Injuries to Muscles Bones and Joints
American Red Cross
Muscles

Injuries to the brain, spinal cord or nerves can affect muscle control. When nerves lose control of muscles, it is called paralysis. When a muscle is injured, a nearby muscle often takes over for the injured one.

Bones

Bones weaken with age. Older adults have more brittle bones. Sometimes they break surprisingly easily. This gradual weakening of bones is called osteoporosis.

Joints

All joints have a normal range of movement in which they can move freely, without too much stress or strain. When joints are forced beyond this range, ligaments stretch and tear.

TYPES OF INJURIES

The four basic types of injuries:

- Fractures
- Dislocations
- Sprains
- Strains
What to Look For

Always suspect a severe injury when any of the following signals are present:

- There is pain. One of the most common signals in any muscle, bone or joint injury is pain. The injured area may be very painful to touch and move.
- There is signiﬁ cant bruising and swelling. The area may be swollen and red or bruised.
- There is signiﬁ cant deformity. The area may be twisted or strangely bent. It may have abnormal lumps, ridges and hollows.
- The person is unable to use the affected part normally.
- There are bone fragments sticking out of a wound.
- The person feels bones grating or the person felt or heard a snap or pop at the time of injury.
- The injured area is cold, numb and tingly.
- The cause of the injury suggests that it may be severe.

When to Call 9-1-1

- There is obvious deformity
- There is moderate or severe swelling and discoloration.
- Bones sound or feel like they are rubbing together.
- A snap or pop was heard or felt at the time of the injury.
- There is a fracture with an open wound at, or bone piercing through, the injury site.
- The injured person cannot move or use the affected part normally.
- The injured area is cold and numb.
- The injury involves the head, neck or spine.
- The injured person has trouble breathing.
- The cause of the injury suggests that the injury may be severe.
- It is not possible to safely or comfortably move the person to a vehicle for transport to a hospital.
What to Do Until Help Arrives

General care for injuries to muscles, bone and joints includes following the mnemonic RICE:

- Rest: Do not move or straighten the injured area.
- Immobilize: Stabilize the injured area in the position it was found. Splint the injured part only if the person must be moved or transported to receive medical care and it does not cause more pain. Minimizing movement can prevent further injury.
- Cold: Fill a plastic bag with ice and water or wrap ice with a damp cloth and apply ice to the injured area for periods of about 20 minutes. Place a thin barrier between the ice and bare skin. If 20-minute icing cannot be tolerated, apply ice for periods of 10 minutes. If continued icing is needed, remove the pack for 20 minutes, and then replace it. Cold reduces internal bleeding, pain and swelling. Do not apply heat as there is no evidence that applying heat helps muscle, bone or joint injuries.
- Elevate: Elevate the injured part only if it does not cause more pain. Elevating the injured part may help reduce swelling.

Splinting an Injury

Anatomic splints.
- The person’s body is the splint. For example, you can splint an arm to the chest or an injured leg to the uninjured leg (Fig. 8-10).
Soft splints.
- Soft materials, such as a folded blanket, towel, pillow or folded triangular bandage, can beused for the splint (Fig. 8-11). A sling is a speciﬁc kind of soft splint that uses a triangular bandage tied to support an injured arm, wrist or hand.
Rigid splints.
- Padded boards, folded magazines or newspapers, or padded metal strips that do not have any sharp edges can serve as splints (Fig. 8-12).
The ground.
- An injured leg stretched out on the ground is supported by the ground.

Head, Neck and Spinal Injuries

Injuries to the head, neck or spine can cause paralysis, speech or memory problems or other disabling conditions. These injuries can damage bone and soft tissue, including the brain and spinal cord.

An injury to the brain can cause bleeding inside the skull.
The spine is a strong, ﬂexible column of small bones that support the head and trunk. Injuries to the spine can fracture vertebrae and tear ligaments. In some cases, the vertebrae can shift and cut or squeeze the spinal cord. This can paralyze the person or be life threatening.

What to Look For

You also should suspect a head, neck or spinal injury if the injured person:

- Was involved in a motor vehicle crash or subjected to another signiﬁcant force.
- Was injured as a result of a fall from greater than a standing height.
- Is wearing a safety helmet that is broken.
- Complains of neck or back pain.
- Has tingling or weakness in the extremities.
- Is not fully alert.
- Appears to be intoxicated.
- Appears to be frail or older than 65 years.
- Is a child younger than 3 years with evidence of a head or neck injury.

What to Do Until Help Arrives

While you are waiting for emergency medical services (EMS) personnel to arrive, the best care you can give is to minimize movement of the person’s head, neck and spine. As long as the person is breathing normally, support the head and neck in the position found. Do this by placing your hands on both sides of the person’s head in the position in which you found it. Support the person’s head in that position until EMS personnel take over supporting the person’s head. If the head is sharply turned to one side, do not move it. Support the head and neck in the position found.

The person may become confused, drowsy or unconscious. Breathing may stop. The person may be bleeding. If the person is unconscious, keep the airway open and check breathing.

Concussions

What to Look For

- Confusion, which may last from moments to several minutes.
- Headache.
- Repeated questioning about what happened.
- Temporary memory loss, especially for periods immediately before and after the injury.
- Brief loss of consciousness.
- Nausea and vomiting.
- Speech problems (patient is unable to answer questions or obey simple commands).
- Blurred vision or light sensitivity.

What to Do Until Help Arrives

- Support the head and neck in the position in which you found it.
- Maintain an open airway.
- Control any bleeding and apply dressings to any open wounds.
- Do not apply direct pressure if there are any signs of an obvious skull fracture.
- If there is clear ﬂ uid leaking from the ears or a wound in the scalp, cover the area loosely with a sterile gauze dressing.
- Monitor the person for any changes in condition.
- Try to calm and reassure the person. Encourage the person to talk with you; it may prevent loss of consciousness.

Chest Injuries

What to Do Until Help Arrives

What to Look For

If the injury is serious, the person will have trouble breathing.

Pelvic Injuries

- Severe pain.
- Bruising.
- Possible external bleeding.
- Nausea.
- Vomiting (which may include blood).
- Weakness.
- Thirst.
- Tenderness or a tight feeling in the abdomen.
- Possible loss of sensation in the legs or inability to move the legs.

Be alert for the signals of shock, which could indicate internal bleeding and/or blood loss.

APPLYING AN ANATOMIC SPLINT

1. Get consent
2. Support both above and below the site of the injury.
3. Check for feeling, warmth and color beyond the injury.
4. Place several folded triangular bandages above and below the injured body part.
5. Place the uninjured body part next to the injured body part.
6. Wrap securely.
7. Recheck for feeling, warmth and color.

APPLYING A SOFT SPLINT

1. Get consent.
2. Support both above and below the site of the injury.
3. Check for feeling, warmth and color beyond the injury.
4. Place several folded triangular bandages above and below the injured body part.
5. Gently wrap a soft object (e.g., a folded blanket or pillow) around the injured body part.
6. Tie bandages securely
7. Recheck for feeling, warmth and color.

APPLYING A RIGID SPLINT

1. Get consent
2. Support both above and below the site of the injury.
3. Check for feeling, warmth and color beyond the injury.
4. Place an appropriately sized rigid splint (e.g., padded board) under the injured body part.
5. Tie several folded triangular bandages above and below the injured body part.
6. Recheck for feeling, warmth and color.
Write the lyrics for a misc song made in 2013, titled "Injuries to Muscles Bones and Joints", by artist "American Red Cross".