Sprains and Strains in Children
The majority of sports injuries are caused by minor trauma involving muscles, ligaments,
and/or tendons, including:
The most commonly sprained or strained joint is the ankle.
The three ligaments involved in ankles sprains or strains include the following:
Sprains or strains are uncommon in younger children. This is because their growth
plates (areas of bone growth located in the ends of long bones) are weaker than the
muscles or tendons. Instead, children are prone to fractures.
What is a contusion?
A contusion (bruise) is an injury to the soft tissue often caused by a blunt force,
such as a kick, fall, or blow. The immediate result will be pain, swelling, and discoloration.
What is a sprain?
A sprain is a wrenching or twisting injury or tear to a ligament. Sprains often affect
the ankles, knees, or wrists.
What is a strain?
A strain is an injury to a muscle or tendon, and is often caused by overuse, force,
or excessive stretching.
How is a sprain or strain diagnosed?
Your adolescent's healthcare provider makes the diagnosis with a physical exam. During
the exam, the healthcare provider takes a complete medical history of your adolescent
and asks how the injury happened.
Diagnostic procedures may also help evaluate the problem. Diagnostic procedures may
X-rays. A diagnostic test that uses invisible electromagnetic energy beams to produce images
of internal tissues, bones, and organs onto film.
Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies,
and a computer to produce detailed images of organs and structures within the body.
Computed tomography scan (also called a CT or CAT scan). This is an imaging test that uses X-rays and a computer to make detailed images of
the body. A CT scan shows details of the bones, muscles, fat, and organs. CT scans
are more detailed than general X-rays.
What are the symptoms of a sprain or strain?
The following are the most common symptoms of a sprain or strain. However, each adolescent
may experience symptoms differently. Symptoms may include:
Pain in the injured area
Swelling in the injured area
Difficulty using or moving the injured area in a normal manner (Your adolescent may
have limited use or may not use the injured area at all. Your adolescent may walk
with a limp if the injury happened in the hip, leg, ankle, or foot area.)
Warmth, bruising, or redness in the injured area
The symptoms of a sprain or strain may resemble other conditions. Always talk with
your adolescent's healthcare provider for a diagnosis.
Treatment for sprains or strains
Specific treatment for a sprain or strain will be determined by your adolescent's
healthcare provider based on:
Your adolescent's age, overall health, and medical history
Extent of the injury
Your adolescent's tolerance for specific medicines, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
Initial treatment for a sprain or strain includes R.I.C.E. (rest, ice, compression,
and elevation). Other treatment choices may include:
Medicines, such as ibuprofen
Splint or cast
Crutches or wheelchair
Physical therapy (to stretch and strengthen the injured muscles, ligaments, and tendons)
Surgery (especially if the injury is reoccurring or if a muscle, tendon, or ligament
is badly torn)
Be sure to talk with your adolescent's healthcare provider if there is a prolonged,
visible deformity of the affected area, or if severe pain prevents use of arm, leg,
wrist, ankle, or knee.
What is an overuse injury?
Children and adolescents who regularly participate in sports activities may develop
microtraumatic damage to a muscle, bone, or tendon. When it is repeatedly stressed,
it does not have time to heal naturally. This cumulative damage is known as an overuse
injury. The injury is called microtrauma because it may not appear on X-ray, but it
can affect the overall health and development of the child or adolescent. Overuse
injuries are classified in four stages:
Pain in the affected area after physical activity
Pain during the activity, without restricting performance
Pain during the activity, with restricted performance
Chronic pain that does not go away
Prevention of overuse injuries
The following are recommendations to prevent overuse injuries in young athletes:
Reserve one to two days per week for rest from competitive sports and training.
Take breaks away from a specific sport during the course of a year.
Emphasize that sports participation should be focused on fun, skill-building, safety
Long-term outlook for an adolescent with a sprain or strain
Contusions, sprains, or strains heal quite quickly in children and adolescents. It
is important that your teen follow the activity restrictions and/or stretching and
strengthening rehabilitation programs to prevent reinjury.
Most sports injuries are due to either traumatic injury or overuse of muscles or joints.
Many sports injuries can be prevented with proper conditioning and training, wearing
appropriate protective gear, and using proper equipment.