Wed, 29 Aug 2001

Things parents should know about sprains, wounds

By Donya Betancourt

SANUR, Bali (JP): As more and more kids and teens take part in sport activities, there is a chance that your child might get an injury even if she or he is careful.

The most common injury experienced by kids and teens when performing sports is sprain.

What is a sprain?

A sprain is a stretched or torn ligament. Ligaments connect one bone to another at a joint and help keep the bones from moving out of place.

The most common site for sprains to occur is the ankle. Since the ankle is made up of many small bones and ligaments, a sprain can happen with an accidental twist, or even by taking an awkward step while walking.

The signs of sprain are swelling, pain, bruising and limitation of movement or stiffness.

How do I take care of a sprained ankle?

The rule of thumb is the "RICE" approach, which is Rest, Ice, Compression and Elevation.

Rest means you need to rest your ankle completely or partially depending on how severe it is. You should use crutches as long as you still feel pain when standing on your foot. A healing cast may be considered in cases of ligament injury or to speed the healing process by preventing the bone and the injured ligament from moving.

Ice packs will decrease swelling, pain and bruising and muscle trauma. You may use ice for the first three days after injury. Use the ice for up to 20 minutes at a time. When your skin feels numb, it is time to remove the ice. Use ice treatment every two to four hours for the first three days. By then, the swelling will be under control.

Compression is accomplished by wrapping the ankle in an ice bandage to avoid swelling and bruising. Wrapping the ankle will be required for a period of two days to two weeks or more, depending on the severity.

Elevation is raising the injury above the level of the heart and it will help prevent the swelling from getting worse while at the same time reducing bruising. Try to keep your ankle elevated for about two to three hours a day if possible.

You can start using the sprained ankle again depending on how serious the sprain is. The average downtime is between one and three days after injury.

Medicine such as acetaminophen or ibuprofen is used to control the pain. If you are an athlete, it will probably take several weeks before you can start training again. Moreover, you may still need to keep your ankle wrapped for support and protection. At this point, athletes are often rushed into returning to their sport before they are allowed to fully recover. In this case, my advice is to think about the long-term effects of your decision to play while still injured. Weak ankles and knees will last for a lifetime after the big game and it can be prevented with proper treatment. So, don't hurry back to the playing field if rest is what your body needs.

Wound

The other common sports-related injury are wounds.

How should I clean a wound?

The best way to clean a cut, scrape or puncture is by running water, or pouring a cup of water, over the wound. Use soap and a soft cloth to clean the wound and skin around the wound, in order to get rid of dirt. It may require tweezers to help remove all the dirt.

Using a strong cleansing solution (such as hydrogen peroxide or an antiseptic) may irritate wounds. But if the wound is really dirty you may have to use it. Leaving a wound uncovered helps it stay dry and helps it heal.

If the wound isn't in an area that will get dirty or be rubbed by clothing, you don't have to cover it. If it is in an area that will get dirty (such as your hand), or be irritated by clothing (such as your knee), cover it with an adhesive strip or with sterile gauze and adhesive tape.

Change the bandage each day to keep the wound clean and dry. Certain wounds, such as scrapes that cover a large area of the body, should be kept moist and clean in order to reduce scarring and speed healing.

In Asian countries where it is humid and there is a lot of dust, your wound should be covered unless you stay in the house.

Antibiotic ointments (such as bacitracin) help healing by preventing infection while keeping the wound clean and moist. Most minor cuts and scrapes will heal just fine without antibiotic ointment, but it can speed healing and help reduce scarring.

When you have a wound, you will develop scabs on the abrasion. Scabs are the body's way of bandaging itself. They form to protect wounds from dirt. It's best to leave them alone and not pick at them. They will fall off by themselves when the time is right.

Do you need a tetanus shot?

Tetanus is a serious infection that you can get after a wound. The infection is also called "lockjaw", because jaw stiffness is the most frequent symptom.

When the wound is clean and minor, you will need a tetanus shot if you haven't had at least three doses before, or haven't had a dose in the last 10 years.

When the wound is more serious, you'll need a tetanus shot if you haven't had at least three doses before or if you haven't had a shot in the last five years.

The writer is a pediatrician based in Sanur, Bali. Questions? Contact her at drdonya@hotmail.com and features@thejakartapost.com