Sprains & Strains

BY LINDA STEVENSON, PhD, RN, FNP-C, PEDIAQ SENIOR NURSE PRACTITIONER

School and sports are in full swing, and with them often comes injuries, the mildest being sprains and strains.

What is the difference between a sprain and a strain? A sprain is the stretching or tearing of ligaments, those bands of fibrous tissue that connect bones together. A strain is the stretching or tearing of muscle or tendon, the fibrous cords that connect muscle to bone. In other words the muscle has stretched too far.

Sprains cause pain, swelling, bruising, decreased ability to move the affected joint, and occasionally at the time of injury you can sometimes hear a pop in the joint. They usually begin to hurt right away, it may look bruised and it is difficult to move the joint.

Strains also cause pain, swelling, decreased ability to move the joint, and they cause muscle spasms. Because it affects the muscle it may hurt immediately or not begin to hurt for several hours – it may appear bruised.

How can you prevent this type of injury? Make sure your child has and uses the proper equipment for each sport. Warm-ups and cool-downs should be a part of your child’s routine. Warmed up muscles are more flexible and cooling down will loosen any muscles that tightened during the exercise. Know the safety rules for your child’s sport and teach them to your child. The coach should be an active participant in having children use equipment wisely, know and enforce safety rules and have knowledge of first-aid. Often as children get older or are in organized sport programs there are athletic trainers on site who pay attention to any child’s injury and make sure they get the care they need. It is also important for your child not go back to sports until cleared by their physician.

But what about when it happens at home or the park when your child is just playing normally? The initial treatment for both sprains and strains is to limit activity, then rest, ice, compression and elevation (RICE). Ice/cold is important in the first 24 hours, as is decreased activity/rest. Apply the ice/cold pack for 20 minutes at a time. Always keep a towel between the ice and your child’s skin to prevent damage to the skin.  An elastic compression bandage, or splint can help with the swelling and provide support to the injured area. It is very important that it is not too tight; you don’t want to cut off the circulation. Elevation means raising the injured area so it is higher than their heart. After 24 hours you can usually use warm compresses or a heating pad for short periods of time, this helps aching muscles.

When should you see a doctor: if your child can’t walk more than 4 steps without significant pain or if they can’t move the affected joint, or they have numbness in any part of the injured area.  If you notice your child limping without having an injury, or if they have a limp after an injury that is not improving, a visit to their pediatrician is in order. Your child should also be seen by a pediatrician if the pain is intense and out of proportion to the injury, or if there is pain directly over the bones in the area – an x-ray may be indicated to check for a fracture.

A strain can take at least a week to heal and a bad sprain can take up to 3-4 weeks. Be sure to give a sprain time, or it is easier to re-injure.