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Sprains & Strains

"I twisted my ankle in basketball, do I put hot or cold on it?"
Always ice an acute injury to an extremity. Rest, Ice, Compression and Elevation (RICE) will help it to recover faster. When have you ever seen a football player on the sidelines bundled up in a heating pad after getting smashed up on the field? Apply ice for 30 minutes or so on the sore area but put a cloth under the ice pack to avoid injuring the skin. Elevated it as high as you can. Get your leg up on top of the sofa back so that gravity can really help reduce the swelling. Wrap it in an ace wrap so that there is some compression and keep it up for several hours. If you wimp out on the ice or the elevation it is likely to lead to slow recovery time.

"How long will my ankle hurt after I sprain it?"
This depends on the amount of time you spend attending to your injury and the severity of the sprain. If you really commit to keeping it elevated, iced and wrapped for the first 2-3 days you can greatly accelerate the healing process and may get on your feet again in 5-6 days. If you wimp out on your home therapy, this injury will dog you for weeks.

"Do I have to get an x ray every time I smash my fingers or twist my ankles?"
Use common sense and try to ice and elevate first for several hours. Unless there is clear evidence of a problem or the mechanism of injury is so dramatic (i.e., falling from a height, dropping a heavy weight on your foot) you can probably treat minor strains and sprains at home conservatively. If you are not much better the next day then have an x ray and evaluation.

"Do I take Tylenol or Advil after a sprain?"
The whole idea of recovery from an injury is to reduce inflammation either by putting cold on it (topical treatment) or by a medication (anti inflammatory) and in this case Advil, Aleve, Motrin or Ibuprofen are the medication of choice. The maximum dose you can take in a day is 2400mg of Ibuprofen for an adult. This translates to 600mg (3 tablets) every 6 hours or 800mg (4 tablets) every 8 hours. Take the medication with food and discuss this with your doctor if you are not sure if you have an allergic reaction or ulcer in your stomach. If you cannot take these medications then try Tylenol for pain relief.

"I smashed my toe, is there anything you can do for this?"
It is worth getting this checked out to rule out any odd fractures which might involve the other bones in the foot or joint spaces so head over for an x ray. If just the toe is broken then usually there is no therapy except 'buddy' taping it to the neighboring toe which is annoying at best.

"Why does my shin hurt so much after I bash it on something?"
The shin has no fat and little skin to absorb a direct blow and usually the trauma is in a small area on some sharp object. With the bone lying just below the surface this exposes the nerves and they are contused (or smashed). Smashed nerve fibers take longer than one expects to heal and the pain or numbness can last for weeks or months.

"I fell on my shoulder and I can't lift my arm up very high."
The first thing to do is get this looked at and x rayed. If there is no obvious fracture or dislocation you may be told to ice the shoulder and treat it conservatively with gentle range of motion. Shoulders are not like knees or ankles and require careful attention and monitoring. It is unwise to try and tough it out and get through a painful shoulder injury yourself because of the potential for a condition called 'frozen shoulder'. The shoulder is a ball and socket joint and needs to stay moving if possible while the healing process is going on. Get it checked out and get some advice to avoid problems later.


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