Definition

• Injuries to the leg (hip to foot)
• Injuries to a bone, muscle, joint or ligament
• Muscle pain caused by too much exercise or work is covered in Leg Pain. (This is called overuse.)

Health Information

Types of Leg and Foot Injuries

• Fractures (broken bones)
• Dislocations (bone out of joint)
• Sprains - stretches and tears of ligaments. A sprained ankle is the most common ligament injury of the leg. It’s usually caused by turning the ankle inward. The main symptoms are pain and swelling of the outside of the ankle.
• Strains - stretches and tears of muscles (a pulled muscle)
• Muscle overuse injuries from sports or exercise (such as shin splints of lower leg)
• Muscle bruise from a direct blow (like thigh muscles)
• Bone bruise from a direct blow (like on the hip)

Symptoms

• The main symptom is pain.

Prevention

• Careful adult supervision of young children
• Education of older children about high risk behaviors

Care Advice

1. Overview:
   • During sports, muscles and bones get bruised.
   • Muscles get stretched.
   • These injuries can be treated at home.
   • Here is some care advice that should help.
2. Treatment of Pulled Muscle, Bruised Muscle or Bruised Bone:
   • Pain Medicine. To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. Ibuprofen works better for this type of pain.
   • Cold Pack. For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth. Put it on the sore muscles for 20 minutes. Repeat 4 times on the first day, then as needed. Reason: Helps with the pain and helps stop any bleeding. Caution: Avoid frostbite.
   • Heat Pack. If pain lasts over 2 days, put heat on the sore muscle. Use a heat pack, heating pad or warm wet washcloth. Do this for 10 minutes, then as needed. Caution: Avoid burns. For stiffness all over, use a hot bath instead. Move the sore leg muscles under the warm water.
   • Rest. Rest the injured part as much as possible for 48 hours.
   • For pulled muscles, teach your youngster about stretching and strength training.
3. Treatment of Mild Sprains (stretched ligaments) of Ankle or Knee:
   • First Aid: Apply ice now to reduce bleeding, swelling, and pain. Wrap quickly with an elastic bandage. The more the bleeding and swelling, the longer the recovery.
   • 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.
   • Cold Pack: For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth. Put it on the ankle or knee for 20 minutes. Repeat 4 times on the first day, then as needed. Reason: Helps with the pain and helps stop any bleeding. Caution: Avoid frostbite.
   • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table. Continue for at least 48 hours.
   • Keep the injured ankle or knee elevated and at rest for 24 hours.
4. What to Expect:
   • Pain and swelling usually peak on day 2 or 3.
   • Most often, swelling is gone in 7 days.
   • Pain may take 2 weeks to fully go away.

Call Your Doctor If

• Pain becomes severe
• Pain is not better after 3 days
• Pain lasts more than 2 weeks
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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