approximately 4.6 days sooner than immobilization 4
- A functional approach with early weight-bearing leads to the fastest resumption of work and daily activities 1
Follow-up Care
- Late physical examination (4-5 days post-injury) is advised to come to conclusions on the severity of the ligament damage when swelling has decreased 1
Common Pitfalls to Avoid
- Complete immobilization should be avoided as it shows no benefits compared to functional treatment 1
- Prolonged rest delays recovery and is not recommended 1
- Delaying the initiation of exercise therapy should be avoided, as early movement promotes better healing 1