Sprains & Strains

Bureau of Workers’ Comp

PA Training for Health & Safety
(PATHS)

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 Topics

• Sprains and strains – what are they?

• Causes
• Difference between sprains and strains
• Common types
• How and where they occur
• Signs, symptoms, treatment
• Ways to prevent

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 What are Sprains & Strains?

• Sprains and strains are two types of MSDs, or

musculoskeletal disorders
• MSD’s are injuries or disorders of the:
o muscles, nerves, tendons, joints, cartilage, and
o supporting structures of the upper and lower
limbs, neck and lower back that are caused,
precipitated, or exacerbated by sudden exertion
or prolonged exposure to physical factors
(e.g. force, repetition, vibration or awkward
posture)
- CDC/NIOSH

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Causes of Sprains & Strains

• They are caused by excessive

reaching, bending, lifting,
gripping, squatting, or twisting
of hands, shoulders or body

• Caused by any work performed

with high force, with many
repetitions, or in an awkward
position

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Causes of Sprains & Strains

• A sprain is a stretch or tear of

a
ligament (band of fibrous
tissue that connects two or
more bones at a joint);
stretched too far from normal
position
• One or more ligaments
may be injured at the same
time
• Most common:

- sprained ankle PPT-053-02 5

 What’s the Difference?

• A strain is an injury to a muscle or tendon (thick,

tough fibrous cord of tissue that connects a muscle

to a bone)

• Can be as simple as overstretching a muscle or

tendon, or it can be a partial or
complete tear

• Most common: strained back

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Examples of Sprains & Strains
• Back injuries, including pulled back muscles and
ruptured discs
• Squashed nerves causing severe pain, such as
carpal tunnel in wrist or sciatic leg pain from back
• Ligament sprains in the upper body
• Shoulder muscle sprains and dislocations
• Abdominal hernias
• Tendon injuries to the hands, forearms and elbows
(tennis elbow)
• Ankle sprains and strains
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 How Do They Occur?

• Carrying, holding, or restraining items, people or

animals
• Lifting, pushing, holding or pulling loads
• Working in a fixed position with the back bent,
sitting or standing continuously, or driving vehicles
for long periods
• Repetitive tasks such as reaching to lift or lower
objects, or to grip tools continuously
• Working in awkward positions involving bending or
twisting your body to reach items
• Vibrations through the body like driving a truck or
using a powered hand tool

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Where Do They Occur?

• Construction

• Agriculture

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 Where Do They Occur?

• Trucking/transportation

• Food services

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Where Do They Occur?

• Delivery services

• Custodial services

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 What are the Signs & Signals?

• For a sprain: Pain, swelling,

bruising, not being able to move
the joint

• For a strain: Pain, muscle

spasms, muscle weakness,
swelling, cramping, trouble
moving the muscle

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Treatments for Sprains & Strains

• FIRST STAGE – to reduce swelling and pain

• RICE therapy (Rest, Ice, Compress, Elevate) for
the first 24 to 48 hours
1. Rest the injured area (reduce regular exercise or
activities as needed)
2. Ice the injured area, 20 minutes at a time, four to
eight times a day (cold pack, ice bag, or plastic bag
filled with crushed ice and wrapped in a towel can be
used)

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Treatments for Sprains & Strains

3. Compress the injured area, using bandages, casts,

boots, elastic wraps or splints to help reduce swelling

4. Elevate the injured area, above the level of the heart, to help
decrease swelling while you are lying or sitting down

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Treatments for Sprains & Strains

• Health care provider may recommend an anti-inflammatory

drug such as aspirin (Bayer), ibuprofen (Advil, Motrin),
naproxen sodium (Aleve) or acetaminophen (Tylenol) to help
decrease pain and inflammation

• If moderate sprain, may require use of mobility aids, such

as
a cane, crutches, a walker or wheelchair
• If severe sprain, may need surgery to repair torn ligaments,
muscles or tendons
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Treatments for Sprains & Strains

• SECOND STAGE – Rehabilitation

1. Physical therapy/exercise program:
designed to help reduce swelling, prevent
stiffness and restore normal, pain-free
range of motion (during first week after
injury)

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Treatments for Sprains & Strains

2. Increase strength and flexibility (about

second week after injury); usually more
demanding exercises to improve function

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Treatments for Sprains & Strains

Advanced stretching?

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Treatments for Sprains & Strains

3. Return to full daily activities, including

sports if appropriate; must work closely
with physical therapist to avoid re-injury

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How Much Time to Heal?

• Time needed for full recovery:

- Mild sprain/strain: three to six weeks

- Moderate sprain/strain: two to three

months

- Severe sprain/strain: eight to 12

months

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 How Can We Prevent This?

• Although we cannot prevent all sprains and

strains from occurring, there are some tips on how
to avoid them:

- Stretch before you workout or

lift heavy items

- Use proper footwear for the

activity you are doing

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How Can We Prevent This?

• Warm up adequately
before activities

• Do not run on icy/uneven

surfaces

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 Stretching Exercises

If bending over for a long period of

time:

o Stand upright
o Place your hands on your lower back
o Bend backward slowly
o Come back to upright position

Note: Before doing any exercises

check with your physician to ensure
you’re able to do them safely!

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 Stretching Exercises

Note: Before doing any

exercises check with your
physician to ensure you’re
able to do them safely!

• Sit or stand with arms hanging loosely

at your sides
• Turn head to one side, then the other
• Hold for 5 seconds, each side
• Repeat 1 to 3 times

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 Stretching Exercises

Note: Before doing any

exercises check with your
physician to ensure you’re
able to do them safely!

o Stand or sit and place right hand

on left elbow
o With left hand, pull right elbow
across chest toward left shoulder
and hold 10 to 15 seconds
o Repeat on other side

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 Stretching Exercises

Note: Before doing any

exercises check with your
physician to ensure you’re
able to do them safely!

o Keep knees slightly flexed

o Stand or sit with arms overhead
o Hold elbow with hand of opposite arm
o Pull elbow behind head gently as you slowly
lean to side until mild stretch is felt
o Hold 10 to 15 sec
o Repeat on other side

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 Summary

• Sprains and strains are classified as musculo-

skeletal disorders
• Many causes including carrying, pushing,
lifting, pulling, doing repetitive tasks, or
working in awkward positions
• Treat by using RICE (Rest, Ice, Compression,
Elevation)
• Prevent by stretching, wearing proper
footwear, using caution while walking

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 References

o National Institute of Arthritis and Musculoskeletal and

Skin Diseases/National Institutes of Health
www.niams.nih.gov

o Mayo Clinic
www.mayoclinic.com

o American Academy of Orthopaedic Surgeons

www.aaos.org

o Centers for Disease Control & Prevention

www.cdc.gov

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 Contact Information

Health & Safety Training Specialists

1171 South Cameron Street, Room 324
Harrisburg, PA 17104-2501
(717) 772-1635
RA-LI-BWC-PATHS@pa.gov

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Questions

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