1. Sprains & Strains PPT-053-01 1 Bureau of Workers’ Comp PA Training for Health & Safety (PATHS)

2. Topics PPT-053-01 2 Sprains and strains – what are they? Causes Difference between sprains and strains Common types How and where they occur Signs, symptoms, treatment Ways to prevent

3. What are Sprains & Strains? PPT-053-01 3 Sprains and strains are two types of MSDs, or musculoskeletal disorders MSD’s are injuries or disorders of the: o muscles, nerves, tendons, joints, cartilage, and o supporting structures of the upper and lower limbs, neck and lower back that are caused, precipitated, or exacerbated by sudden exertion or prolonged exposure to physical factors (e.g. force, repetition, vibration or awkward posture) - CDC/NIOSH

4. Causes of Sprains & Strains? PPT-053-01 4 They are caused by excessive reaching, bending, lifting, gripping, squatting, or twisting of hands, shoulders or body Caused by any work performed with high force, with many repetitions, or in an awkward position

5. Causes of Sprains & Strains? PPT-053-01 5 A sprain is a stretch or tear of a ligament (band of fibrous tissue that connects two or more bones at a joint); stretched too far from normal position One or more ligaments may be injured at the same time Most common: - sprained ankle

6. What’s the Difference? PPT-053-01 6 A strain is an injury to a muscle or tendon (thick, tough fibrous cord of tissue that connects a muscle to a bone) Can be as simple as overstretching a muscle or tendon, or it can be a partial or complete tear Most common: strained back

7. Types of Sprains & Strains PPT-053-01 7 Back injuries, including pulled back muscles and ruptured discs Squashed nerves causing severe pain, such as carpal tunnel in wrist or sciatic leg pain from back Ligament sprains in the upper body Shoulder muscle sprains and dislocations Abdominal hernias Tendon injuries to the hands, forearms and elbows (tennis elbow) Ankle sprains and strains

8. How Do They Occur? PPT-053-01 8 Carrying, holding, or restraining items, people or animals Lifting, pushing, holding or pulling loads Working in a fixed position with the back bent, sitting or standing continuously, or driving vehicles for long periods Repetitive tasks such as reaching to lift or lower objects, or to grip tools continuously Working in awkward positions involving bending or twisting your body to reach items Vibrations through the body like driving a truck or using a powered hand tool

9. Where Do They Occur? PPT-053-01 9 Construction Agriculture

10. Where Do They Occur? PPT-053-01 10 Trucking/transportation Food services

11. Where Do They Occur? 11 Delivery services Custodial services PPT-053-01

12. What are the Signs & Signals? PPT-053-01 12 For a sprain: Pain, swelling, bruising, not being able to move the joint For a strain: Pain, muscle spasms, muscle weakness, swelling, cramping, trouble moving the muscle

13. Treatments for Sprains & Strains PPT-053-01 13 FIRST STAGE – to reduce swelling and pain RICE therapy (Rest, Ice, Compress, Elevate) for the first 24 to 48 hours 1.Rest the injured area (reduce regular exercise or activities as needed) 2.Ice the injured area, 20 minutes at a time, four to eight times a day (cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used)

14. Treatments for Sprains & Strains PPT-053-01 14 3.Compress the injured area, using bandages, casts, boots, elastic wraps or splints to help reduce swelling 4.Elevate the injured area, above the level of the heart, to help decrease swelling while you are lying or sitting down

15. Treatments for Sprains & Strains PPT-053-01 15 Health care provider may recommend an anti-inflammatory drug such as aspirin (Bayer), ibuprofen (Advil, Motrin), or acetaminophen (Tylenol) to help decrease pain and inflammation If moderate sprain, may require use of mobility aids, such as a cane, crutches, a walker or wheelchair If severe sprain, may need surgery to repair torn ligaments, muscle or tendon

16. Treatments for Sprains & Strains PPT-053-01 16 SECOND STAGE – Rehabilitation 1.Physical therapy/exercise program: designed to help reduce swelling, prevent stiffness and restore normal, pain-free range of motion (during first week after injury)

17. Treatments for Sprains & Strains PPT-053-001 17 2. Increase strength and flexibility (about second week after injury); usually more demanding exercises to improve function

18. Treatments for Sprains & Strains PPT-053-01 18 Advanced stretching?

19. Treatments for Sprains & Strains PPT-053-01 19 3. Return to full daily activities, including sports if appropriate; must work closely with physical therapist to avoid re-injury

20. How Much Time to Heal? PPT-053-01 20 Time needed for full recovery: - Mild sprain/strain: three to six weeks - Moderate sprain/strain: two to three months - Severe sprain/strain: eight to 12 months

21. How Can We Prevent This? PPT-053-01 21 Although we cannot prevent all sprains and strains from occurring, there are some tips on how to avoid them: - Stretch before you workout with heavy items - Use proper footwear for the activity you are doing

22. How Can We Prevent This? PPT-053-01 22 Warm up adequately before activities Do not run on icy/uneven surfaces

23. Summary PPT-053-01 23 Sprains and strains are classified as musculo- skeletal disorders Many causes including carrying, pushing, lifting, pulling, doing repetitive tasks, or working in awkward positions Treat by using RICE (Rest, Ice, Compression, Elevation) Prevent by stretching, wearing proper footwear, using caution while walking

24. References PPT-053-01 24 National Institute of Arthritis and Musculoskeletal and Skin Diseases/National Institutes of Health www.niams.nih.gov Mayo Clinic www.mayoclinic.com American Academy of Orthopedic Surgeons www.aaos.org

25. Questions PPT-053-01 25