• Muscle, Bone and Joint Injury

    What are the different types of muscle, bone and joint injuries?

    • Strain: Tendon (attaches muscles to bones) or muscle is stretched, torn or damaged—often by lifting something heavy or working a muscle too hard.
    • Sprain: Ligament (connects bones to bones at a joint) is stretched, torn or damaged.
    • Dislocation: Bone within a joint moves out of its normal position in the joint, usually caused by a violent force.
    • Fracture: Complete break, a chip or a crack in a bone. Fractures can be open (the end of the broken bone breaks through the skin) or closed (the broken bone does not break through the skin).

    Emergency Steps


    Check the scene safety, form an initial impression, obtain consent and put on PPE, as appropriate.


    Check for signs and symptoms.

    • Bent, crooked or deformed injured area*
    • “Grating” when moving injured area*
    • Coldness, numbness or tingling at or below injured area*
    • Bleeding or bone protruding through skin*
    • Injury to head, neck, spine, pelvis or upper leg*
    • Significant cause of injury*
    • Severe or multiple injuries*
    • Unable to safely move them*
    • Signs & symptoms of shock*
    • Unable or unwilling to move injured area
    • “Popping” or “snapping” at time of injury*
    • Pain, swelling or bruising
    • Signs of broken rib(s): shallow, uncomfortable or painful breaths; support of injured area

    *Note: Signs and symptoms with a * require immediate emergency medical treatment.


    Call 9-1-1 and get equipment if the person requires immediate emergency medical treatment.


    Give Care.

    General Care

    1. Give care according to the condition found and level of training.
    2. Treat all injuries as potential fractures.
    3. If head, neck or back injury, tell them NOT TO MOVE and to verbally respond to your questions.
      1. Leave in position found unless you must move for safety, to perform CPR or to control bleeding.
      2. Keep infants and children in their car seats unless you need to move them to give CPR.
      3. If the person is wearing a helmet, do not remove it unless you need to give CPR.
    4. Have them limit use of body part and rest without moving or straightening it.
    5. If wound is closed, apply a cold pack wrapped in a thin, dry towel to area for no more than 20 minutes.
      1. Wait 20 minutes before applying again.
    6. If wound is open, apply direct pressure to control bleeding.
    7. Continue checking them as appropriate to determine if additional care is needed.
    8. Keep person from getting cold or overheated.
    9. Give care for shock, if necessary.
    10. Reassure person you will help and that EMS has been called (if appropriate).
    11. Watch for changes in condition, including breathing and responsiveness, and give care as appropriate and trained.

    Muscle, Bone and Joint Injury FAQs

    How do I check for circulation?

    When checking for circulation, check the skin on the side of the injury farthest from the heart (e.g., the hand or foot) for temperature, color and feeling. Also ask the person is there is any numbness or tingling.

    How can I make sure I do a compression wrap successfully?

    • With each wrap, overlap the previous layer by one-half the width of the compression wrap.
    • Apply more tension toward the toes and less toward the calf.
    • Make sure to leave the toes and heel uncovered.

    The person can move their limb, or stand on it. Does this mean they probably don’t have a broken bone?

    Not necessarily. An X-ray is usually required to diagnose a broken bone. The person may still have a broken bone, even if they can move their limb. If the injury causes pain or discomfort, and symptoms do not improve, seek medical advice.

    Shouldn’t I apply heat to a muscle, bone or joint injury to help speed healing?

    No. This is a myth. Although applying heat is commonly used to relieve pain associated with chronic muscle, bone and joint conditions such as arthritis, it is not the best treatment for an acute muscle, bone or joint injury.

    If the person has a suspected rib fracture, is it life-threatening?

    Although painful, a simple broken rib is rarely life-threatening. Broken ribs are less common in children than in adults because children’s ribs are more flexible and tend to bend rather than break. However, the forces that can cause a broken rib in adults can severely bruise the lung tissue of children, which can be a life-threatening injury.

    If a person has a suspected pelvic fracture, is it life-threatening?

    Pelvic injuries are serious and may be life-threatening because of the risk of damage to major arteries or internal organs. Fractures of bones in this area may cause severe internal bleeding and are associated with an increased risk for death in older adults.

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    Information Provided the Scientific Advisory Council (SAC)

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