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Break, sprain or strain -- it's all a pain

Break, sprain or strain -- it's all a pain

My dream of one day going pro died with a cruel twist of fate. It was a severe turn of the ankle, where I simultaneously heard and felt a "pop." While the look in the doctor's eyes said it all, I do recall his words quite clearly, too.

"You're 43 years old now," he lectured. "You might have to think about giving up touch football for something a little less hazardous to your health."

I'm not sure which hurt more -- my broken ankle or that remark -- but I do know I found little solace in my buddy's cheerful comment that, "a break is much better than a sprain."

I was reminded of this entire incident, including my friend's tact, after watching both Mike Lowell and J.D. Drew suffer wrist sprains recently. I asked Dr. Arun Ramappa, chief of sports medicine in the Department of Orthopedic Surgery at Beth Israel Deaconess Medical Center, for a little clarification. Does a break heal faster than a sprain?

"Well, it's not that simple," explained Ramappa. "Both a broken bone and a soft tissue injury, like a sprain, can be quite debilitating. Both take quite some time for recovery."

Let's start with bones. Why does this impression that a break is better, exist?

"When a fracture or break occurs between joints, usually the bone heals quite well when it's set properly. If, however, the fracture extends into a joint there can be problems," says Ramappa.

He likens it to road repairs. "If a crack or a pothole isn't filled correctly, you'll feel a bump when you drive over it. With bones, those bumps transmit forces to the other surfaces of the joint and can cause cartilage damage. That can lead to arthritis."

That's why in children, whose ligaments and tendons are stronger than their growing bones, an injury which would likely lead to a sprain in an adult can cause a break.

"In a growing child, the end of the bone is made up of cartilage. It's what we refer to as the growth plate. It's not uncommon for breaks to happen in the area of the growth plate," says Ramappa. "The pain may be quite similar to that of a severe sprain and an X-ray is often the only way to ensure that the child gets the right treatment."

Sprains are injuries to the tendons and ligaments. When those tissues are stretched beyond their normal range, the fibers can tear on a microscopic level. If there's a great deal of tearing, the injury might require surgery. The result is pain and, depending upon the severity of the injury, a considerable amount of swelling.

Doctors suggest remembering the acronym RICE when treating simple sprains. R -- rest, I -- icing the site of the injury, C -- compression to reduce swelling and E -- elevation of the injured area.

"I would also suggest immobilizing the injured area to provide some stability. Once the pain subsides, we like people to get moving again to regain their normal motion," he adds. "That's important when it comes to getting back to 100 percent. Maintaining or increasing your flexibility can go a long way in avoiding the possibility of re-injury."

For ballplayers, getting back into the lineup becomes a full-time job once they are hurt. It's not a job that anybody wants to keep.

"For you and me, a sprained wrist might not be that much of a problem," says Ramappa. "But for a guy who makes a living fielding, throwing and batting, his return to the lineup depends upon when he can do those things without pain and with a normal range of motion."

As for me, it's been 10 years since the injury, but I still feel the pain.

I think it's from a broken heart. I could have been a contender!

Gary Gillis is a contributor to MLB.com. The BID Injury Report is a regular column on redsox.com. Beth Israel Deaconess Medical Center is the official hospital of the Boston Red Sox. This story was not subject to the approval of Major League Baseball or its clubs.

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