What are sprains and strains in children?

Sprains and strains are types of injuries. A sprain is an injury to a ligament while a strain is an injury to a muscle or tendon.

Ligaments and tendons are made of fibrous tissue. They connect different parts of the body. Ligaments are found at the joints, where they join bones together. Tendons attach muscles to bone.

What causes sprains and strains in a child?

A sudden stretching, twisting, or tearing of a ligament causes a sprain. This injury can happen when a child falls or suffers a hit to the body. Sprains often affect the ankles, knees, or wrists.

A pulling or tearing of a muscle or a tendon causes a strain. 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 similar movements to be repeated over and over.

Which children are 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 common in younger children. That is because their growth plates are weaker than the muscles or tendons. Growth plates are areas of bone growth at the ends of long bones. Instead, younger children are more likely to have broken bones.

What are the symptoms of sprains and strains in a child?

Symptoms may occur a bit differently in each child. Symptoms of a sprain or a strain often depend on the severity of the injury. Below are the most common symptoms your child may feel in the injured area:

• 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. Make sure your child sees their healthcare provider for a diagnosis.

How are sprains and strains diagnosed in a child?

Your child’s healthcare provider makes the diagnosis with a physical exam. During the exam, they ask about your child’s health history and how the injury happened.

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, radiofrequencies, 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 in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

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 or cast

• Crutches or wheelchair

• Physical therapy to stretch and strengthen the injured muscles, ligaments, and tendons

• Surgery, especially if the injury reoccurs or if a muscle, tendon, or ligament is badly torn

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 reinjury. The risk for reinjury is greater in the first 2 months, but can occur even after that.

What can I do to prevent sprains and strains in my child?

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:

• Warming up first

• Training and conditioning properly

• Wearing the right protective gear

• Using the right equipment

You can help your child prevent overuse injuries by making sure your child:

• Sets aside 1 to 2 days per week for rest from competitive sports and training

• Takes breaks from a specific sport during the year

• Focuses on fun, skill-building, safety, and sportsmanship when playing sports

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if:

• There is a prolonged, visible deformity of the affected area

• Severe pain prevents the use of the ligament, tendon, or muscle

• The affected area is still unstable after the sprain or strain has healed

Key points about sprains and strains in children

• Sprains and strains are types of injuries. A sprain is an injury to a ligament, while a strain is an injury to a muscle or tendon.

• Sprains and strains are uncommon in younger children, and fractures or injuries to the growth plate should always be suspected.

• A sudden stretching, twisting, or tearing of a ligament causes a sprain. It can happen from a fall or a hit to the body.

• A pulling or tearing of a muscle or a tendon causes a strain. It can happen suddenly or over time.

• Pain and swelling are some of the most common symptoms of both injuries.

• A physical exam and certain tests, such as X-rays, can help diagnose sprains and strains.

• Treatment may include RICE, pain medicine, and physical therapy. In some cases, surgery may be needed.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.