Sprain vs. fracture: How to identify your child’s injury

When your child gets hurt during sports or play, it can be hard to know whether it’s a sprain, strain, or something more serious. These injuries can feel similar, but they affect different parts of the body, and the details matter. Dr. Robert G. Tysklind, pediatric orthopedic surgeon with Riley Children’s Health Orthopedics & Sports Medicine, says that paying attention to how the injury happened and what your child is feeling can help their care team better understand what’s going on so they can recommend the right next step with confidence.

Questions that help identify a sprain, strain or fracture

A sprain is an injury in which a ligament (the tough tissue connecting one bone to another) is stretched or torn, usually from twisting a joint too far. A strain is the overstretching or tearing of a muscle or tendon, often caused by overworking a muscle. And a fracture is a break, crack, or chip in a bone, ranging from a small hairline crack to a complete break that may even pierce the skin.

The questions below can help your child clearly describe the symptoms they are experiencing.

Where is your pain located – around a joint, in a muscle, or directly over a bone?

Pain directly over a bone is more likely to be a fracture or stress injury to the bone. Muscular pain or pain in the soft tissues around the joint tends to be more of a sprain or a tear.

What were you doing when the injury occurred?

How the injury happened can give the doctor helpful clues about what kind of injury it may be. The way a leg or arm is positioned when an injury happens can result in different outcomes, such as a dislocation or a fracture.

Did you hear a “pop” at the time of injury?

The feeling of a pop or hearing a pop can clue the physician into if something was potentially torn or dislocated. For example, a pop in the knee with a twist and immediate swelling has a high likelihood of an ACL injury. Fractures can also cause a pop that you can hear.

Is there swelling or bruising? Where is it most noticeable?

Swelling can occur after many types of injuries. Big swelling immediately around a joint can indicate ligament injuries or fractures within the joint. Bruising can be caused by many different things.

What movements make the pain worse?

Pain with stairs, lunges, or squatting can indicate problems in the front of the knee for example, around the kneecap. Pain with repetitive movement versus one single movement can give the physician information about various types of injuries and how long they have been going on.

Does the joint feel unstable?

Feelings of unsteadiness can result from several things including weakness, ligament injuries and even pain. Differentiating these types of feelings can really help in identifying how the joint is acting.

Is there numbness, tingling, or unusual sensations?

Numbness and tingling can indicate nerve injuries in some cases. There can also be a feeling of numbness or tingling after having a traumatic injury to the extremity without true nerve injury.

Do you have muscle spasms or cramping?

Cramping and spasms can indicate dehydration as well as electrolyte abnormalities. Sometimes patients experience muscle cramping after surgical procedures as well.

What movements are limited?

Certain limitations such as full motion of the joint or maybe even specific athletic positions can give the physician a better idea of how the limb is injured. Motion may be limited by injuries or significant swelling.

Can you continue normal activity or put weight on the area?

Typically, if the patient or athlete can put weight on the area and perform some basic athletic movements without noticeable difficulty, then they are ok to go back into the activity. If limping or significant pain is still ongoing, the patient is at risk of reinjury or new injuries during that activity.

Your child’s answers to the above questions help the physician understand what parts of the body may be hurt and what type of care will support their recovery.

Specialized care for orthopedic injuries at Riley Children’s Health

If your child does suffer an injury, they can receive same-day access to highly skilled pediatric experts. Riley Children’s offers walk-in care for orthopedic injuries at the IU Health North Medical Office Building in Carmel, Monday - Friday from 9 am - 6 pm. No appointment needed. If your child needs emergency care, you can find Riley Children’s 24/7 emergency medicine services at one of our three Riley Children’s Health emergency medicine locations.