What are they?

A strain is a twist, pull and/or tear of a muscle and/or tendon. Tendons are fibrous cords of tissue that attach muscles to bone. Strains and sprains [1] are among the most common sports injuries. However, because the growth plates at the end of the major bones in a child's arms and legs are open, pain at a joint should be evaluated by a doctor because it may be a fracture, not a simple strain or sprain, which become more common as a child matures and the growth plates close.

Two types

There are two types of strains:

• Chronic strains that result from overuse (prolonged, repetitive movement) of muscles and tendons, or inadequate rest during intensive training

• Acute strains that result from a direct blow to the body, overstretching, or excessive muscle contraction.

Classification based on severity

There are three classes of strains:

• Mild strains, in which the muscle/tendon is slightly stretched or pulled.

• Moderate strains, in which the muscle/tendon is overstretched and slightly torn, which results in some loss of function

• Severe strains, in which the muscle and/or tendon is partially or completely ruptured, often resulting in an incapacitating injury.

Most common sprains

The two most common strains are:

• Back strain: a twisting, pulling, or tearing of the muscles supporting the spine.
  

• Hamstring muscle strain: a tear or stretch of a major muscle in the back of the thigh most likely caused by a muscle strength imbalance between the hamstrings and the quadriceps muscles in the front of the thigh. Hamstring injuries tend to recur.

If your child has a strain, he will likely have one or more of the following symptoms:

• Pain

• Muscle spasm

• Muscle weakness

• Swelling

• Inflammation

• Cramping
  

Typical strains by sport

Treatment

Experts, including the American Academy of Orthopedic Surgeons, recommend the treatment of strains as follows:

• RICE [4] (rest, ice, compression, elevation) will usually help minimize the damage.

• Evaluation of the injury by a doctor (except for mild cases) to establish a treatment and rehabilitation plan.

• Surgery for a severe strain may be required or immobilization followed by months of therapy.

• Mild strains may require rehabilitation exercises and activity modification during recovery.