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Soft tissue injuries

Teen girl with ankle sprain Teen girl with ankle sprain  

What is a soft tissue injury?

Soft tissue injuries can include injuries to the skin, muscles, tendons, ligaments or the tissue capsules that surround certain joints.

Sprains and strains

  • Sprains are injuries to the ligaments when they are overstretched. Ligaments are the tissues that connect two bones.
  • Strains are injuries to muscles and/or the tendons that attach or connect the muscles.

These types of soft tissue injury are common. They are usually mild, but they can sometimes be quite serious. They can also occur together in the same injured area.

Symptoms of a soft tissue injury

A person with a soft tissue injury will have pain and swelling. Depending on how severe it is and where it is, the injury may affect activities that use the injured body part. Severe soft tissue injuries will cause the child or teen to stop their activity.

Causes of a soft tissue injury

Sprains and strains are caused by severe or sudden twisting, stretching or (for muscles) contraction. These forces stretch or even tear the fibres of the muscle, tendon or ligament. They may even cause the muscle, tendon or ligament to detach from its anchor point (for example, a bone).

Taking care of your child at home

Most soft tissue injuries are mild and can be cared for by parents, coaches, teachers or other caregivers. In very mild cases, it may be okay to continue the activity that caused the injury.

To decide if it is safe to return to activity, a parent or responsible caregiver should check your child’s injury. They should also tend to the injury later.

Ideally, tending to the injury will:

  • relieve discomfort
  • keep the joint stable
  • minimize swelling.

After an injury, the swelling of the injured body part may interfere with healing.

How to tend to an injury

  • Rest and keep the injured area still. If the area is very painful, use splints, slings, dressings or crutches as directed by your healthcare provider.
  • Use ice, or cold packs, in the first 48 hours after an injury. Do not apply ice directly to the skin; wrap it in a thin cloth first. You can also use a bag of frozen vegetables or crushed ice; it will shape itself to the injured area. Apply the cold pack for up to 20 minutes every two or three hours or as directed.
  • Use compression or elastic dressings to help reduce swelling when your child is up and moving around, but do not rely on them to provide support. Your child should remove them when resting and before going to sleep. If the area near the dressing becomes numb, loosen the dressing, as it may be too tight.
  • Elevate (raise) the injured area as much as possible above the level of the heart in the first day or two after the injury. This will help reduce swelling. For example, if your child injures their leg, they can use cushions or pillows as props to keep it raised when they are sitting or lying down.
  • If needed, your child may take medicine such as ibuprofen to decrease any pain and inflammation. Use according to the package directions​ or as instructed by your healthcare provider.

When can my child return to regular activity?

Your healthcare provider will talk to you about your child's gradual return to activity based on the type of injury. For mild to moderate injury, early movement and light activity will help your child get better faster. More severe injuries may take as long as four to six weeks to heal and activity may make the injury worse.

How to prevent soft tissue injuries

Many tissue injuries can be prevented by wearing protective gear such as helmets or wrist protectors. Stretching and warming up before activity is also very important for joint and ligament health.

When to see a doctor

Call your child’s regular doctor if:

  • your child is not getting better by four or five days after the injury
  • your child needs a medical check up before going back to sports or activities
  • there is increasing redness or swelling around the site of injury
  • your child has a fever.

Call your child’s doctor immediately if your child has a significant break in the skin or has decreased feeling (sensation) around the site of injury. These are signs that the injury may be more than a soft tissue injury.

When to get help from emergency services

Go to your nearest Emergency Department or call 911 if:

  • your child cannot use the affected area at all within a short time after the injury
  • your child has a constant numbness, coldness or loss of feeling in the injured area
  • the affected body part no longer has its normal shape
  • your child has constant or severe pain that does not get better with medicine such as acetaminophen or ibuprofen.

Key points

  • Soft tissue injuries include strains and sprains. Strains affect muscles and tendons; sprains affect ligaments.
  • Most soft tissue injuries are mild and can be treated with rest, cool packs, compression and raising the injured body part. Over-the-counter pain medicine can also help with pain.
  • Your healthcare provider will talk to you about how soon your child can return to their regular activity.

Shawna Silver, MD, FRCPC, FAAP, PEng