Editing Sprain (section)

== Treatment ==
Treatment of sprains usually involves incorporating [[Conservative treatment|conservative measures]] to reduce the signs and symptoms of sprains, surgery to repair severe tears or ruptures, and rehabilitation to restore function to the injured joint. Although most sprains can be managed without surgery, severe injuries may require tendon [[grafting]] or ligament repair based on the individual's circumstances.<ref>{{Cite journal|last1=Petersen|first1=Wolf|last2=Rembitzki|first2=Ingo Volker|last3=Koppenburg|first3=Andreas Gösele|last4=Ellermann|first4=Andre|last5=Liebau|first5=Christian|last6=Brüggemann|first6=Gerd Peter|last7=Best|first7=Raymond|date=August 2013|title=Treatment of acute ankle ligament injuries: a systematic review|journal=Archives of Orthopaedic and Trauma Surgery|volume=133|issue=8|pages=1129–1141|doi=10.1007/s00402-013-1742-5|issn=0936-8051|pmc=3718986|pmid=23712708}}</ref> The amount of rehabilitation and time needed for recovery will depend on the severity of the sprain.<ref name=":6">{{Cite web|url=https://www.health.harvard.edu/pain/recovering_from_an_ankle_sprain|title=Recovering from an ankle sprain|last=Publishing|first=Harvard Health|website=Harvard Health|date=8 February 2007|access-date=2020-04-21}}</ref>

A foot sprain is an injury to the ligaments that connect bones within the foot. The recovery process for a foot sprain is crucial for restoring normal function and preventing future injuries. This article outlines the general approach to foot sprain recovery, which varies depending on the severity of the injury.<ref>{{Cite web |date=2024-04-19 |title=Stepping Up Your Game: Mastering Foot Sprain Recovery |url=https://revivalpt.net/foot-sprain-recovery/ |access-date=2024-05-16 |website=revivalpt.net |language=en-US}}</ref>

=== Non-surgical ===
Depending on the mechanism of injury, joint involvement, and severity, most sprains can be treated using conservative measures following the acronym [[RICE (medicine)|RICE]] within the first 24 hours of sustaining an injury.<ref>{{MedicalMnemonics|235|||}}</ref> However, it is important to recognize that treatments should be individualized depending on the patient's particular injury and symptoms.<ref>{{Cite journal|last1=van den Bekerom|first1=Michel P.J|last2=Struijs|first2=Peter A.A|last3=Blankevoort|first3=Leendert|last4=Welling|first4=Lieke|last5=van Dijk|first5=C. Niek|last6=Kerkhoffs|first6=Gino M.M.J|date=August 2012|title=What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?|journal=Journal of Athletic Training|volume=47|issue=4|pages=435–443|doi=10.4085/1062-6050-47.4.14|issn=1062-6050|pmc=3396304|pmid=22889660}}</ref> Over-the-counter medications such as [[non-steroidal anti-inflammatory drugs]] (NSAIDs) can help relieve pain, and [[Topical medication|topical]] NSAIDs can be as effective as medications taken by mouth.<ref>{{cite journal | vauthors = Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ | title = Topical NSAIDs for acute musculoskeletal pain in adults | journal = The Cochrane Database of Systematic Reviews | volume = 6 | issue = 6 | pages = CD007402 | date = June 2015 | pmid = 26068955 | doi = 10.1002/14651858.CD007402.pub3 | pmc = 6426435 }}</ref>

* '''Protect:''' The injured site should be protected and immobilized, as there is an increased risk of recurrent injury to the affected ligaments.<ref name=":1">{{cite journal | vauthors = Bleakley CM, O'Connor SR, Tully MA, Rocke LG, Macauley DC, Bradbury I, Keegan S, McDonough SM | title = Effect of accelerated rehabilitation on function after ankle sprain: randomised controlled trial | journal = BMJ | volume = 340 | pages = c1964 | date = 10 May 2010 | pmid = 20457737 | doi = 10.1136/bmj.c1964 | doi-access = free }}</ref>
* '''Rest:''' The joint affected should be immobilized and bearing weight should be minimized. For example, [[walking]] should be limited in cases of [[sprained ankle]]s.<ref name="AAOS">{{cite web|url=http://orthoinfo.aaos.org/topic.cfm?topic=A00150 |title=Sprained Ankle |access-date=2008-04-01 |date=March 2005 |publisher=American Academy of Orthopaedic Surgeons}}</ref>
* '''Ice:''' Ice should be applied immediately to the sprain to reduce swelling and pain.<ref>{{Cite journal|last1=Hubbard|first1=Tricia J.|last2=Denegar|first2=Craig R.|date=2004|title=Does Cryotherapy Improve Outcomes With Soft Tissue Injury?|journal=Journal of Athletic Training|volume=39|issue=3|pages=278–279|issn=1062-6050|pmid=15496998|pmc=522152}}</ref> Ice can be applied 3–4 times a day for 10–15 minutes at a time or until the swelling subsides and can be combined with a wrapping for support.<ref name="AAOS" /> Ice can also be used to numb pain but should only be applied for a short period of time (less than twenty minutes) for this purpose.<ref>{{cite journal | vauthors = Cramer H, Ostermann T, Dobos G | title = Injuries and other adverse events associated with yoga practice: A systematic review of epidemiological studies | journal = Journal of Science and Medicine in Sport | volume = 21 | issue = 2 | pages = 147–154 | date = February 2018 | pmid = 28958637 | doi = 10.1016/j.jsams.2017.08.026 }}</ref> Prolonged ice exposure can reduce blood flow to the injured area and slow the healing process.<ref>{{Cite journal|last1=Singh|first1=Daniel P.|last2=Barani Lonbani|first2=Zohreh|last3=Woodruff|first3=Maria A.|last4=Parker|first4=Tony J.|last5=Steck|first5=Roland|last6=Peake|first6=Jonathan M.|date=2017-03-07|title=Effects of Topical Icing on Inflammation, Angiogenesis, Revascularization, and Myofiber Regeneration in Skeletal Muscle Following Contusion Injury|journal=Frontiers in Physiology|volume=8|pages=93|doi=10.3389/fphys.2017.00093|issn=1664-042X|pmc=5339266|pmid=28326040|doi-access=free}}</ref>
* '''Compression:''' Dressings, bandages, or wraps should be used to immobilize the sprain and provide support. When wrapping the injury, more pressure should be applied to the [[distal]] end of the injury and decrease in the direction of the heart. This helps circulate the blood from the extremities to the heart. Careful management of swelling through [[cold compression therapy]] is critical to the healing process by preventing further pooling of fluid in the sprained area. However, compression should not impede circulation of the limb.<ref name="AAOS" />
* '''Elevation:''' Keeping the sprained joint elevated (in relation to the rest of the body) can minimize swelling.<ref name="AAOS" />

