CONTUSIONS,

SPRAINS, STRAINS
 CONTUSIONS
 What is a contusion?
 Another name for a bruise. What is a bruise ? A bruise, or
contusion, is caused when blood vessels are damaged or broken
as the result of a blow to the skin (be it bumping against something
or hitting yourself with a hammer). The raised area of a bump or
bruise results from blood leaking from these injured blood vessels
into the tissues as well as from the body's response to the injury. A
purplish, flat bruise that occurs when blood leaks out into the top
layers of skin is referred to as an ecchymosis.
 Contusions, typically known as bruises, are injuries to your tissue
or bone in which the skin is not broken. Blood vessels rupture and
bleed into the tissue causing discoloration. Bruises are usually blue
or purple at first, and then gradually fade to various shades of
brown, yellow and green as they rise to the surface of the skin.
SPRAINS
 What is a sprain?
 A sprain is a stretched or torn ligament. Ligaments are
tissues that connect bones at a joint. Falling, twisting, or
getting hit can all cause a sprain. Ankle and wrist sprains
are common. Symptoms include pain, swelling, bruising,
and being unable to move your joint. You might feel a pop
or tear when the injury happens.
 Sprains result when you over stretch or tear your capsule
or ligament. Ligaments are tissues that connect bone to
bone. The joint capsule is similar to a ligament and
surrounds the joint.
STRAINS
 What is a strain?
 A strain is a stretched or torn muscle or tendon. Tendons
are tissues that connect muscle to bone. Twisting or
pulling these tissues can cause a strain. Strains can
happen suddenly or develop over time. Back and
hamstring muscle strains are common. Many people get
strains playing sports. Symptoms include pain, muscle
spasms, swelling, and trouble moving the muscle.
 Strains, also referred to as pulls, result from over
stretching or tearing a muscle or tendon. Tendons are
tissues that attach muscles to bones.
 What is the difference between a strain and
a sprain?
The difference between a sprain and a strain is
that a sprain injures the bands of tissue that
connect two bones together, while a strain
involves an injury to a muscle or to the band of
tissue that attaches a muscle to a bone.
 SIGNS & SYMPTOMS
STRAIN SPRAIN CONTUSION
•sudden onset of •Signs and symptoms • Pain that increases
pain will vary, depending on when you touch the
•soreness the severity of the bruise, walk, or use the
•limited range of injury, and may include: area around the bruise
movement • Pain • Swelling or a lump at
•bruising or • Swelling the site of the bruise or
discoloration • Bruising near it
•swelling • Limited ability to • Red, blue, or black skin
•a “knotted-up” move the affected that may change to
feeling joint green or yellow after a
•muscle spasms • Hearing or feeling few days
•stiffness a "pop" in your • Stiffness or problems
•weakness joint at the time of moving the bruised area
injury of your body
 CAUSE
Sprain
 Many things can cause a sprain. Falling, twisting, or getting hit can
force your joint out of its normal position. This can ligaments around
your joint to stretch or tear. Sprains usually happen when you:
Fall and land on an arm.
Fall on the side of their foot.
Twist a knee.
Strain
 A strain happens when you twist or pull a muscle or tendon. Strains can
happen suddenly or develop over days or weeks. A sudden or acute
strain is caused by:
A recent injury.
Lifting heavy objects the wrong way.
Overstressing the muscles.
 Chronic strains usually happen when you move the muscles and
tendons the same way over and over.
 TREATMENT
 Treatments for sprains and strains are the same. To reduce swelling
and pain in the first day or two, doctors usually say to:
Rest the injured area. If the ankle or knee is hurt, your doctor may tell you to use
crutches or a cane.
Put ice on the injury for 20 minutes 4 to 8 times a day.
Compress (squeeze) the injury using special bandages, casts, boots, or splints.
Your doctor will tell you which one is best for you and how tight it should be.
Put the injured ankle, knee, elbow, or wrist up on a pillow.
Take medicines, such as aspirin or ibuprofen.
 After treating pain and swelling, your doctor may tell you to exercise the
injured area. This helps to prevent stiffness and increase strength. In
addition, you may need physical therapy. Your doctor or physical
therapist will tell you when you can start to do normal activities,
including sports. If you begin too soon, you can injure the area again.
For Contusions
 To control pain, bleeding, and inflammation, keep the muscle in a gentle
stretch position and use the RICE protocol:
Rest. Protect the injured area from further harm by stopping play. You may also use
a protective device (i.e., crutches, sling).
Ice.  Use cold packs for 20 minutes at a time, several times a day. Do not apply ice
directly on the skin.
Compression. Lightly wrap the injured area in a soft bandage or ace wrap.
Elevation. Raise the injured area to a level above the heart.
 Most athletes with contusions get better quickly with simple treatment
measures. Your doctor may give you nonsteroidal anti-inflammatory drugs
(NSAIDs), such as ibuprofen, or other medications for pain relief. Do not
massage the injured area.
 During the first 24 to 48 hours after injury (acute phase), you will probably
need to continue using rest, ice, compression bandages, and elevation of the
injured area to control bleeding, swelling, and pain. While the injured muscle
heals, be sure to keep exercising the uninjured parts of your body to maintain
your overall level of fitness.
 If there is a large hematoma that does not go away within several days, your
doctor may drain it surgically to expedite healing.
 NURSING DIAGNOSIS
 Acute pain related to
contusions/sprains/strains
 Impaired mobility related to sprains/strains
 Risk for injury related to sprains/strains
 NURSING MANAGEMENT
 for Sprains and Strains
1. Provide nursing care for a client who sustains a sprain
Elevate or immobilize the affected joint, and apply ice packs immediately
Assist with tape, splint or cast application, as necessary
Prepare the client with a severe sprain for surgical repair or reattachment, if
indicated.
2. Provide nursing care for a client’s suffering muscle or tendon strain.
Instruct the client to allow the muscle or tendon to rest and repair itself by
avoiding use for approximately week and then by progressing activity
gradually until healing is complete.
Teach appropriate stretching exercises to be performed after healing to help
prevent reinjury.
Prepare the client for surgical repair in severe injury.
3. Administer prescribed medications, which may include nonopioid
analgesics.