American Medical Association Family Medical Guide - American Medical Association [686]
Diagnosis and Treatment
The doctor will evaluate the severity of your injury and may take X-rays to rule out a fracture. If the muscle is strained and does not seem to be severely damaged, he or she will probably recommend doing the RICE routine (see page 978) at home. For a more serious strain or a tear, the doctor may prescribe a pain reliever or recommend immobilizing the muscle to allow it to heal by, for example, using crutches for a leg injury or a sling for an arm injury. The doctor may also recommend physical therapy. As the pain and swelling subside, the therapist will show you how to gradually start exercising the injured muscle to help restore its movement and strength. If the muscle is torn, surgery may be necessary to repair it.
Sprained Ligament
If excessive demands are made on a joint, the ligaments that hold the neighboring bones together and keep the joint in position may be stretched or torn. This type of injury is called a sprain. Any ligament can be sprained, but the ligaments at the knees, ankles, and fingers are the most susceptible because they generally receive the greatest force.
Minor sprains cause no damage, but a joint will weaken eventually if its ligaments are repeatedly stretched and torn. For example, if the ankle joint is sprained often, it may begin to give way occasionally for no apparent reason. If a sprain is so severe that all the supporting ligaments are torn, the joint may be misshapen.
Symptoms
The amount of pain and tenderness from a sprained ligament depends on the extent of damage to the soft tissues that support the joint. A sprained ligament can often continue to function but is painful to use. The injury may also cause swelling and skin discoloration. If the pain from a sprain is severe or if it lasts for more than 2 or 3 days, see your doctor.
Diagnosis and Treatment
The doctor will examine your joint and may take X-rays to rule out a fracture. If you have a mild sprain and the muscle does not seem to be severely damaged, he or she probably will recommend performing the RICE routine (see page 978) at home. After a day or so, start to exercise the joint as much as possible without forcing it to bear weight. When you are not exercising the strained muscle, keep it elevated to reduce the swelling.
If you have a severe sprain, your doctor may put a cast or splint on it. Occasionally, surgery is necessary to repair torn ligaments. After ligament surgery, your joint will be immobilized in a protective brace for a short time and you will be encouraged to use the joint to avoid stiffness. Ultrasound therapy, in which high-frequency sound waves are directed at the injured area, is used for some sprains to improve circulation and promote healing. Physical therapy can usually help strengthen the joint and enable it to heal more quickly.
Torn or Severed Tendon
Tendons are long, fibrous cords that connect muscles and bones, such as those that move the fingers and toes. The muscles that move the fingers are in the forearms and hand; those that move the toes are in the calves and feet. If you cut or severely injure your forearm or hand or your calf or foot, one or more tendons may be partly torn or completely severed. The Achilles tendon, which connects the calf muscles to the end of the heelbone, is the most frequently torn tendon.
Symptoms and Diagnosis
If you cut or severely injure a tendon, you will be in extreme pain and may be unable to move one or more of your fingers or toes. Go to the nearest hospital emergency department as soon as possible if you think you may have severed a tendon.
Treatment
Depending on the severity of the injury, a surgeon may immediately reconnect the severed ends of the tendon. Tendons are elastic and are under constant tension.