Sprains and Strains a Line Up to Halt the Pain

SPRAINS AND STRAINS

A Line-Up to Halt the Pain

You're trying to fly a kite with your son, but you're having trouble getting it airborne. To get some extra lift, your son decides to take a running start down the hill. As the kite climbs upward, your son suddenly hits the turf, tripped by a treacherous rock.

You look at his swollen ankle and figure that he's probably gotten a sprain or a strain. And whichever it is, you probably wonder whether the injury needs a doctor's attention.

A strain is different from a sprain, though both may be treated in similar ways. A strain can occur when you overwork or overstretch a muscle. The pain and tenderness that results is a sign that muscle fibers have been torn. If you tear or overstretch a ligament (the tough, fibrous band that connects bones at a joint), the injury is called a sprain. Though children's bodies are flexible, they do at times suffer a sprain or strain, according to Morey S. Moreland, M.D., professor of orthopedic surgery and vice chairman of the Department of Orthopaedic Surgery at the University of Pittsburgh and chief of orthopaedic surgery at the Children's Hospital of Pittsburgh. Both injuries involve pain, swelling and tenderness, and both may cause some black-and-blue discoloration because capillaries (tiny blood vessels) in the injured area bleed underneath the skin. To make life more complicated, says Dr. Moreland, if your young child has all of these symptoms, there is a greater likelihood that she may have a fracture.

An Ounce of Prevention

It is impossible to prevent your child from ever getting a sprain or a strain when he participates in sports, but you can try to minimize his chances, says Brian Halpern, M.D., clinical instructor of sports medicine at the Hospital for Special Surgery in New York City and fellowship director of Sports Medicine at University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School in New Brunswick.

'It's worthwhile to make sure that the playing field and equipment is in good condition, that your child stretches and warms up before the game and that everyone understands and plays by the rules. In addition, your child should avoid participating in contact sports until he is physically mature and in good shape.'

Anytime an injury causes swelling and pain, you should take your child to the doctor, says Dr. Moreland. But there are also some things you can do yourself if you suspect your child has suffered a sprain or a strain.

Take a load off. At the first sign of an injury, make sure that your child stops using the affected limb, says Lewis E. Zionts, M.D., assistant professor of orthopedic surgery at the University of Southern California in Los Angeles. 'If your child has an injury, attempting to walk on the affected foot, for example, or trying to flex an injured wrist will only aggravate the condition,' Dr. Zionts says.

Ice it down. The rule of thumb for all sprains and strains is to apply ice--immediately. 'Ice eases the pain and limits the swelling,' says Brian Halpern, M.D., clinical instructor of sports medicine at the Hospital for Special Surgery in New York City and fellowship director of Sports Medicine at the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School in New Brunswick. 'Place a towel or cloth over the injured area, and apply ice in whatever form you have handy,' says Dr. Halpern. Keep the injury iced for 20 minutes, and then let the area rest for a while. Reapply as needed.

'Commercial ice-packs do a good job, but so does a bag filled with ice cubes--or even a bag of frozen peas, if that's all that is available,' says Dr. Halpern.

Immobilize the injury site. Splint a finger, keep an injured arm or wrist in a sling, wrap the ankle or knee with an elastic bandage to give it some support, suggests Dr. Moreland. 'The less you move the damaged tissue, the less you damage it further,' he says.

Elevate it. To help keep the swelling down, try to keep the injured area above your child's heart level if possible, suggests Dr. Zionts. For an injury involving the hand or wrist, elevate the area by using a sling. For an injured ankle, foot, knee or leg, prop it up on a pile of pillows.

Be alert to limping. 'The injury may seem minor if you see very little swelling and no discoloration, but take the child to the doctor if she starts to limp,' says Dr. Zionts. 'Children don't usually limp unless they have a fair amount of pain, and if your child avoids using the injured body part in any way, it could be a more serious problem.'

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