SPRAINS & STRAINS
Sprains and strains are injuries to ligaments that hold joints together and in position. A strain is a stretched ligament. A sprain is a stretched and torn ligament. Sprains occur most often in ankles, knees, or fingers, although any joint can be sprained. Sprained joints can function -- but only with pain. Any ligament (tendon) attached to any joint can be involved. The most commonly injured joint is the ankle, followed by the knee, wrist, and back.
Appropriate health care includes:
Self-care if the injury is not severe.
Physician's monitoring of general condition and medications, if the joint cannot move or bear weight normally.
Cast for a severely sprained joint.
Surgery to repair badly torn ligaments.
Physical therapy to regain strength and normal use of the joint.
SIGNS & SYMPTOMSPain or tenderness in the area of injury; severity varies with the extent of your child's injury.
Swelling of the affected joint.
Redness or bruising in the area of the child's injury, either immediately or several hours after injury.
Loss of normal mobility in the injured joint.
Overuse or stress of a ligament or membrane around a joint. A sprain usually occurs when the body weight is placed abnormally on ligaments, causing them to stretch and tear. The ankle is injured most often because of its anatomical weakness, its exposed position, and the stress it sustains in athletic and recreational activities.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should avoid injury:
Wrap the child's weak joints with support bandages before strenuous activity.
Strengthen the child's weak joints with rehabilitative exercises to prevent a recurrence. Consult your doctor or a physical therapist for exercises.
Accident-proof your home.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of the injured area.
POSSIBLE COMPLICATIONSPermanent weakness if your child's sprain is severe or if a joint is sprained repeatedly.
Strains usually heal in 1 to 2 weeks. Sprains generally heal in 2 weeks without complications.
Apply ice to the child's injured joint during the first 24 hours. Place ice in a plastic bag and separate it from the child's skin with a thin towel. Hold it against the joint with your hand or an elastic bandage. Keep the ice pack on the joint up to 2 hours at a time--either constantly or intermittently--depending on your child's ability to tolerate the cold. Continue the ice treatment at 2-hour intervals for 24 hours.
After 24 hours, some doctors recommend continued ice treatment. Others recommend heat.
To use heat, soak the child's joint in hot water or apply heat for 15 minutes every 2 hours or whenever possible. Don't apply heat during the first 24 hours. It may increase bleeding and swelling and prolong healing time.
Whenever possible, elevate the child's joint so fluid can drain and diminish swelling.
A cast may be necessary for severe sprains or following surgery. See Care of Casts, Appendix 41. Following cast removal, your child will wear support bandages for a while.
Your child will have to learn how to use crutches, if needed.
MEDICATIONUse non-prescription pain relievers such as aspirin. If the child's sprain is severe, your doctor may prescribe a stronger pain reliever.
See Medications section for information regarding medicines your doctor may prescribe.
Allow the child's joint to rest 1 or 2 days. Then the child can begin exercising the joint gently, without putting weight on it.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?Yes, when mobility has returned with or without crutches.
CALL YOUR DOCTOR IF
Your child has a sprained joint that won't bear weight or move normally.
Pain becomes intolerable.
Swelling or bruising increases, despite treatment.