Strains - stretches and tears of muscles (e.g., pulled muscle)
Muscle overuse injuries from sports or exercise (e.g., shin splints of lower leg)
Muscle bruise from a direct blow (e.g., thigh muscles)
Bone bruise from a direct blow (e.g., hip or elbow)
See More Appropriate Topic (instead of this one) If
Involves finger or toe, see FINGER OR TOE INJURY.
(To go directly to this topic, click on the link following this document.)
WHEN TO CALL YOUR DOCTOR FOR ARM OR LEG INJURY
Call 911 Now (your child may need an ambulance) If
Serious injury with multiple fractures.
Major bleeding that can't be stopped.
Call Your Doctor Now (night or day) If
You think your child has a serious injury.
Looks like a broken bone or dislocated joint.
Swollen elbow or any large swelling.
Skin beyond the injury is pale or blue.
Age less than 1 year old.
Bicycle spoke or washing machine wringer injury.
Severe pain.
Won't stand or walk / Has a limp when walking.
Unable to move arm normally (especially if someone pulled on the arm).
Joint nearest the injury can't be moved fully (opened and closed).
Knee injury with a "snap" or "pop" felt at the time of impact.
Call Your Doctor Within 24 Hours (between 9am and 4pm) If
You think your child needs to be seen.
Call Your Doctor During Weekday Office Hours If
You have other questions or concerns.
Parent Care at Home If
Bruised muscle or bone from direct blow.
Pain in muscle (probably from mild pulled muscle).
Pain around joint (probably from mild stretched ligament).
HOME CARE ADVICE FOR MILD ARM OR LEG INJURIES
1. Treatment of Pulled Muscle, Bruised Muscle or Bruised Bone:
Apply an ice bag or massage the area with ice for 20 minutes per hour. Repeat for 4 consecutive hours. After 48 hours, use local heat for 10 minutes 3 times per day to help reabsorb the blood.
Give acetaminophen (e.g. Tylenol) or ibuprofen 4 times per day for pain. Continue for at least 48 hours.
Rest the injured part as much as possible for 48 hours.
For pulled muscles, teach the youngster about stretching exercises and strength training.
2. Treatment of Mild Sprains (stretched ligaments) of Ankle or Knee:
First aid: immediate compression and ice to reduce bleeding, swelling, and pain.
Treat with R.I.C.E. (rest, ice, compression, and elevation) for the first 24 to 48 hours.
Apply compression with a snug, elastic bandage for 48 hours. Numbness, tingling, or increased pain means the bandage is too tight.
Apply crushed ice in a plastic bag for 20 minutes per hour. Repeat for 4 consecutive hours.
Give acetaminophen (e.g. Tylenol) or ibuprofen 4 times per day for pain. Continue for at least 48 hours.
Keep injured ankle or knee elevated and at rest for 24 hours.
After 24 hours, allow any activity that doesn't cause pain.
3. Expected Course: Pain and swelling usually peak on day 2 or 3. Swelling is usually
gone by 7 days. Pain may take 2 weeks to completely resolve.
4. Call Your Doctor If:
Pain becomes severe.
Pain is not improving after 3 days.
Pain lasts more than 2 weeks.
Your child becomes worse or develops any of the "Call Your Doctor" symptoms.
Lucile Packard Children's Hospital is located in Palo Alto, adjacent to Stanford University Hospital, approximately 20 miles north of San Jose, CA and 40 miles south of San Francisco.
