Physical activity is essential for good health and proper development of children and adolescents. However, with activity comes the risk of injuries. Active kids will inevitably have trips and fall, scrapes and bruises. Most of these are minor injuries that heal quickly, but sometimes parents worry that it is something more serious.
Some of the more common injuries that occur are strains and sprains. A strain is a tear to a muscle or tendon, the tissue connecting the muscle to a bone. A sprain is a tear to a ligament, the tissue that connects one bone to another to form a joint.
One of the most important and sometimes difficult tasks for parents and physicians is differentiating between a sprain or strain and a fracture. This is important, though, as each is treated differently. A fracture, which can be diagnosed by an X-ray, needs to be immobilized to allow the bone to heal. Failure to properly treat a fracture can result in misalignment of the bone that could disrupt further growth.
In young children who are still growing, ligaments and tendons are stronger than the bones, so children are more likely to have a fracture. Once the bones are fully grown, they become stronger than the ligaments and tendons, and sprains and strains are more likely. Ligaments and tendons are not visible on an X-ray, but if no fracture is seen, doctors will usually be able to make the diagnosis of a sprain or strain.
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Treatment for a sprain or strain has three phases. The first is to decrease the pain and inflammation and let the tissue begin to heal. This starts with resting the injured area, which can be as simple as refraining from a particular activity, or may require a brace or crutches.
Ice is a great way to reduce pain, inflammation and swelling, and should be used as long as any of these are present. Place a bag of ice cubes or frozen vegetables directly on the injury and leave it in place for 20 minutes. The ice may initially feel uncomfortable with a burning or tingling sensation, but these sensations usually disappear as the skin cools. Each session should be limited to 20 minutes to prevent cold injury to the skin (do not go to bed with ice), but the 20-minute sessions can be repeated multiple times throughout the day.
Anti-inflammatory medications such as ibuprofen or naproxen can also be helpful if your child can take them safely. However, they should be used only to allow a child to make it through their normal daily activities such as walking at school. If they are using the medicine to make it through athletic activities such as practice or games, they are doing too much on the injured muscle or joint and need to slow down to give it more time to heal.
The second phase of treatment is to restore normal range of motion. Many times the affected muscle or joint is stiff from immobilization or decreased use. Gentle stretching or resuming normal use of the injured area can help restore range of motion.
The third phase of the treatment involves strengthening the muscles affected by the injury or surrounding the injured joint. Often, the focus is on the first phase of the rehabilitation, and the second and third phases are forgotten as the pain from the injury subsides. Unfortunately, this can lead to prolonged pain, decreased performance and risk for re-injury.
Other common injures are scrapes and cuts. The first thing to be done is to clean the area and stop the bleeding. Cleaning should be done with soap and water. Other substances such as hydrogen peroxide should be avoided as they can damage the healthy skin that is trying to heal.
Direct pressure can be used to stop bleeding. If the bleeding does not stop after pressure is applied, the cut may need stitches and you should call your child’s doctor immediately or go to an urgent care center or emergency room. Once the bleeding has stopped, you can apply an antibiotic ointment or Vaseline and cover the area with a bandage.
While it is healing, keep the area clean and dry, and monitor for signs of infection such as increased redness around the area, increased pain or swelling or the development of pus.
Any injury that causes joint swelling, locking or instability, a visible deformity, or inability to fully move a joint, walk or stand should be seen by a doctor. Additionally, any injury that does not quickly and progressively improve or prevents your child from engaging in normal activity should be evaluated.
If you suspect a strain, sprain or fracture and need medical assistance, call UHealth Sports Medicine at (305) 689-5500.
Carolyn Kienstra, M.D., is a pediatric sports medicine specialist, at UHealth – the University of Miami Health System. For more information, visit UHealthSystem.com/patients/pediatrics.