Sprains & Strains – What to do
Written by Stephanie Austin, Founder & Lead Trainer, Prima Cura Training
Reviewed & Updated: 23rd February 2026 to reflect current UK first aid guidance, including changes in the traditional RICE approaches in line with General Resuscitation UK First Aid guidance. Clinical guidance aligned with current UK first aid recommendations.
You’re walking the dog.
You step off a curb awkwardly.
You hear that little “oh no” sound in your head before the pain even kicks in.
Or maybe it’s at work. Someone lifts something slightly wrong. Or twists quickly. Or misses a step.
Sprains and strains are common. Really common. But the number of people who still say “just walk it off” or “put heat on it straight away” tells me we need to talk about this properly.
So let’s break it down in plain English.
First Things First – What’s the Difference?
Sprain
A sprain is when a ligament (the tissue connecting bone to bone) is stretched or torn.
Common around ankles, knees and wrists.
Strain
A strain is when a muscle or tendon (the tissue connecting muscle to bone) is overstretched or torn.
They feel similar. They’re treated similarly in early stages. But the structures involved are different.
What Causes Sprains and Strains?
In my experience teaching thousands of learners across workplaces in Manchester and beyond, the usual culprits are:
- Slips, trips and falls
- Poor lifting technique
- Sudden twisting movements
- Sport and physical activity
- Fatigue (tired muscles don’t protect joints well)
If you work in care, hospitality, construction, education, offices… honestly, anywhere… these injuries crop up.
This is why understanding basic injury management is part of Workplace First Aid Training and why the HSE First Aid Guidance expects employers to consider musculoskeletal risks.
What Are the Signs of a Sprain or Strain?
Look for:
- Pain (especially when moving)
- Swelling
- Bruising
- Reduced movement
- Tenderness
With more severe injuries, you might see:
- Instability in the joint
- Severe swelling very quickly
- Inability to weight-bear
- A visible deformity (this may suggest fracture, not just a sprain)
And this is where calm thinking matters.
Because not everything is “just a twist”.
What Should You Do? (The Right Way)
Forget the old “put heat on it immediately” advice.
Early management follows RICE:
R – Rest
Avoid weight-bearing or strain for the first 24–48 hours.
I – Ice
Apply a wrapped cold pack for 10–20 minutes at a time.
Never directly on skin.
Cold helps reduce swelling and inflammation in early stages.
C – Comfort (used to be Compression)
Focus has softened from “compression as a treatment” to “comfort as the priority”.
E – Elevation
Raise the injured limb above heart level if possible.
Gravity helps reduce swelling.
This guidance aligns with UK first aid teaching and current best practice referenced by organisations such as the NHS.
Why Has “Compression” Shifted Towards “Comfort”?
For years, first aid advice included compression as a standard part of managing sprains and strains. The idea was simple: apply a firm bandage to limit swelling and support the injured area.
But our understanding of soft tissue injuries has evolved.
Swelling is not automatically a bad thing. It’s part of the body’s normal healing response. Inflammation helps deliver the cells and nutrients needed for repair. Trying to completely suppress that response, especially in the early stages, isn’t always helpful.
There’s also a practical issue.
In real-world settings, bandages are often applied too tightly. When compression is excessive or left on too long, it can:
- Restrict circulation
- Increase pain
- Cause numbness or tingling
- Potentially delay recovery
In workplace and community first aid, the priority is safety. Most first aiders are not clinicians. They need guidance that reduces risk, not adds to it.
That’s why the language has softened from “compression” to “comfort”.
Comfort means:
- Supporting the injured area, if it helps reduce pain
- Avoiding tight or restrictive wrapping
- Checking circulation regularly
- Removing support if symptoms worsen
A supportive bandage can still be used, but it should feel reassuring, not restrictive. The aim is to make the person more comfortable while monitoring for signs that medical assessment may be needed.
It’s a small wording change. But it reflects a bigger shift in thinking: support the body while it heals, rather than trying to control it too aggressively.
When Is It More Than “Just a Sprain”?
This is where good first aiders make a difference.
Seek medical assessment if:
- The person cannot bear weight at all
- Pain is severe and not settling
- There is an obvious deformity
- Numbness or tingling occurs
- Swelling is extreme
- You suspect a fracture
If in doubt? Get it checked. Only an X-ray can confirm a fracture!
If something doesn’t look right, trust your instincts.
You don’t need to diagnose. You need to recognise when it’s outside basic first aid scope.
What About Heat?
Heat is useful later.
After the first 48 hours, once swelling has reduced, gentle heat can help with stiffness and muscle relaxation.
But not straight away.
Ice early. Heat later.
Should You Keep Moving It?
Gentle movement after the acute phase can help recovery.
But forcing it too soon can delay healing.
This is why proper workplace risk assessments matter. If someone returns to full duties too quickly, you often see repeat injuries.
If you’re responsible for staff safety, it’s worth reviewing your moving and handling training. We cover injury prevention properly in our Manual Handling Training and our Moving & Positioning of People Training.
Prevention beats recovery every time.
How Long Do Sprains and Strains Take to Heal?
Everyone is individual, and we all heal at our own unique rates. However, the rough guide is:
Mild: 1–2 weeks
Moderate: 3–6 weeks
Severe: 8+ weeks
Ligaments and tendons have a limited blood supply. They take time.
Rushing it is how small injuries turn into chronic problems.
Workplace Responsibilities
Under UK health and safety law, employers must:
- Assess risks
- Provide suitable first aid provision
- Support injured employees
- Prevent recurrence
The Health and Safety Executive (HSE) makes it clear that first aid provision must be appropriate to the risks present.
If slips, trips and musculoskeletal injuries are common in your setting, your first aiders should know how to manage them confidently.
And that’s not about ticking a box.
It’s about preventing small injuries from becoming long-term absences.
Real Talk From The Training Room
One thing I always say in training:
People are very brave for about 20 minutes.
Then the swelling kicks in.
Then they realise they probably shouldn’t have tried to “walk it off”.
Early calm action makes a difference.
Knowing what to do makes a difference.
Confidence makes a difference.
That’s why we don’t just teach “what”. We teach “why”.
Quick Sprain & Strain Checklist
If you’re in a workplace and someone twists or pulls something:
- Stop activity
- Check for red flags
- Apply RICE
- Monitor
- Escalate if needed
- Record the incident
And yes, recording matters. It protects everyone.
So What’s The Takeaway?
Sprains and strains aren’t dramatic.
They don’t come with flashing lights or sirens.
But they are the injuries we see again and again — in workplaces, in care settings, in schools, on building sites, in offices.
And when they’re brushed off or managed badly, they hang around far longer than they should.
Most of the time, what’s needed isn’t heroics. It’s common sense.
Stop.
Support.
Reduce swelling early.
Keep an eye on it.
Escalate if it doesn’t look right.
That’s it.
Calm, practical, sensible first aid. The kind that makes a quiet difference.
Disclaimer – This article is for general information only and reflects current UK first aid guidance at the time of review. It does not replace professional medical assessment or emergency care. If an injury is severe, worsening, or you suspect a fracture or serious damage, seek advice from a qualified healthcare professional or contact NHS 111. In an emergency, call 999.
For workplace-specific advice, ensure your organisation follows current HSE guidance and relevant UK legislation.
