Orthopaedics

Sprains and Strains

The majority of sports injuries are caused by minor trauma involving muscles, ligaments, and/or tendons, including:

• contusions (bruises)
• sprains
• strains

The most commonly sprained or strained joint is the ankle.

The three ligaments involved in ankles sprains/strains include:

• anterior talofibular ligament
• posterior talofibular ligament
• calcaneofibular ligament

Sprains or strains are uncommon in younger children 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 produced 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 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 stretching.

How is a sprain/strain diagnosed?

Your child's physician makes the diagnosis with a physical examination. During the examination, the physician obtains a complete medical history of the child and asks how the injury occurred.

Diagnostic procedures may also help evaluate the problem. Diagnostic procedures may include:

• x-rays - a diagnostic test which 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.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including 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 child may experience symptoms differently. Symptoms may include:

• pain in the injured area (The child typically may guard or protect this area from being touched or looked at.)
  
  
• swelling in the injured area
  
  
• difficulty using or moving the injured area in a normal manner (The child may have limited use or may not use the injured area at all. The child may walk with a limp if the injury occurred 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 consult your child's physician for a diagnosis.

Treatment for sprains or strains:

Specific treatment for a sprain or strain will be determined by your child's physician based on:

• your child's age, overall health, and medical history
• extent of the injury
• child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the injury
• your opinion or preference

Initial treatment for a sprain or strain includes R.I.C.E. (rest, ice, compression, and elevation). Other treatment options may include:

• activity restrictions
  
  
• splint/cast
  
  
• crutches/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 consult your child's physician if there is a prolonged, visible deformity of the affected area, or if severe pain prevents use of arm, leg, wrist, ankle, or knee.

Long-term outlook for a child with a sprain or strain:

Contusions, sprains, or strains heal quite quickly in children. It is important that the child adhere to the activity restrictions and/or stretching and strengthening rehabilitation programs to prevent re-injury.

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.