First Aid: Sprains and Strains in Children
With lots of kids starting fall sports these last few weeks, it’s a great time to discuss popular types of sports injuries so that us parents (and our children!) can be well-prepared this sports season. Here we’ll consider two common injuries to look out for including what they are, how they happen, how they’re treated, and, most importantly, how they can be prevented.
Most sports injuries are caused by minor trauma to muscles, ligaments, and/or tendons. These types of injuries include sprains and strains. The ankle is the most common joint to be sprained or strained, and these injuries typically occur in older children and adolescents. That is because the growth plates in younger children are more fragile. Growth plates are areas of new bone growth located on the ends of long bone. They’re made of flexible, rubbery cartilage and are weaker than their neighboring muscles and tendons. Therefore, young children are more prone to growth plate injuries such as fractures than they are to sprains or strains.
What is a Sprain and How is it Caused?
A sprain is an injury to a ligament where it is stretched or torn. A ligament is a strong, flexible tissue that connects bone to bone at a joint, holding them together. Sprains can occur from falling, twisting (such as “twisting an ankle”), or getting hit, all of which can cause the joint and its ligaments to stretch into an unnatural position. Ankles and wrists are common joints to be sprained.
What is a Strain and How is it Caused?
A strain is an injury to a muscle or tendon where it is stretched or torn, sometimes referred to as a “pulled muscle.” A tendon is a tissue that connects muscle to bone. Strains can happen suddenly such as from a fall or hit to the body. They can also develop over time with overuse. An overuse injury occurs when too much or repeated stress is applied to a body part without enough time to rest to properly heal.
What are the Signs and Symptoms of Sprains and Strains?
Joint or muscle pain
Swelling
Joint stiffness or difficulty moving/using the area
Discoloration of the skin (such as bruising or redness)
How are Sprains and Strains Diagnosed?
A sprain or strain is diagnosed with a physical exam where the cause of injury will be discussed, the injury will be assessed including the joint’s range of motion, and imaging may be ordered to further evaluate. Possible imaging studies include x-rays, magnetic resonance imaging (MRI), and computed tomography scan (CT/CAT scan).
How is a Sprain or Strain Treated?
The first-line treatment for a sprain or strain is typically R.I.C.E. which stands for rest, ice, compression, and elevation. Follow these four steps when using the R.I.C.E. method for the first 48 hours after injury:
Rest the injured area to help protect it and avoid swelling. Your child may use crutches or a brace for a leg injury or a sling for an arm injury to assist
Ice the area immediately for 20 minutes, repeating every 2-4 hours as needed to help reduce inflammation. Remember to always wrap the ice in a towel or cloth and never place directly on the skin to avoid skin injury
Compression should be applied to the area with a bandage or splint to reduce inflammation, limit movement, and stabilize the joint. Wrap the bandage firmly—but not too tight
Elevation of the injured joint above your heart to reduce swelling—even while sleeping
Over-the-counter pain relievers such as ibuprofen can be given to help with pain and swelling. Heat (such as hot baths or heat packs) and massage should be avoided as these can make swelling worse by increasing blood flow to the area.
Sprains and strains can heal quickly in children and adolescents with pain and swelling improving in as little as 2-3 days. Seek immediate medical attention if there is severe pain when the area is touched or moved, your child is unable to bear weight, your child experiences numbness or “pins and needles” to the injured area, there are signs of infection such as warmth, redness, swelling, pain, or streaks, or if the injury does not seem to be improving.
Early physical therapy of the area is recommended such as stretching and strengthening exercises. This helps to promote healing, increase range of motion, and may help to prevent future reinjury which is at the greatest risk during the first two months after injury.
How Can I Help My Child Prevent Sprains and Strains?
Many sprains and strains are sports-related injuries resulting from either a direct injury or from the overuse of muscles or joints. These sports-related injuries can help be prevented in young athletes by warming-up properly and stretching before and after exercise. Using proper protective gear and equipment is essential.
It is also important to avoid overuse injuries by taking appropriate rest and breaks from vigorous exercise and training. You can help your child’s body get proper rest by taking 1-2 days off from competitive sports and training per week and 2-3 months off during the year.
Key Points to Remember
Older children and adolescents are more prone to sprains and strains than younger children, and they often occur during sports. Fortunately, most sprains and strains in children heal quickly with proper care and physical therapy. Your child can help prevent any sprains or strains with proper training and conditioning, the use of proper protective gear and equipment, and appropriate rest when needed to allow the body time to heal. With these prevention strategies in mind, you and your child can have a fun and fulfilling sports season ahead!
