Monday, April 22, 2013

Series Post: Ask Dr. Dina - Sprains and Strains

DISCLAIMER: I am not a doctor, nor do I play one on TV. I do not hold a current medical license or certification (I let them lapse because I no longer work in the medical field and don't intend to ever again). What I do have is an extensive medical background in various fields. Everything you read here is the result of either education, training, research and interpretation, or personal experience. The information in this post is not to be taken as a substitute for professional medical advice or examination. Seriously, if you're having an immediate medical problem and you're reading this blog for help, get off the damned computer and call an ambulance! 

Welcome back, Evil Readers! Or rather, welcome back, Gothic Goddess (that would be me)! Yes, I've been away the last few posts, but it's not because I don't love you.

Oh, wait. I don’t love you. Oh, well! Never mind then.

Anyway! Today we continue our "Ask Dr. Dina" series with sprains and strains. You may remember last time we talked about breaking stuff, so I thought it only fair to give soft tissue injuries their say.

Now, there are various kinds of soft tissue injuries – bruises (these have varying degrees and names, so this will be a fun post to write!), pulled muscles, "stitches" (the kind in your side you get when you run, not sutures used for cuts), sprains, strains, and many more.

Each kind of injury will probably get its own post of a sort, so today we're going to concentrate on sprains and strains.

There's a vast difference between them, but you'll hear people say, "I sprained my ankle." Chances are, no, they didn't. If you can walk on it afterward, you didn't sprain it. You twisted it and strained the tendon, but most likely did not "sprain" it, and I'll tell you why.

Which is which? Well, remember it like this: ligaments LINK bone to bone. Tendons JOIN muscle and bone. Easy mnemonic. Ligaments LINK. Tendons JOIN.

Also, spraIn = lIgament, sTrain = Tendon.

Also, sprains tend to be caused by trauma (sports injuries, kicks, body blows, falls) whereas strains are generally overuse/repetitive motion injuries (running, working out, taking the stairs instead of the elevator). 

Sprains hurt like a mother and take a longer time to heal. There's usually tearing and popping and sometimes (more often than not, actually) surgery is needed to repair the damage a sprain does. You've heard of athletes tearing their ACL? That's medical speak for "you fucked up your knee." I mean, "you tore the anterior cruciate ligament" (which is located beneath your kneecap and connects to your tibia).

Strains usually make a muscle twitch, or feel weak (because you strained it, remember), but you can still move it without too much pain or effort. For instance, if your wobbly ankle feels a little better after a few minutes and you're able to bear weight/walk on it, it's NOT sprained. It's "strained."

Sprains, you ain't goin' anywhere fast. There's usually swelling, bruising, and lots and lots of pain and you can't poke it let alone put any pressure on it without it hurting. It's more than weak; it's non-functional. You've seen athletes being carried off the field because they can't walk? Now you know a little more about what's possibly going on.

Don't feel bad if you've misused the term before, either in real life or in fiction. Even doctors use the terms wrongly, unless they specialize in orthopedics. Common use of "sprained ankle" just adds to the problem, but this is why we have blog posts like these, so you can avoid the misnomer. 

And so you can avoid potential misdiagnosis should you ever be in this situation yourself. Remember, strain = stretched (sometimes torn)/tendon, sprain = (usually torn) ligament. Sprains are usually worse than strains, though both (depending on location and severity) can take months of physical therapy to rehabilitate.

Now, surgery and physical therapy aside, the treatment for both a mild sprain and a moderate strain are the same – rest the affected area, ice, compression, elevation (if possible – kind of hard to elevate a low back strain). With both types of injuries there's going to be pain, swelling, and BOTH should be seen by a doctor.

Without the proper training, you generally can't tell from looking whether your injury is a sprain or a strain. Pain is always bad and both injuries hurt, and if something hurts you should see your health care professional as soon as possible. Sure, they might just tell you "go home, rest, take some ibuprofen, put some ice on it," but that's better than needing cruciate repair surgery and not getting it done because you were too stubborn to let someone look at your hurt knee. So go see someone for both, especially if you've done all of the above and things aren't getting any better.

Remember these things for your characters, too. If you're going to injure your character, remember that some injuries, even if they seem mild, can take months to heal.

Next time we'll talk about cuts, scrapes, and bruises!

Questions about medical issues with your writing? Leave them in the comments below and I'll get back to you as soon as I can. (THESE MUST APPLY TO FICTIONAL SITUATIONS ONLY. I AM NOT YOUR DOCTOR, NOR A SUBSTITUTE FOR ONE.)

Oh, and the winner of our Andrew Shaffer ELEW Anniversary Giveaway is Shannon Ginther! Shannon, I'll be contacting you shortly!


  1. Great information. Having played sports myself, as well as my son I have never had this explained as thouroughly as you have here Dina.

    Not only depending on the severity of the strain/sprain sometimes its not just months but a permanent gimp you have when all is said and done. I have an ankle that has a mind of its own after being dislocated once (sprain) and moderate to severe sprains over the course of a couple of years. It just likes to fold over for whatever reason, gum, light breeze..etc etc...I have to wear hiking type boots for walking long distances, and I am very aware of my footing (no hooker heels for me) because I could go down like a ton of bricks with no notice.

    Most "hero" types in writing seems to recover in short order with little repercussions to their re-occuring injury or gimp due to life style/fighting style.

  2. You got anything for writers-eyeballs? You know, when they get all gelatinous and hurty. : )


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