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Sprains and strains

Sprains and strains are common injuries affecting the muscles and ligaments. Most can be treated at home without seeing a GP.

Check if you have a sprain or strain

It’s likely to be a sprain or strain if:

  • you have pain, tenderness or weakness – often around your ankle, foot, wrist, thumb, knee, leg or back
  • the injured area is swollen or bruised
  • you cannot put weight on the injury or use it normally
  • you have muscle spasms or cramping – where your muscles painfully tighten on their own

Is it a sprain or a strain?

A table explaining the differences between strains and sprains.
Sprains Strains
Torn or twisted ligament (tissue that connects the joints) Overstretched or torn muscle (also known as a pulled muscle)
Most common in: wrists, ankles, thumbs, knees Most common in: knees, feet, legs, back

How to treat sprains and strains yourself

For the first couple of days, follow the 4 steps known as RICE therapy to help bring down swelling and support the injury:

  1. Rest – stop any exercise or activities and try not to put any weight on the injury.
  2. Ice – apply an ice pack (or a bag of frozen vegetables wrapped in a tea towel) to the injury for up to 20 minutes every 2 to 3 hours.
  3. Compression – wrap a bandage around the injury to support it.
  4. Elevate – keep it raised on a pillow as much as possible.

To help prevent swelling, try to avoid heat (such as hot baths and heat packs), alcohol and massages for the first couple of days.

When you can move the injured area without pain stopping you, try to keep moving it so the joint or muscle does not become stiff.

A pharmacist can help with sprains and strains

Speak to a pharmacist about the best treatment for you. They might suggest tablets, or a cream or gel you rub on the skin.

Painkillers like paracetamol will ease the pain and ibuprofen will bring down swelling.

But you should not take ibuprofen for 48 hours after your injury as it may slow down healing.

How long it takes for a sprain or strain to heal

After 2 weeks, most sprains and strains will feel better.

Avoid strenuous exercise such as running for up to 8 weeks, as there’s a risk of further damage.

Severe sprains and strains can take months to get back to normal.

You cannot always prevent sprains and strains

Sprains and strains happen when you overstretch or twist a muscle.

Not warming up before exercising, tired muscles and playing sport are common causes.

Urgent advice: Get advice from 111 now if:

  • the injury is not feeling any better after treating it yourself
  • the pain or swelling is getting worse
  • you also have a very high temperature or feel hot and shivery – this could be an infection

111 will tell you what to do. They can tell you the right place to get help if you need to see someone.

Other ways to get help

Go to an urgent treatment centre

Urgent treatment centres are places you can go if you need to see someone now.

They’re also called walk-in centres or minor injuries units.

You may be seen quicker than you would at A&E.

Treatment at a minor injuries unit

You may be given self care advice or prescribed a stronger painkiller.

If you need an X-ray, it might be possible to have one at the unit, or you may be referred to hospital.

Physiotherapy for sprains and strains

If you have a sprain or strain that’s taking longer than usual to get better, your GP may be able to refer you to a physiotherapist.

Physiotherapy from the NHS might not be available everywhere and waiting times can be long. You can also get it privately.

Immediate action required: Go to A&E or call 999 if:

  • you heard a crack when you had your injury
  • the injured body part has changed shape
  • the injury is numb, discoloured or cold to touch

You may have broken a bone and will need an X-ray.

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Page last reviewed: 12 January 2018
Next review due: 12 January 2021

Sprains and strains are common injuries affecting the muscles and ligaments. Most can be treated at home without seeing a GP.

Foot sprain – aftercare

There are many bones and ligaments in your foot. A ligament is a strong flexible tissue that holds bones together.

When the foot lands awkwardly, some ligaments can stretch and tear. This is called a sprain.

When the injury occurs to the middle part of the foot, this is called a mid-foot sprain.

More about Your Injury

Most foot sprains happen due to sports or activities in which your body twists and pivots but your feet stay in place. Some of these sports include football, snowboarding, and dance.

There are three levels of foot sprains.

  • Grade I, minor. You have small tears in the ligaments.
  • Grade II, moderate. You have large tears in the ligaments.
  • Grade III, severe. The ligaments are completely disrupted or detached from the bone.

What to Expect

Symptoms of a foot sprain include:

  • Pain and tenderness near the arch of the foot. This can be felt on the bottom, top, or sides of the foot.
  • Bruising and swelling of the foot
  • Pain when walking or during activity
  • Not being able to put weight on your foot. This most often occurs with more severe injuries.

Your health care provider may take a picture of your foot, called an x-ray, to see how severe the injury is.

If it is painful to put weight on your foot, your provider may give you a splint or crutches to use while your foot heals.

Most minor-to-moderate injuries will heal within 2 to 4 weeks. More severe injuries, such as injuries that need a cast or splint, will need a longer time to heal, up to 6 to 8 weeks. The most serious injuries will need surgery to reduce the bone and allow the ligaments to heal. The healing process can be 6 to 8 months.

Symptom Relief

Follow these steps for the first few days or weeks after your injury:

  • Rest. Stop any physical activity that causes pain, and keep your foot still when possible.
  • Ice your foot for 20 minutes 2 to 3 times a day. DO NOT apply ice directly to your skin.
  • Keep your foot raised to help keep swelling down.
  • Take pain medicine if you need it.

For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store.

  • Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
  • DO NOT take more than the amount recommended on the bottle or by your provider.

Activity

You can begin light activity once the pain has decreased and the swelling has gone down. Slowly increase the amount of walking or activity each day.

There may be some soreness and stiffness when you walk. This will go away once the muscles and ligaments in your foot begin to stretch and strengthen.

Your provider or physical therapist can give you exercises to help strengthen the muscles and ligaments in your foot. These exercises can also help prevent future injury.

  • During activity, you should wear a stable and protective shoe. A higher-top shoe can protect your ankle while a stiffer sole shoe can protect your foot. Walking bare foot or in flip flops can make your sprain worse.
  • If you feel any sharp pain, stop the activity.
  • Ice your foot after activity if you have any discomfort.
  • Wear a boot if your provider suggests it. This can protect your foot and allow your ligaments to heal better.
  • Talk to your provider before returning to any high impact activity or sport.

Follow-up

You may not need to see your provider again if your injury is healing as expected. You may need additional follow up visits if the injury is more severe.

When to Call the Doctor

Call the health care provider if:

  • You have sudden numbness or tingling.
  • You have sudden increase in pain or swelling.
  • The injury does not seem to be healing as expected.

Alternative Names

References

Molloy A, Selvan D. Ligamentous injuries of the foot and ankle. In: Miller MD, Thompson SR, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 116.

Rose NGW, Green TJ. Ankle and foot. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 51.

There are many bones and ligaments in your foot. A ligament is a strong flexible tissue that holds bones together.