Sprains/Strains

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What is a sprain? What is a strain?
Sprains and strains are common injuries that occur in both adult and pediatric patients. A sprain is an injury to a ligament (tissue that connects bone to bone) or a joint capsule, which is responsible for joint stability. This occurs when a joint is forced beyond its normal limits, such as rolling your ankle. A strain is an injury to the musculo-tendinous (muscle or tendon) unit. A strain occurs with an acute pull on a contracted muscle, such as an explosive run or a sudden twist, or can be a chronic process due to overuse or repetitive stress. Common sites for sprains and strains include the neck, low back, hamstring and ankle.

Because the growth plate is the weakest part of a child’s growing skeleton, kids will typically develop a growth plate fracture before injuring a ligament or tendon. However, there are cases where a child can injure both soft tissue as well as bone. For this reason, appropriate evaluation, care, and management are important to ensure no damage to the growth plate.

Management
Sprains and strains are graded as I (mild fraying), II (partial tearing), or III (full thickness tearing). They are typically treated with RICE (rest, ice, compression, elevation) and a period of immobilization. A short stint of physical therapy is typically recommended to help regain full strength and range of motion. For ankle sprains, a short period of immobilization with an ankle brace or walking boot is recommended to permit healing. Although a patient may feel better after a short period of rest and immobilization, there often remains some underlying weakness throughout the joint, which could lead to recurrent ankle inversion injuries. For this reason, physical therapy is often recommended to ensure ankle strength and stability. With appropriate treatment, simple ankle sprains typically heal within four to six weeks.