Chest Contusion in Children: Care Instructions

A chest contusion, or bruise, is caused by a fall or direct blow to the chest. Car crashes, falls, getting punched, and injuries from bicycle handlebars are common causes of chest contusions. A very forceful blow to the chest can injure the heart or blood vessels in the chest, the lungs, the airway, the liver, or the spleen.

Pain may be caused by an injury to muscles, cartilage, or ribs. Deep breathing, coughing, or sneezing can increase your child's pain. Lying on the injured area also can cause pain.

• Rest and protect the injured or sore area. Have your child stop, change, or take a break from any activity that may be causing pain.
• Put ice or a cold pack on your child's chest for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when your child is awake). Put a thin cloth between the ice and your child's skin.
• After 2 or 3 days, you can try applying heat to your child's chest. Apply heat for 10 to 20 minutes at a time, several times a day. You might also try switching between ice and heat.
• Do not wrap or tape your child's ribs for support. This may cause your child to take smaller breaths, which could increase the risk of pneumonia and lung collapse.
• Give your child acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain. Read and follow all instructions on the label.
• Do not give a child two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• Give medicines exactly as prescribed. Contact your doctor if you think your child is having a problem with the medicine.
• Even if it hurts, try to get your child to cough or take the deepest breath they can at least once every hour. This will get air deeply into the lungs. This may reduce the chance of getting pneumonia. Have your child hold a pillow against their chest to make this less painful.
• Gentle stretching and massage may help your child feel better after a few days of rest. Help your child stretch slowly to the point just before discomfort begins, then hold the stretch for 30 to 60 seconds. Do this 3 or 4 times a day.
• As the pain gets better, your child can slowly return to their normal activities. Be patient, because chest bruises can take weeks or months to heal. Any increased pain may be a sign that your child needs to rest a while longer.