Sprains and Strains in Children: What To Do, When To Worry

Sprains and strains may sound alike, but they are completely different types of injury – and both are very common in children.

A sprain is an injury to a ligament, which is a fibrous tissue that connects bones. A strain is an injury to a muscle or a tendon, which is another kind of fibrous tissue that attaches muscles to bone.

We asked Michael Glotzbecker, MD, Chief of Pediatric Orthopedics at UH Rainbow Babies & Children’s Hospital, about sprains and strains in children.

What Causes Sprains and Strains?

Sprains happen when a ligament suddenly stretches, twists, or tears. This injury can occur when a child falls or suffers a hit to the body. Sprains often affect the ankles, knees or wrists. 

Strains happen when a muscle or tendon is pulled or torn. This type of injury can happen suddenly, such as when a child overstretches a muscle. Or it can happen over time if a child overuses a muscle or tendon. Overuse can occur during activities that require movements that are performed over and over. 

Who is at Risk for Sprains and Strains?

Active teens or those who play sports are most at risk for a sprain or a strain. These injuries are not as common in younger children because their growth plates are weaker than the muscles or tendons in younger kids and may be injured instead of the ligament. Growth plates are areas of bone growth at the ends of long bones.

What are Symptoms of Sprains and Strains in a Child?

Symptoms of a sprain or a strain often depend on the severity of the injury and may be different in each child. Injuries to the growth plate will often present in the same way.

The most common symptoms your child may feel in the injured area include:

• Pain
• Swelling
• Warmth, bruising or redness
• Weakness
• Trouble using or moving the injured area in a normal way

These symptoms may look like other health problems, so make sure your child sees a healthcare provider for a diagnosis.

How are Sprains and Strains Diagnosed?

Your child’s healthcare provider makes the diagnosis with a physical exam. During the exam, he or she asks about your child’s health history and how the injury happened. They will also find where the pain is to help determine where the injury may be.

Your child may also need:

• X-rays -- This test makes images of internal tissues, bones, and organs. 
• MRI -- This test uses a combination of large magnets, radio frequencies, and a computer to make detailed images of organs and structures within the body. 
• CT scan -- This test 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.

How Are Sprains and Strains Treated?

Treatment will depend on your child’s symptoms, age and general health. It will also depend on the severity of the condition.

Initial treatment for a sprain or a strain includes rest, ice, compression and elevation (RICE).

Other treatment choices may include:

• Pain medicines, such as ibuprofen
• Activity restrictions
• Splint, cast, or a removable walking boot
• Crutches or wheelchair
• Physical therapy to stretch and strengthen the injured muscles, ligaments, and tendons
• Surgery, is not commonly needed, but occasionally is needed if there is a fracture 

Sprains and strains usually heal quite quickly in children and teens. Make sure your child follows any activity restrictions and stretching and strengthening exercises to prevent re-injury. The risk for re-injury is greater in the first 2 months, but can occur even after that.

How Can My Child Avoid Sprains and Strains?

Many sprains and strains are sports injuries. They are from either injury or overuse of muscles or joints. Many sports injuries can be prevented by ensuring your child warms up first, trains and conditions properly, wears the right protective gear, and uses the right equipment.

You can also help your child prevent overuse injuries by making sure your child sets aside one to two days each week for rest from competitive sports and training and takes breaks from a specific sport during the year. Also encourage your child to focus on fun, skill-building, safety and sportsmanship when playing sports.

When Should I Call My Child’s Health Care Provider?

You should call your child’s healthcare provider if:

• The affected area has a prolonged, visible deformity
• Severe pain prevents use of the ligament, tendon, or muscle
• The affected area is still unstable after the sprain or strain has healed

Related Links

If your child has a broken bone or an injury that needs immediate attention, UH Rainbow Babies & Children has two walk-in pediatric orthopedic injury clinics that can fast-track your child’s care with one hassle-free visit – and without multiple appointments or a pricey trip to the emergency room. Or make an appointment for your child with one of our board-certified and fellowship-trained pediatric orthopedic doctors.

In addition, the UH Rainbow Sports Medicine team provides management of sports sprains and strains, with numerous clinics throughout Northeast Ohio.