When Your Child Has a Strain, Sprain, or Contusion

Strains, sprains, and contusions are common injuries in active children. These injuries are similar, but involve different types of body tissue. Most of these injuries happen during sports or active play. But they can happen at any time. A strain, sprain, or contusion can be painful. With the right treatment, most heal with no lasting problems.   

How are strains, sprains, and contusions diagnosed?

The healthcare provider asks about your child’s symptoms and medical history. An exam is also done. An X-ray (test that creates images of bones) may be done to rule out broken bones.

How are strains, sprains, and contusions treated?

• Strains and sprains can take up to months to heal. If not treated and allowed to heal, a strain or sprain can lead to long-term problems. These include lasting pain and stiffness. So it is important to follow the healthcare provider’s instructions.

• The pain of a contusion often goes away within the first week or two. But the swelling and discoloration may take weeks to go away.

Treatment consists of one or more of the following:

• RICE. This stands for Rest, Ice, Compression, and Elevation

  • Rest. As much as possible, your child should not use the injured area. In some cases, your child may be given a brace or sling to keep an injured joint still. Your child may also be given crutches to keep some weight off a strain to the leg or a sprain to the ankle or knee.

  • Ice. Put ice on the injured area 3 to 4 times a day for 20 minutes at a time. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Never put ice directly on the skin.

  • Compression. If instructed, wrap the area to keep swelling down. Use an elastic bandage. Do this as instructed by your child’s healthcare provider.

  • Elevation. Have your child raise the injured body part above the level of the heart.

• Medicines to relieve inflammation and pain. These will likely be NSAIDs (nonsteroidal anti-inflammatory drugs). NSAIDs include ibuprofen and naproxen. Give these medicines to your child only as directed by your child’s healthcare provider.

• Physical therapy (PT). This is done to strengthen the injured area. This is especially helpful for moderate to severe strains or sprains.

• Cast. Casting the affected area is done to keep it still and let the strain or sprain heal.

• Surgery. This may be needed if the strain or sprain is severe and there is tearing. During surgery, the torn muscle, tendon, or ligament is repaired.

What are the long-term concerns?

If allowed to heal, most strains, sprains, and contusions cause no further problems. Strains or sprains that are not treated and don’t heal correctly can lead to pain or stiffness that doesn’t go away. Be sure to follow your child’s treatment plan. Your child’s healthcare provider can tell you more about the expected outcome based on your child’s injury.