Breaks, Sprains, and Strains: Managing Bone and Joint Injuries

A 3-Minute Read on Dealing with Musculoskeletal Injuries in the Workplace

The delivery driver stepped out of his van and immediately knew something was wrong. His ankle had twisted awkwardly, and the pain was excruciating. He couldn't put any weight on it, and it was already starting to swell. The question everyone was asking: is it broken or just sprained? More importantly, what should we do about it?

This scenario reminded me of a training exercise during my 22 years in the Army when one of our soldiers was caught when a piece of heavy equipment shifted unexpectedly, resulting in a suspected fracture to his lower leg.

We were in a remote training area, miles from the nearest medical facility. We had to rely on our field medical training to stabilise him for evacuation. That experience taught me the critical importance of proper splinting and immobilisation techniques. These skills proved invaluable throughout my 14 years in the police and now as the founder of Typhon Training Solutions.

Whether it's a military exercise, a police incident, or a workplace accident, the principles of managing bone and joint injuries remain the same.

Understanding Musculoskeletal Injuries

After years of teaching first aid with Typhon Training Solutions, I've learned that bone, muscle, and joint injuries are among the most common workplace emergencies. They range from minor sprains that heal in days to complex fractures requiring surgery and months of rehabilitation.

The challenge is that it's often impossible to tell the difference between a severe sprain and a fracture without an X-ray. That's why the first aid approach is the same regardless of what you think the injury might be.

The RICE Principle (With Updates)

For decades, people were taught RICE: Rest, Ice, Compression, Elevation. While this is still largely valid, our understanding has evolved. The modern approach is more nuanced and focuses on what actually helps healing.

• Rest doesn't mean complete immobilisation for weeks. Early, gentle movement often helps healing, but the injured part needs protection from further damage.

• Ice is still useful for pain relief and reducing swelling in the first 48 hours, but it's not the miracle cure people once thought. Apply for 15-20 minutes at a time, with breaks between applications.

  
  

• Compression helps control swelling and provides support. Use elastic bandages or supports, but not so tight that they cut off circulation.

  
  

• Elevation helps reduce swelling by using gravity to drain fluid away from the injury. Raise the injured limb above heart level when possible.

  
  

Recognising Fractures

In our HSE-approved First Aid at Work courses, I teach people to look for the classic signs of fractures: severe pain, inability to use the injured part normally, obvious deformity, swelling, and bruising. But here's the thing – you can have a fracture without all these signs.

Some fractures, particularly stress fractures or hairline breaks, might only cause mild pain initially. Others might not show obvious deformity. When in doubt, treat it as a fracture and get medical assessment.

The Splinting Decision

Splinting can be incredibly helpful for fractures, but it can also cause harm if done incorrectly. The basic principle is to immobilise the joints above and below the suspected fracture.

For arm injuries, a simple sling often provides excellent support. For leg injuries, you might need to improvise with boards, magazines, or even the other leg as a splint. But remember – if the ambulance is coming quickly, sometimes it's better to just support the injury and wait for professional help.

Open Fractures: The Emergency

An open fracture – where bone breaks through the skin – is a medical emergency. Don't try to push the bone back in or clean the wound extensively. Cover it with sterile dressings, control bleeding with gentle pressure around (not on) the bone, and get immediate medical help.

These injuries have a high risk of infection and require urgent surgical treatment. Time is critical for the best outcomes.

Spinal Injury Concerns

Any high-energy injury that could cause fractures might also cause spinal injuries. Falls from height (2m and over, is a rough rule of thumb), vehicle accidents, or impacts to the head or back all raise this possibility.

If you suspect spinal injury, keep the person still and call 999. Don't allow them to get up and walk around, even if they say they feel fine. Spinal cord damage can be permanent, and movement can make it worse.

The Dislocation Dilemma

Dislocated joints look dramatic and are usually very painful. The temptation is to try to "pop" them back into place, but this is almost always a mistake. Attempting to relocate joints can damage blood vessels, nerves, or surrounding tissues.

Support the joint in the position you found it, provide pain relief if available, and get medical help. Leave the relocation to professionals who have X-rays and proper equipment.

Muscle Strains and Ligament Sprains

Not all musculoskeletal injuries involve bones. Muscle strains (pulled muscles) and ligament sprains are common and can be just as painful as fractures.

The treatment is similar – rest, ice, compression, and elevation. But these injuries often benefit from gentle, early movement once the initial pain and swelling subside. Complete rest for weeks can actually delay healing.

The Workplace Reality

Different workplaces see different patterns of injury. Construction sites have more high-energy trauma and fractures. Offices see more repetitive strain injuries and back problems. Warehouses have lifting injuries and slips.

Understanding your workplace risks helps you prepare for the most likely scenarios. But remember, any injury can happen anywhere – I've heard of people fracturing bones simply by tripping over a cable in an office.

Pain Management

Pain from musculoskeletal injuries can be severe, and managing it is part of good first aid.

Simple measures like supporting the injury, applying ice, and reassuring the casualty all help.

If your workplace first aid kit includes pain relief medication, follow your protocols for when and how to give it. But remember – pain serves a purpose. It prevents further damage by discouraging movement.

The Return-to-Work Challenge

Deciding when someone can return to work after a musculoskeletal injury is complex. It depends on the nature of their job, the severity of the injury, and their recovery progress.

Someone with a desk job might return with a minor arm injury, while the same injury could keep a manual worker off for weeks. Occupational health input is often invaluable for these decisions.

Prevention is Key

Most musculoskeletal injuries are preventable. Proper manual handling training, good workplace design, appropriate equipment, and risk assessments all reduce injury rates.

But when prevention fails, prompt, appropriate first aid can limit damage and improve outcomes.

The Psychological Impact

Serious musculoskeletal injuries can be life-changing. Someone who's been active and independent might suddenly face months of disability and rehabilitation. The psychological impact can be as significant as the physical injury.

Good first aid includes emotional support – staying calm, providing reassurance, and helping the person understand what's happening.

Building Competence in First Aid

Musculoskeletal injuries are common enough that everyone should know the basics of recognition and management. It's not just about having a qualified first aider – it's about creating a workplace where everyone can provide appropriate initial care.

Want to ensure your team can handle bone and joint injuries effectively? Contact Typhon Training Solutions. Call me on 07939557029 or email mark.phillips@typhontrainingsolutions.co.uk to discuss practical training that builds real knowledge, skills, and confidence.

Because when someone's injured, the first few minutes of care can determine how well they recover.

Mark provides comprehensive first aid training through Typhon Training Solutions, helping workplaces across the UK respond effectively to musculoskeletal injuries and other emergencies.