From the Guidelines
For a 7-year-old with a pulled muscle causing leg pain, the most effective treatment approach is to give children's ibuprofen (Motrin or Advil) at a dose of 5-10 mg per kg of body weight every 6-8 hours, or children's acetaminophen (Tylenol) at 10-15 mg per kg every 4-6 hours, as these medications reduce inflammation and block pain signals 1. When managing a pulled muscle in a child, it's essential to consider the principles of reducing pain and inflammation.
- Apply ice wrapped in a towel to the affected area for 15-20 minutes several times daily for the first 48 hours to reduce inflammation and pain, as recommended by the 2010 American Heart Association and American Red Cross International Consensus on First Aid Science with Treatment Recommendations 1.
- Rest is crucial—limit activities that cause pain and have your child elevate the leg when sitting or lying down.
- Gentle stretching may help once the acute pain subsides, but don't force the leg to straighten if it causes pain. These interventions work together to reduce pain, inflammation, and promote healing.
- It's also important to monitor the child's condition and seek medical attention if pain persists beyond 3-5 days, worsens significantly, or if the child cannot bear any weight on the leg. The treatment approach should prioritize the child's comfort and safety, and medications like ibuprofen or acetaminophen can be effective in managing pain and inflammation, as supported by the American College of Foot and Ankle Surgeons' guidelines for diagnosis and treatment of heel pain 1.
From the Research
Treatment Options for a Pulled Muscle
- For a 7-year-old with a pulled muscle, the RICE principle (Rest, Ice, Compression, and Elevation) can be applied as first aid 2, 3.
- Topical nonsteroidal anti-inflammatory agents (NSAIDs) have been shown to have the greatest net benefit for acute pain from non-low back, musculoskeletal injuries, followed by oral NSAIDs and acetaminophen with or without diclofenac 4.
- Early mobilization, guided by the pain response, can promote a more rapid return to full activity and functional recovery 2, 3.
- Progressive resistance exercises (isotonic, isokinetic, and isometric) are essential to restore full muscle and joint function 3.
Pain Management
- Oral NSAIDs and acetaminophen with or without diclofenac can be used to manage pain, with effects on pain being modest (around 1 cm on a 10-cm visual analogue scale) 4.
- Opioids have been shown to increase the risk for gastrointestinal and neurologic harms, and their use should be limited 4.
Stretching and Exercise
- Static stretching (SS) and proprioceptive neuromuscular facilitation (PNF) stretching can induce small to moderate performance changes, while dynamic stretching (DS) can produce small-to-moderate performance improvements when completed within minutes of physical activity 5.
- All forms of training can induce range of motion (ROM) improvements, typically lasting <30 min 5.