Sprains and Strains

Common signs and symptoms include:³

• Pain, tenderness, or weakness in the effected joints and/or muscles

• Swelling and bruising

• Difficulty using or putting weight on the injured area

• Muscle spasms or cramping (more typical in strains)²

Sprains are often graded by severity:

• Grade 1: Mild stretch, minimal fibre damage.²

• Grade 2: Partial tear, some joint looseness.²

• Grade 3: Complete tear, significant joint instability.²

Muscle strains also have a grading system:

• Grade I: Few fibres torn, muscle strength largely preserved.

• Grade II: More fibres torn, swelling, weakness.

• Grade III: Complete rupture; the muscle may be non-functional.⁵

These injuries often happen when tissue is forced beyond its normal limits:¹

• A fall, twist or awkward landing (sprains)¹
• Sudden, forceful contraction of a muscle (strains)⁴
• Overuse over time (chronic strain)
• Intrinsic factors like poor flexibility, fatigue, or a previous injury also raise risk.⁸

For the first 2–3 days after injury, you can often manage at home using these well-established steps:

**PRICE (Protection, Rest, Ice, Compression, Elevation)**³

• Protect the area with support or a brace to avoid further harm.³
• Rest, especially for the first 48–72 hours; avoid putting weight on the injury.³
• Apply Ice packs wrapped in a cloth for 15–20 minutes, every 2–3 hours while awake.¹
• Use medical elasticized bandage to compress the area, but don’t wrap too tightly.¹
• Elevate the limb to reduce swelling.³  For leg injuries, in a lying position, support the whole leg with the foot above the knee and knee above the hip, to create a gentle gradient. An injured arm can be supported along its length on pillows in the sitting or lying position to the level of the shoulder.

Avoid the following during the first 72 hours (HARM): Heat, Alcohol, Running, Massage³

• Heat (like hot baths) can worsen swelling.³
• Alcohol increases bleeding/swelling and slows healing.³
• Avoid running or strenuous exercise until healing begins.³
• Avoid massage early on — it can increase bleeding.³

• Over-the-counter painkillers like paracetamol (acetaminophen) can help.³
• Topical NSAID gels (e.g., ibuprofen) can also reduce pain and inflammation.³
• Oral NSAIDs may be used after 48 hours, if needed, but only under advice.³
• Note: According to South African guidance, limiting NSAIDs in the very acute phase may be beneficial because inflammation plays a role in healing.⁹

See a healthcare provider if:

• Your pain is severe or worsening
• You notice large bruising, rapidly increasing swelling, or you can’t bear weight.⁶
• You suspect a fracture or dislocation (e.g., very misaligned limb)
• You have persistent symptoms after several days, or limited improvement.⁶

Your doctor may order imaging (X-ray or ultrasound) to rule out fractures or assess soft-tissue damage.¹
In South Africa, the Primary Healthcare Emergency & Injuries guideline also outlines when sprains/strains need escalation.¹⁰

To help avoid future sprains and strains:

• Warm up and stretch before and after exercise.⁴
• Build up exercise intensity gradually — don’t push too hard too soon.
• Wear supportive, well-fitting shoes to reduce ankle risk.²
• Use braces or taping if you have a history of sprains.²
• Work on strength and flexibility (especially of ankles, knees, back) under guidance.
• Listen to your body — rest when tired or sore.

This brochure is for educational purposes only and is not intended to provide a diagnosis or treatment or replace the advice of your doctor, pharmacist, primary health care nurse or other health care provider. You are advised to discuss any questions or concerns you have with your health care provider.