What are the symptoms of a sprain

sprain (Distortion)

Sprains (distortions) are among the most common sports injuries and describe joint injuries. These are so-called closed injuries, in which the force applied exceeds the physiological extent of the range of motion of the joint and ligament structures are injured. However, this does not result in a dislocation of the joint (dislocation) and no fractures.

A sprain can affect any joint, but is particularly common in the upper ankle, knee, thumb and finger joints. The spine can also be affected.

The trigger is often the classic twisting of the foot or the compression of the hand when catching a fall. The sprain has a wide range, starting with harmless stretching and ending with severe ligament tears:

  • Grade I.: slight sprains (the ligaments were overstretched, but no structural changes were visible)
  • Grade II: Ligament tear (partial tear of the ligaments, but the joint is still stable)
  • Grade III: Ligament tear (complete tear of the ligaments)

The majority of those affected do not see a doctor for (supposedly) minor sprains, as the injury is often trivialized. However, the injury should definitely be treated medically so that there are no long-term effects.


With a joint sprain, the joint capsule and the surrounding muscles and ligaments are overstretched. Usually blood vessels also tear and a bruise forms. Excessive overstretching can result in partial or complete rupture of the joint capsule and ligaments. The consequences are instability of the affected joint, which in turn can lead to further sprains and joint diseases such as osteoarthritis.

A sprain often happens when you twist your foot, for example when you trip over the curb or fall while walking on uneven ground. Sprains also occur more frequently in (professional) sport; athletes' ankles are particularly affected and a knee sprain is not uncommon in football. In team sport, additional contact with other players increases the risk of contracting a sprain from external forces.

Similar to the joints in the legs and arms, the capsules and ligaments of the flexible connections of the spine can also become overstretched. The most common spine distortions are in the area of ​​the cervical spine. An example of this is what is known as “whiplash”, which occurs in a car accident, for example.

Symptoms & course of the disease

The most immediate symptoms of a sprain (Grade I) are severe pain and swelling of the affected joint. However, the joint can withstand pain. If this is no longer possible, a more serious injury, which can also affect the bones, can be assumed. A hematoma ("bruise") on the affected area is also possible.

A ruptured ligament can lead to chronic instability of the joint, which can result in secondary injuries. This means that those affected buckle even with the smallest bumps, as the ligaments of the joint wear out more and more.

A sprain in the area of ​​the spine also leads to a painful restriction of movement in the affected part of the spine. In addition, the sprain is noticeable as a local pain in the affected segment. Neck pain, headaches, dizziness and nausea can also occur. If the cervical spine is severely distorted, the involvement of the nerves can lead to symptoms such as tingling in the arm. Even motor failures are possible. In any case, a doctor should be consulted immediately!


The acute treatment of a sprain must be immediate and should ideally be based on the PECH principle:

  • Break: Stop exercising immediately and do not continue! The painful part of the body must be immobilized.
  • ice: The affected area should be cooled immediately; Do not place the ice directly on the skin, but wrap it in a cloth. Also compresses with cold water (20 minutes exposure time) or cool packs help to reduce bleeding and swelling. Do not use cold on open wounds!
  • Compression: After the cold treatment, a firm bandage with an elastic bandage should be applied, preferably around a cold compress. In this way, major bruises can be avoided, which may lead to further destruction of the muscle fibers.
  • Elevation: Elevating the affected area reduces the blood supply and fluid that has leaked into the surrounding tissue can be more easily removed.

A sprain should always be clarified by a doctor, ideally by an orthopedic doctor or a trauma surgeon. A medical history discussion is followed by a careful physical examination, which should be supplemented by imaging procedures such as X-rays or MRI. In this way the extent of the injury can be determined. Further treatment takes place depending on which joint structures (joint capsule, ligaments, cartilage) are affected.

In the case of minor injuries in which the joint capsule and ligaments were only slightly overstretched or pulled, the affected joint is stabilized for some time. If the joint is spared enough, the injury usually heals quickly and the joint can be loaded normally again after a few weeks.

In the case of a severe sprain that has torn the joint capsule and ligament, however, more intensive treatment is required. Otherwise permanent joint instability can occur, the consequence of which is premature joint wear (osteoarthritis). If parts of the tape are torn, a four to six week rest period can be assumed. A special splint supports the affected joint. If the damage is very severe, surgery may be necessary.

Sprains of the spine are usually mild and in most cases do not cause permanent damage. However, they are potentially more dangerous than in other parts of the body, as important nerve pathways run in the area of ​​the cervical spine. A "neck tie" supports the healing process, but should be removed at short notice after one or two days during the day in order not to limit the functionality too much. In addition, dry, but also moist heat promotes the healing process (e.g. red light, moor packs).


Proper warming up is the best prophylaxis and greatly reduces the risk of a sprain. The right equipment is just as important during sports, such as well-fitting running shoes.

As a preventive measure, bandages or tapes can protect joints that are prone to sprains. Particularly noteworthy is the proprioceptor training. Proprioceptors are peripheral "sense organs" in a joint that are in mutual communication with the brain. This processing speed can be improved through training and, for example, with repeated overknuckling, rapid "countermeasures" prevent trauma. This also leads to an improvement in self-perception and coordination.

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Karin Jirku
Medical review:
Dr. Fernas Amir
Editorial editing:
Dr. med. Stefanie Sperlich

Status of medical information:

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Breusch S. et al. (Ed.): Clinical guidelines for orthopedic trauma surgery, Urban & Fischer Verlag / Elsevier GmbH, 2009

Feil W. et al .: Sports injuries from A-Z: Health coach: From Schumedizin to Naturheilkunde, Hans Sachbuch Verlag, 2009

Krüger S: Orthopedics for family doctors, Verlag Hans Huber, Bern 2013

Langendoen J: Taping in Sport: Immediate Help for Pain and Injuries, Trias Verlag, 2014

Niethard, F. N. et al .: Dual Series Orthopedics and Trauma Surgery, Georg Thieme Verlag, 2009

Ruchholtz, S. & Wirtz, C .: Orthopedics and trauma surgery essentials: Intensive course for further training, Georg Thieme Verlag, 2012