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Muscle, Tendon Strains: Symptoms, Types, Severity and Treatment

Doctor's Exam Recommended to Rule Out Fracture in Younger Children

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 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

Type of Sport Activity

Type of Strain

Contact sports in general

Elbow, shoulder, back

Track and field events featuring quick starts (hurdling, long jump, sprints)


Sports involving gripping (gymnastics, racquet sports, rowing, golf)

Hand, wrist, fingers and forearms.

Racquet sports, sports involving throwing (football, baseball, softball, javelin)

Elbow, shoulder

Sports involving jumping (basketball, volleyball)

Back strain, hamstring

Sports involving running


Sports involving kicking (football, soccer)



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

  • RICE (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.