Ligament sprain: what to do and when to see a trauma doctor

How to tell it is a ligament sprain

Ligaments hold the bones of a joint together. When a joint is suddenly twisted, they overstretch and some of their fibers tear. That is why doctors often call it a ligament injury: it can range from a small tear to a complete rupture.

The most common one is a sprained ankle. The foot rolls inward when you miss a step on the stairs, a curb or an uneven road. The knee, wrist and fingers are also often affected.

Signs of a sprain:

• pain right after the injury that gets worse when you move the joint or stand on the leg;
• swelling around the joint;
• a bruise that often appears a few hours later or the next day;
• sometimes a click or crunch at the moment of injury.

How badly the ligament is damaged is for the doctor to judge. As a rough guide, with a mild sprain you can stand on the leg and the swelling is small. With a partial tear, you limp and the swelling and bruising are larger. After a complete tear it is hard to stand on the leg, and the joint feels wobbly.

You cannot always tell a sprain from a cracked or broken bone by looking, so severe pain needs an examination and often an X-ray. In children, the growth plate of a bone is weaker than the ligaments, and an injury that looks like a sprain can turn out to be a fracture. Have a doctor see your child after this kind of injury, even if they can walk.

What to do in the first 48 hours

• Rest the joint and do not walk through pain.
• Apply cold as early as possible: ice or frozen vegetables wrapped in a thin towel, for up to 20 minutes every two to three hours. Do not put ice directly on the skin.
• Wrap the joint in an elastic bandage, moderately firmly. If your toes go numb, cold or blue, the bandage is too tight, so loosen it.
• Keep your leg raised: when lying down, rest it on a pillow so that it is above the level of your heart. This helps the swelling go down faster.

Take only a painkiller your doctor has recommended, at the dose given in the leaflet.

What not to do with a sprain

For the first few days after the injury, avoid:

• heating the joint: a hot bath, a heating pad, a sauna or warming compresses, including vodka compresses, make the swelling worse;
• massaging or rubbing the injured area;
• running, going back to sports or putting weight on the leg through pain;
• drinking alcohol, which increases swelling and slows healing;
• trying to put the joint back in place yourself if it looks deformed.

When to see a trauma doctor

Go to a trauma unit (travmpunkt) or call an ambulance on 103 if:

• you cannot stand on the leg and take a few steps;
• the joint or limb is visibly deformed;
• the pain is very severe and the swelling is growing fast;
• the foot or toes are numb, cold, white or blue;
• the ankle bone or the bone along the outer edge of the foot hurts when you press on it.

They will take an X-ray there right away and, if there is a fracture, immobilize the limb.

Book an appointment with an orthopedic and trauma doctor in the next few days if you can walk but the pain and swelling do not ease within a few days, or if the joint feels wobbly and your ankle keeps giving way.

At the appointment, describe exactly how you twisted your leg, whether you heard a click and whether you could stand on it straight away. To check for a fracture or a complete ligament tear, the doctor will examine the joint, see how it moves and whether it is stable, and order an ultrasound if needed. Ultrasound of joints and soft tissues is done at the Viva Clinic polyclinic at 27a Sobornosti St, and for an X-ray, CT or MRI the doctor will give you a referral.

The Viva Clinic orthopedic and trauma doctor in Slavuta sees patients at 27a Sobornosti St or 3 Danyla Halytskoho St (the exact address is confirmed when you book). You can book by phone or on Viber. If you are not sure which doctor to see, read about the difference between a traumatologist and an orthopedist.

How to treat a sprained ligament in the leg and how long recovery takes

Most sprains are treated without surgery. The doctor will explain how long to protect the joint, whether you need a brace or crutches and when to start moving.

After the first few days of rest, the joint is gradually brought back into movement, because a joint kept still for a long time recovers more slowly. Exercises for muscle strength and balance lower the risk of the ankle giving way again. The doctor will tell you which exercises to do and when to increase the load.

A mild sprain usually feels noticeably better within one to two weeks. A more serious injury takes several weeks to heal, and recovery after a torn ligament can take months. If the pain comes back every time you increase the load, see the doctor again.

To keep the sprain from happening again, keep doing balance exercises even after the leg has stopped hurting. Warm up before training, and wear a brace during sports if your doctor has recommended one.