Recovery from Knee Contusion in an 11-Year-Old
For an 11-year-old recovering from a knee contusion, immediately initiate rest, ice application (15-20 minutes every 2-3 hours), compression, and elevation (RICE protocol) for the first 24-72 hours, combined with acetaminophen for pain control, followed by progressive range-of-motion exercises and gradual return to activity as tolerated. 1, 2, 3
Initial Management (First 24-72 Hours)
The cornerstone of acute soft tissue injury treatment is the RICE protocol:
- Rest: Complete avoidance of activities that stress the injured knee 1, 3
- Ice: Apply ice for 15-20 minute intervals every 2-3 hours during waking hours to reduce pain and swelling 1, 2
- Compression: Use an elastic bandage to minimize swelling and provide support 1, 3
- Elevation: Keep the knee elevated above heart level when possible to reduce edema 1, 3
Pain Management
Acetaminophen is the preferred first-line analgesic for pediatric patients:
- Use age-appropriate dosing of acetaminophen (not exceeding 75 mg/kg/day or 4 grams/day, whichever is lower) 4, 5
- Avoid NSAIDs beyond 48-72 hours, as they can be detrimental to muscle healing in contusion injuries 2
- Topical NSAIDs may be considered as an alternative if oral medication is problematic 4, 5
Critical Pitfall to Avoid
Never use corticosteroids for muscle contusions, as they should be completely avoided in this injury type 2. This is a key distinction from other knee injuries where intra-articular corticosteroids may be beneficial 4, 5.
Progressive Rehabilitation (After 72 Hours)
Once acute pain and swelling begin to subside:
- Begin gentle range-of-motion exercises to prevent stiffness 2, 3
- Progress to quadriceps strengthening exercises as pain allows 4, 5
- Gradually advance weight-bearing activities based on pain tolerance 2, 3
- Return to sports only when full range of motion is restored and the child can perform sport-specific movements without pain 3
Monitoring for Complications
Watch carefully for signs requiring urgent evaluation:
- Increasing pain, swelling, or firmness suggesting compartment syndrome 2
- Development of a hard mass indicating myositis ossificans (heterotopic bone formation) 2
- Persistent inability to bear weight or severe limitation in range of motion after 5-7 days 3
Expected Recovery Timeline
Most uncomplicated knee contusions in children heal within 1-3 weeks with appropriate conservative management 1, 3. The child can typically return to full activity when pain-free range of motion is achieved and functional strength is restored 3.