Other non-operative therapies including the [[continuous passive motion|continuous passive motion machine]] (moves joint without patient exertion) and cryocuff (type of cold compress that is activated similarly to a blood pressure cuff) have been effective in reducing swelling and improving range of motion.<ref>{{Cite journal|last1=Liao|first1=Chun-De|last2=Tsauo|first2=Jau-Yih|last3=Huang|first3=Shih-Wei|last4=Chen|first4=Hung-Chou|last5=Chiu|first5=Yen-Shuo|last6=Liou|first6=Tsan-Hon|date=April 2019|title=Preoperative range of motion and applications of continuous passive motion predict outcomes after knee arthroplasty in patients with arthritis|journal=Knee Surgery, Sports Traumatology, Arthroscopy|volume=27|issue=4|pages=1259–1269|doi=10.1007/s00167-018-5257-z|issn=1433-7347|pmid=30523369|s2cid=54446697|doi-access=free}}</ref>  Recent studies have shown that traction is just as effective as the RICE technique in treating ankle sprains in pediatric patients.<ref>{{Cite journal|last1=Iammarino|first1=Kathryn|last2=Marrie|first2=James|last3=Selhorst|first3=Mitchell|last4=Lowes|first4=Linda P.|title=Efficacy of the Stretch Band Ankle Traction Technique in the Treatment of Pediatric Patients with Acute Ankle Sprains: A Randomized Control Trial|date=February 2018|journal=International Journal of Sports Physical Therapy|volume=13|issue=1|pages=1–11|doi=10.26603/ijspt20180001|issn=2159-2896|pmc=5808004|pmid=29484236}}</ref>

=== Functional rehabilitation ===
The components of an effective rehabilitation program for all sprain injuries include increasing the range of motion of the affected joint and progressive muscle strengthening exercises.<ref>{{Cite journal|last1=Keene|first1=David J|last2=Williams|first2=Mark A|last3=Segar|first3=Anand H|last4=Byrne|first4=Christopher|last5=Lamb|first5=Sarah E|date=2016-02-25|title=Immobilisation versus early ankle movement for treating acute lateral ankle ligament injuries in adults|journal=Cochrane Database of Systematic Reviews|doi=10.1002/14651858.cd012101|s2cid=74861780 |issn=1465-1858|doi-access=free}}</ref> After implementing conservative measures to reduce swelling and pain, mobilizing the limb within 48–72 hours following injury has been shown to promote healing by stimulating [[growth factor]]s in musculoskeletal tissues linked to cellular division and [[Extracellular matrix|matrix]] remodeling.<ref name=":6" />

Prolonged [[Muscle immobilization|immobilization]] can delay the healing of a sprain, as it usually leads to [[muscle atrophy]] and weakness.<ref>{{Cite journal|last1=Mattacola|first1=Carl G.|last2=Dwyer|first2=Maureen K.|date=2002|title=Rehabilitation of the Ankle After Acute Sprain or Chronic Instability|journal=Journal of Athletic Training|volume=37|issue=4|pages=413–429|issn=1062-6050|pmid=12937563|pmc=164373}}</ref> Although prolonged immobilization can have a negative effect on recovery, a study in 1996 suggest that the use of bracing can improve healing by alleviating pain and stabilizing the injury to prevent further damage to the ligament or re-injury.<ref name="familydoctor">{{cite web|url=https://811.novascotia.ca/health_topics/ankle-sprains-healing-and-preventing-injury/ |title=Ankle Sprains: Healing and Preventing Injury|author=familydoctor.org editorial staff|publisher=American Academy of Family Physicians|date=2010-12-01 |orig-year=Created:1996-01-01}}</ref> When using a brace, it is necessary to ensure adequate blood flow to the extremity.<ref name=":2">{{Citation|last1=Hsu|first1=Hunter|title=Forearm Splinting|date=2019|url=http://www.ncbi.nlm.nih.gov/books/NBK499980/|work=StatPearls|publisher=StatPearls Publishing|pmid=29763155|access-date=2019-03-12|last2=Siwiec|first2=Ryan M.|name-list-style=vanc}}</ref> Ultimately, the goal of functional rehabilitation is to return the patient to full daily activities while minimizing the risk of re-injury.