Sprain, Strain, Break or Dislocate? How to Tell Them Apart

Injuries are a simple, unavoidable fact of life. Knowing quality first aid will ensure you and your loved ones are given the best first responder treatment, but sometimes it can be hard to determine what has happened. Knowing the differences between sprains, strains, fractures (breaks), and dislocations will help ensure you are well looked after.

Sprains

A sprain is a sudden injury that occurs to the ligaments within a joint as a result of a wrenching or twisting motion. Simply put, it affects our joints and not our muscles (unlike a strain). In most cases, the patient will have bruising, swelling, and tenderness in the area, and are unlikely to be able to move it without pain or bear weight on it. Patients may also report a “popping” sensation at the time of injury. In severe sprains, the patient may also experience altered sensations beyond the site of injury and have limited to no movement at all. In most cases, sprains can be treated with the RICER (Rest, Ice, Compress, Elevate, Referral) method, however may require further medical attention. In most cases, the sprained joint can heal within 2 to 8 weeks, although more severe sprains may take up to 8 months.

Strains

Unlike sprains, strains are injuries that affect the tendons or muscles of the body, and are most often caused by over-reaching, excessive weightlifting, twisting, jarring, or repetitive movements. They can occur suddenly or over a long period of time. Symptoms of strains include tenderness, bruising, swelling, muscle spasms or cramps, restricted movement throughout the area, and weakness. Like sprains, most strains can be treated with the RICER method. Recovery for strains can be anywhere from a few weeks to several months, and in extreme cases may require surgical consult or physical therapy.

Fractures

Fractures (more commonly known as breaks) are injuries to the bone that cause it to crack. Although there are many types of fractures, the recognition and treatment of them is consistent. Patients may experience or hear a “cracking” sound when the injury occurs, although this is not always the case. The affected area will often be bruised, swollen, tender, and may have obvious deformity. The patient will likely experience limited to no movement in the area and may complain of pins and needles in extremities after the injury site. For all suspected fractures, immobilise the area. If not too painful, ice may be applied to the injury to reduce pain and swelling. Encourage the patient to seek medical attention as soon as possible- either at hospital, the doctor, or an urgent care clinic.
Although most fractures are not life threatening, it is important to call for an ambulance if you see bone coming through the skin, or if you suspect there is a fracture to the head, neck, spine, ribs, hips, or thigh, as these require immediate medical attention. In these cases, keep the patient as still as possible and treat any other injuries (such as bleeding).

Dislocations

Like sprains, dislocations are injuries that affect the joints, and occur when a sudden impact causes an abnormal separation of bones within the joint. Patients will likely present with bruising, swelling, tenderness, limited or no movement to the joint or beyond it, and deformity. The severity of dislocations varies, with some people experiencing the affected bones returning to position on their own, while others will require medical assistance. If you suspect a dislocation do not attempt to relocate it. Our joints contain many different parts, including muscles, nerves, and blood vessels, and relocating bones without medical imaging could cause damage to these parts. Instead, provide an ice pack to help reduce swelling and ease the pain, immobilise the joint (if possible), and refer for further medical treatment.

If at any point you are unsure if your patient has a sprain, strain, fracture, or dislocation, treat them as though it is a fracture, and refer for immediate medical attention. And remember, it is always better to be safe than sorry.

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