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Home / News and Events / Health Tips / When a strain might be a break
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When a strain might be a break

Reviewed By: Andrew Gregory, M.D. (Last Updated: April 19, 2010)

As spring youth sports and outdoor activities get underway, injuries aren't far behind. A sports medicine expert at the Monroe Carell Jr. Children's Hospital at Vanderbilt says when you compare "sprains or strains" of an ankle or a finger in a child with a similar injury in an adult, the child is more likely to have a broken bone.

Andrew Gregory, M.D., assistant professor of Pediatric Orthopedics and Rehabilitation says children, especially those younger than 14 years old, have very strong tendons and ligaments, but their bones have yet to reach their peak strength.

"All jammed fingers in kids need to be X-rayed because they are usually broken, where as in an adult it is typically a sprain," Gregory said.

Parents can have a tough time telling the difference, because kids can be pretty tough, trying to minimize the injury. But there are times when not treating a broken bone in a key area, like a growth plate, can have long-term effects on that bone's growth.

"Girls reach skeletal maturity between the ages of 14 to 16. For boys, it's 16 to 18. Until that time, if a child turns their ankle on the soccer field, it's more likely to be a fracture that needs to be seen," said Gregory.

The most common sport-related fractures are fingers, wrists, and ankles. So how do parents know when a sprain isn't just a sprain? Gregory says if they are walking on or using it normally pretty quickly, you can be less concerned, but if several hours or a day later there is still pain, swelling, or bruising, or if they refuse to use the hurt extremity, it's time to see the doctor.

"Children's bones are smaller and less dense, but their tendons and ligaments are stronger, to the force of a twist or jam can do more damage to the bone. But the good news is if it has been set well, they heal much faster because they also have a thicker lining of the bone that has a great blood supply. Their healing time may be half that of an adult," Gregory said.

Here are some tips if a child complains of an injury.

  • RICE: Enforce rest, icing, compression, and elevation of the extremity
  • Ibuprofen or Tylenol for pain, following the labeled dosage carefully
  • Cal your doctor if there is continued pain, swelling, bruising, or deformity; or if the extremity is limp; or if your child refuses to bear weight on or use the extremity.

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