Sprains and Strains

With summer vacation just days away, your children are probably gearing up for foot races in the park, bike riding, and swimming, which often leads to injuries like sprained ankles or strained wrists. Sprains and strains are common injuries among active children with more than 900,000 kids in the United States visiting emergency rooms each year.

It’s important to recognize the signs and symptoms of these common injuries:

• pain and swelling in the injured area,
• difficulty moving the injured area, and
  
• bruising or redness.

A sprain is a twist or tear of a ligament – the short band of tough flexible, fibrous connective tissue that connects two bones. A strain is also a twist or tear but of a muscle.

In pediatric medicine, sprains and strains occur most often in tweens and teens than younger children. The growth plates – the areas of bone growth located in the ends of long bones – in younger children are weaker than the muscles or tendons. Instead, children are more prone to fractures or breaks.

If you suspect your child has a sprain or strain, it is best to bring your child to theirpediatrician or the pediatric emergency department, so a trained medical professional with experience and knowledge of your child’s developing body can make the diagnosis with a physical examination. Your child may diagnostic testing like an X-ray, magnetic resonance imaging (MRI) or computed tomography scan (CT scan).

After a proper medical evaluation, sprains and strains can be treated at home with R.I.C.E – rest, ice, compression, and elevation. Additional treatment measures like splints, crutches and activity restrictions may be necessary to aid in healing.

These injuries heal quickly in children, but it is important to adhere to any activity restrictions to prevent re-injury. If there is a prolonged or visible deformity to the affected area, consult your child’s pediatrician or visit the emergency department.

Fast Facts: What are sprains and strains?

What is a sprain?

A sprain is a twist or tear of a ligament (the short band of tough flexible, fibrous connective tissue that connects two bones).

What causes a sprain?

Sprains are most commonly caused by falling, twisting or getting hit in a way that forces a joint out of its normal position. Sprains happen most often in the ankle, though children also sprain their wrists and thumbs.

What are strains?

A strain is also a twist or tear to a muscle or tender (tissue that connects muscle to bone).

What causes strains?

Strains are caused by twisting or pulling a muscle, typically by lifting heavy objects the wrong way or overstressing muscles. Strains often happen in the back or the hamstring muscle of the thigh. Children who play soccer, football, hockey or wrestling are at risk for straining their back or legs. Children who do gymnastics or play tennis are at greater risk for straining their hand, arm or elbow.

What are the signs and symptoms of strains and sprains?

Symptoms for strain and sprain include:

• pain in the injured area
• swelling in the injured area
• difficulty using or moving the injured area in a normal manner
• bruising or redness in the injured area

How are sprains and strains treated?

To reduce swelling and pain associated with strains or sprains, we recommend using R.I.C.E.:

• Rest the injured area. This may mean using crutches or a cane if the ankle or knee is hurt.
• Ice the injured area for 20 minutes up to eight times a day.
• Compress the injury with bandages. Consult with your pediatrician about the best compression method and how tight it should be.
• Elevate the injured area above the level of the heart as much as possible to reduce swelling.

Consult with your pediatrician about over-the-counter pain relievers such as ibuprofen.

This post was written by Joshua Rocker, MD, and Jahn Avarello, MD, of the North Shore-LIJ Health System.

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