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last updated 2 Feb 2024

- A Sprain is an injury to a ligament, the tissue that links bones together at joints. Sprains happen most often in the ankle, knee, elbow, or wrist.
- Tears (strains) in muscle tissue. They happen most often in the muscles that support the calf, thigh, groin, and shoulder.

Signs and Symptoms:

When a sprain occurs, blood vessels will leak fluid into the tissue that surrounds the joint. White blood cells responsible for inflammation migrate to the area, and blood flow increases as well.

Swelling damages cells by decreasing oxygen supply.

Compression wraps can push the swelling away from the injury which is good.

  • Muscle stiffness, tenderness, or soreness
  • Swelling
  • Pain at the time of injury
  • Swelling
  • Bruising

All but the most minor strains and sprains should be evaluated by a health care provider.
- Rest, Ice, Compression, and Elevation

  • Rest the sprained or strained area.
  • Ice for 20 minutes every hour. You can reduce frequency over 2-3 days.
    Cold numbs the nerves and constricts the blood vessels, reducing swelling and tissue breakdown, and easing pain.
    The time-honored cold pack for a sprain or a fresh, swollen bruise is a bag of frozen corn or peas.
    Cold reduces metabolism and allows cells to survive temporarily with the lack of oxygen.
    After 3 days you can start using heat.
    Don't use heat for muscle strains. see below.
  • Compress by wrapping an elastic (Ace) bandage or sleeve.
    It pushes the swelling away from the injury.
  • Elevate the area above heart level.
  • Give an over-the-counter NSAIDs (non-steroidal anti-inflammatory drug) like aspirin, ibuprofen (Advil®, Motrin®), and naproxen (Naprosyn®, Aleve®) or Acetaminophen (Tylanol®).
    However NSAIDs may increase bleeding by decreasing platelet function.
Heat is generally used for chronic injuries or injuries that have no inflammation or swelling. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. Moist heat is best.
Apply heat to an injury 15 to 20 minutes at a time.

Alternating ice and heat (Contrast therapy)
Contrast therapy, which consists of alternating applications of heat and cold, is also used to treat athletic injuries, although the benefits have not been proved.
A cold-to-warm ratio of 1 to 3 min or 1 to 4 min appears reasonable based upon clinical observations and experience.
Many have suggested that contrast therapy results in cycles of vasodilation and vasoconstriction, thus creating a pumping action to reduce swelling. However, tissue temperatures are not affected by contrast treatments (Myrer et al. 1994, 1997; Higgins and Kaminski 1998). The brief exposure to cold and the fact that superficial heating has minimal effect on deep blood flow suggest that there is little vascular response to contrast therapy.

Even though there is no good explanation for the effects of contrast therapy, this approach has been used to treat some physically active individuals. For example, contrast therapy may be effective in reducing edema (swelling) in subacute foot and ankle injuries.

As with many therapies, there has been little investigation of the effectiveness of contrast treatments. Cote et al. (1988) reported that swelling increased in sprained ankles after contrast therapy administered over 3 days after acute lateral ankle sprain.

See the article for more. But my take was if swelling and/or pain gets worse after heat, then don't use it.
Source: How to use heat and cold to treat athletic injuries at Human Kinetics

See more on Muscle Strains below.

Sprains and Strains Treatment: First Aid Information for Sprains and Strains
Sprains and strains - Penn State Hershey Medical Center
Ice or Heat - When to Use Ice and When to Use Heat on a Sports Injury
Heat and cold therapies: self-care for aches, pains, sprains, strains, swelling, bruises at the Old Farmers Alminac
Kinesiology tape
Compression Socks - Plantar Fasciitis Socks - Knee Compression Sleeve - Calf Compression Sleeves - Resistance Loop Bands - Kinesiology Tape - Muscle Roller Sticks - - Physix Gear Sport
Pain Relievers

Muscle Tear or Strain:
How to Heal a Torn Muscle: What You Need to Know | Princeton Orthopedic Associates

Recognizing Muscle Tear Symptoms
When you tear a muscle, you'll know it right away. Expect pain, soreness, spasms, and swelling in the affected area. Depending on the severity, you may have difficulty moving the affected area, or it may even become immobile. You might also notice swelling, bruising, discoloration, and a "knotted up" feeling or stiffness. In cases of overuse, symptoms might take a while to become noticeable. However, if the strain or tear is acute and severe, like from an accident, seek immediate medical attention. Your orthopedist might order an MRI or X-ray to confirm the diagnosis and recommend the appropriate treatment.

Muscle Tear Symptom Summary:

  • Pain
  • Soreness
  • Spasms
  • Swelling in the affected area
  • Difficulty moving the affected area or immobility
  • Swelling
  • Bruising or discoloration
  • A "knotted up" feeling or stiffness

Muscle strains | Mayo Clinic
For immediate self-care of a muscle strain, try the R.I.C.E. approach — rest, ice, compression, elevation:

  • Rest. Avoid activities that cause pain, swelling or discomfort. But don't avoid all physical activity.
  • Ice. Even if you're seeking medical help, ice the area immediately. Use an ice pack or slush bath of ice and water for 15 to 20 minutes each time and repeat every two to three hours while you're awake for the first few days after the injury.
  • Compression. To help stop swelling, compress the area with an elastic bandage until the swelling stops. Don't wrap it too tightly or you may hinder circulation. Begin wrapping at the end farthest from your heart. Loosen the wrap if the pain increases, the area becomes numb or swelling is occurring below the wrapped area.
  • Elevation. Elevate the injured area above the level of your heart, especially at night, which allows gravity to help reduce swelling.
Some doctors recommend avoiding over-the-counter pain medications that can increase your risk of bleeding — such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — during the first 48 hours after a muscle strain. Acetaminophen (Tylenol, others) can be helpful for pain relief during this time period.

A physical therapist can help you to maximize stability and strength of the injured joint or limb. Your doctor may suggest that you immobilize the area with a brace or splint. For some injuries, such as a torn tendon, surgery may be considered.

How to Heal a Torn Muscle: What You Need to Know | Princeton Orthopedic Associates
Severe tears that require surgery can take months or even longer to heal. In these situations, a nifty rule is: Do no H.A.R.M. - this means avoid:

  • Heat
  • Alcohol
  • Running
  • Massage
These activities can exacerbate bleeding and swelling in the muscle tear.
Calf Tear
Muscle Pain Relief creams & Supplements
More information on sprains and strains abaove