DESCRIPTION
A strain is a stretched or torn muscle. A sprain is a stretched or torn ligament. Sprains occur most often in the ankles, knees or fingers, although any joint can be sprained. Sprained joints can function but usually with pain. A health care provider should evaluate most injuries of this type. Contact your child's physician immediately if your child has a sprained joint that will not bear weight, will not move normally or has pain that is intolerable.

FREQUENT SIGNS AND SYMPTOMS

• Pain or tenderness in the area of injury
• Swelling of the affected joint
• Skin discoloration in the area of injury
• Loss of normal mobility in the injured joint.

• Obesity
• Trauma
• Excessive exercise
• Poor conditioning
• Poor-fitting shoes, shoes with little support and shoes with higher than 1-inch heals
• High-risk activities: skateboarding, contact sports, ice and roller-skating.

CAUSES
Strains usually are associated with overuse injuries. Sprains usually occur due to trauma (fall, twisting injury or automobile accident). The ankle is injured most often because of its anatomical weakness, its exposed position and the stress it sustains in athletic and recreational activities. It is difficult to differentiate sprains from strains.

PREVENTIVE MEASURES

• Maintain a good level of fitness and try to avoid injury
• Stretch muscles before and after exercise
• Strengthen weak muscles with rehabilitative exercises to prevent a recurrence
• Accident-proof your home.

EXPECTED OUTCOME
With appropriate treatment, expect six to eight weeks for recovery. It may take longer depending on the severity of the injury.

TREATMENT

• Rest: Allow the joint to rest one or two days
• Ice: Apply ice to the injured joint for 20 minutes every three to four hours while awake for the first two to three days or until the pain goes away. Place ice in a plastic bag and separate it from the skin with a thin towel
• Compression: Wrap an elastic bandage around the injured area to keep the swelling from getting worse. The injured area should not be wrapped too tightly
• Elevation: Elevate the injured area above the level of the heart
• After a few days of less pain, the child should begin exercising the joint gently, without putting weight on it
• Physical therapy may be recommended to regain strength and normal use of the joint.

MEDICATION
You may give your child nonprescription pain relievers such as acetaminophen or ibuprofen. Avoid aspirin because of the risk of Reye's syndrome.

CONTACT YOUR CHILD'S PHYSICIAN IMMEDIATELY IF ANY OF THE FOLLOWING OCCUR:

• Your child has a sprained joint that will not bear weight or move normally
• Pain becomes intolerable
• Swelling, bruising or pain increases, despite treatment.