Evaluating a Toddler Who Refuses To Walk

Q)

Hi  Dr.Gwenn,

Our daughter is 3 years old and fell on her knee recently. She will stand on it but is refusing to walk. We personally think there is nothing wrong apart from the graze on the knee.

Could you please shine some light on this situation? This is the 2nd time we have had this problem after a fall on both knees.

Yours gratefully,

Mr.G

A)

Dear Mr. G,

This is not an uncommon situation with toddlers. Toddlers stop toddling quickly after a fall and our job as parents and providers is to sort out the times it is a matter of low “boo-boo” tolerance from something more serious going on beneath the surface where we can not see well without xrays and other radiographic tests.

It’s always helpful to hunt for reassuring characteristics of an injury first and to do a double check of how your daughter is acting now compared with how she normally acts when not injured.

What we all have to keep in mind is falls hurt, especially when on weight bearing parts of our bodies. If she fell square on her knee, that knee is sore. That much we can say with certainly. You and I would know that and realize that a little soreness doesn’t mean anything serious in our knee and walk on it. A toddler freezes.

The second issue to consider is that true injuries that are serious requiring further investigation hurt at rest and with motion. If your child is happy, playful and otherwise herself, no need to worry.

Third, even minor injuries have some element of swelling and tendon, ligament and muscle pulling and tugging which amounts to a minor sprain. That also contributes to the discomfort. Ice helps a great deal. Rest, which your daughter is doing by refusing to walk. If she will allow you to prop up her leg while reading a story or watching a DVD, elevation helps. And, ibuprofen can be very beneficial for its anti-inflammatory qualities and to combat the pain. Ibuprofen is dosed by weight. This link should help.

Finally, the injuries we tend to worry about have swelling, bruising, deformity and more behavioral changes of pain such as crying, whincing, grimaces, holding the knee.

We often try giving a dose of ibuprofen and watching how the few days after an injury unfolds. If, however,your toddler truly refuses to restart her toddling in a reasonable amount of time, call your pediatrician.

Best,

Dr. Gwenn

(Originally posted October 2008; Updated December 2009)

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