Does My Child Have a Sprain or a Strain?

Sprains and strains are similar injuries with common symptoms. They often occur when children return to sports or other physical activities after a summer or holiday break. Both injuries involve tearing or trauma to the muscle, tendon or ligament tissue. But a strain — sometimes referred to as a “pulled muscle” — is a muscle or tendon injury often affecting the hamstring or lower back. A sprain refers to a stretched or torn ligament, with the ankle particularly susceptible. Both injuries bring pain, swelling, and limited flexibility and range of motion. 

What’s the main difference between the two? Look for bruising around the joint, as that is the hallmark of a sprain, whereas muscle spasms often accompany a strain. Recovery differs, too, as a strain may take days or weeks to heal, whereas a severe sprain may take four to six weeks, or longer. 

How to Tell and Treat 

At any age, body joints can end up either sprained or strained from playing sports, but these injuries often occur when someone doesn’t take time to stretch or warm up first. Ankles, knees, wrists, elbows, backs, shoulders and thumbs are most at-risk.

Strains and sprains range from mild to severe. After a brief physical exam, your doctor may request an X-ray or MRI to rule out any breaks or fractures. Otherwise, whether your child is diagnosed with a sprain or strain, the treatment is often the same, starting with RICE:

• Rest

• Ice

• Compression

• Elevation.

Physical therapy and a temporary splint or cast also may be needed.

Preventing Injuries

Sometimes we forget that children, with their abundance of energy, should take the same precautions as adults to prevent sports injury. Whether your child takes part in soccer, gymnastics or karate — or you’re about to go on a family hike — remember to:

• Stretch first and cool down after. Working out or playing sports on cold muscles is bad for joints. Set your child up for good lifelong habits by ensuring they warm up with stretches that prepare their joints for both physical activity and recovery. 

• Encourage regular movement. Moderate activity every day is better than aggressive activity once or twice a week. This keeps muscles limber and flexible, so they’re able to recover and strengthen over time. If your kids don’t play sports or remain active consistently, ensure that they get shorter periods (10 to 15 minutes) of exercise or play.

• Be cautious. Muddy trails and wet, slippery grass can be treacherous, so be sure to teach kids how and when to tread carefully. Check to make sure they’ve got shoes with good treads and ensure they take their time when conditions require it. 

• Take breaks. Sitting or standing for too long, or doing repetitive motions can put strain on muscles. This includes spending time on electronic devices. Encourage kids to get up, stretch and give muscles a break whenever possible.

• Use the right equipment. If your child is active in a particular sport or martial art, be sure you have access to good equipment. Ill-fitting, poorly made or worn out equipment increases the chance of injury. This includes shoes, which can wear out more quickly than you may realize. Check your child’s shoes often. 

• Invest in rest. Kids deal with stress and juggle full schedules. Being overly fatigued raises the risk for injury at any age, so pay attention. Make sure they have scheduled time off for rest and recovery.

When Can My Child Resume Activity? 

To avoid re-injury, your child needs to heal completely before returning to sports or other physical pursuits. They may return when: 

• The swelling goes down

• Participating in the sport or activity is pain-free

• The doctor says your child may return

• They can participate without limping and have full range of motion

• They are back to full strength