Your health
By Sally Robinson and Keith Bly 

If you have a child who participates in sports, chances are you will have to help treat a strain or a sprain at some point. Many people do not know the difference between the two. 

A strain occurs when a muscle or tendon, which is elastic-like tissue that connects a muscle to a bone, is stretched too far. People commonly get strains in the neck, back and legs. There are two types of strains – chronic and acute. Acute strains are associated with a recent injury, while chronic strains occur after overuse. 

A muscle that has been strained may start hurting immediately, or it may not begin hurting for several hours. The area around the strained muscle will be tender and swollen, and it may appear bruised. In general, strains begin hurting immediately and there is weakness in the muscle when the person attempts to move it. Severe strains, in which the muscle is partially or completely torn, can be very painful. 

Sprains are more serious than strains They occur when ligaments — strong bands of elastic-like tissue that connect two or more bones at a joint — are stretched too far or torn. Sprains can result from falls, sudden twists, or blows to the body that force a joint out of its normal position and stretch or tear the ligaments that support that joint. They can occur in both the upper and lower body, but the most common site for sprains is the ankle. The area surrounding the stretched or torn ligament will swell and look bruised. It will also be hard to move the injured area. When the accident happens, it may sound like a bone is breaking, and the child may feel a popping or tearing sensation. Sprains normally take about two to four weeks to heal. 

You should see a doctor for a sprain if:

·        There is severe pain and no weight can be put on the injured joint.

·        The injured area looks lumpy or crooked, other than the swelling.

·        The injured joint cannot be moved.

·        There is significant pain if your child walks more than four steps.

·        There is numbness in any part of the injured area.

·        There is redness or red streaks spreading from the injury.

·        This is not the first injury to this joint.

·        You are unsure of how serious the injury is. 

The focus of treatment for minor sprains or strains should be to reduce swelling and pain. Ibuprofen can be taken for pain and inflammation. For the first 24 to 48 hours, patients are usually told to rest the injured area, apply an ice pack (with a towel between the pack and the skin) for 20 minutes at a time, use compression bandages, and elevate the injury above the level of the heart so that the swelling goes down. 

The risk of getting strains and sprains can be lowered by:

·        Avoiding exercise or playing sports when tired or in pain.

·        Maintaining a healthy, well-balanced diet, which will help to keep muscles strong.

·        Practicing safety measures, such as keeping stairways, walkways, and driveways clear of clutter.

·        Wearing shoes that fit properly.

·        Stretching before exercising.

·        Wearing protective equipment when playing a sport.

·        Running on level surfaces. 

Sally Robinson is a clinical professor of pediatrics at the University of Texas Medical Branch at Galveston Children’s Hospital and Keith Bly is an assistant professor of pediatrics in the UTMB Children’s Emergency Room. This column is not intended to replace the advice of a physician.