You’re at the ballpark watching your son’s game when suddenly he’s hit in the shoulder by a hurtling line drive. He doubles over in pain.
Then the star base stealer skids into second, resulting in several cuts on his arm and an abrasion on his side. The coach pulls them from the game and applies ice to their injuries.
We regularly see this type of first aid at kids’ sporting events, but are there certain guidelines for using ice or other topical treatments on children — and are they safe?
To ice or not to ice?
According to Jennifer Brey, M.D., pediatric orthopedic surgeon and sports medicine specialist with Norton Children’s Hospital Children’s Orthopedics of Louisville, applying ice is a safe and effective way to help with swelling and pain. It can be a go-to for a variety of minor injuries.
“For injuries such as these you want to use ice, but follow what is known as the RICE method,” Dr. Brey said.
RICE stands for rest, ice, compression and elevation.
Rest is vital to protect the injured muscle, tendon, ligament or other tissue from further injury.
Ice provides short-term pain relief and limits swelling by reducing blood flow to the injured area. Never put ice directly on skin. Wrap a bag of ice in a towel and leave on for no more than 20-30 minutes.
You have options for treatment of your child’s pain or injury.
- In an emergency, call 911 or visit one of three Norton Children’s emergency departments.
- If an injury persists, see your child’s pediatrician for follow up.
- When a sports injury requires pediatric orthopedic care, Norton Children’s Orthopedics of Louisville has the specialists you need.
Compression also helps to reduce swelling. Wrap an ACE bandage around the swollen area to provide compression. According to Dr. Brey, the bandage may be left on for as long as needed.
Elevating the injured part of the body helps control swelling as well. Elevate as long as needed for the swelling to go down and pain to be relieved.
RICE may be done as much as needed after an injury, whether it is for 24 hours or one to two weeks,” Dr. Brey said. “If pain is not improving after that long, medical attention should be sought.”
Abrasions are injuries to the skin. Wash these areas with soap and water, then apply ice for pain relief.
“Place a clean towel on top of the abrasion, then put the ice on top of that. Don’t put the ice directly on the wound,” Dr. Brey said. “Abrasions may be covered with clean gauze or an ACE bandage, or if they are not draining clear fluid, may be left uncovered.”
Abrasions rarely get infected, but always keep an eye out for signs of infection: increasing pain, yellow or thick drainage, or redness that is spreading.
Antibiotic ointment, such as Neosporin, may be used to help prevent infection.
Using heat to treat?
“There’s kind of a myth out there that you should ice for 24 hours then heat after that, and that’s not at all true,” Dr. Brey said. “I very rarely recommend using heat. It’s important to use ice consistently for minor injuries.”
How about icy-heat ointments?
Are those “icy” and “hot” ointments adults use for aching muscles safe for a child?
“Some of these muscle rubs contain the ingredient capsaicin, which can help with aches and soreness,” Dr. Brey said. “They are likely safe for kids, however nobody’s really done studies and there’s not a lot of data on it being used on kids. If it helps, great; and if it doesn’t help, don’t use it. Every child is going to be different.”
Dr. Brey cautions against using these topical rubs on babies or very young children due to the possibility of skin irritation. She suggests using them only on children age 6 and older, however watch for skin irritation on these children as well.
For parents who prefer homeopathic remedies, such as essential oils, to soothe the pain, Dr. Brey hasn’t seen them provide any better relief than applying ice, but if it makes a child feel better, go for it.
When does your child’s injury need something more than rest and ice?
“If your child has pain that isn’t relieved by an ice pack and a few days of rest or if swelling persists, the injury should be looked at by a doctor right away,” Dr. Brey said.