Sprains and strains

Self-care

For immediate self-care of a sprain or strain, try the P.R.I.C.E. approach — protection, rest, ice, compression, elevation:

• Protection. Immobilize the area to protect it from further injury. Use an elastic wrap, splint, sling or air cast to immobilize the area, and use a cane or crutches to help you get around.

• Rest. Avoid activities that cause pain, swelling or discomfort. But don't avoid all physical activity. Instead, give yourself relative rest. For example, with an ankle sprain you can usually still exercise other muscles to prevent deconditioning. For example, you could use an exercise bicycle, working both your arms and the uninjured leg while resting the injured ankle on a footrest peg. That way you still exercise three limbs and keep up your cardiovascular conditioning.

• Ice. Even if you're seeking medical help, ice the area immediately. Use an ice pack or slush bath for 15 to 20 minutes each time and repeat every two to three hours while you're awake for the first 48 to 72 hours. Cold reduces pain, swelling and inflammation in injured muscles, joints and connective tissues. It also may slow bleeding if a tear has occurred. If the area turns white, stop treatment immediately. This could indicate frostbite. If you have vascular disease, diabetes or decreased sensation, talk with your doctor before applying ice.

• Compression. To help stop swelling, compress the area with an elastic bandage until the swelling stops. Don't wrap it too tightly or you may hinder circulation. Begin wrapping at the end farthest from your heart. Loosen the wrap if the pain increases, the area becomes numb or swelling is occurring below the wrapped area.

• Elevation. To reduce swelling, elevate the injured area above the level of your heart, especially at night. Gravity helps reduce swelling by draining excess fluid.

Continue with P.R.I.C.E. treatment for as long as it helps you recover. Over-the-counter pain medications such as ibuprofen (Advil, Nuprin, others) and acetaminophen (Tylenol, others) also can be helpful. If you want to apply heat to the injured area, wait until most of the swelling has subsided.

After the first two days, gently begin to use the injured area. You should see a gradual, progressive improvement in the joint's ability to support your weight or your ability to move without pain.

Mild and moderate sprains usually heal in two to four weeks. If pain, swelling or instability persists, see your doctor.

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Treatments