Category: Health & Safety

Handling Sprains, Strains & Possible Broken Bones

A fall, awkward step, sudden twist, sports injury, or household accident can injure a muscle, tendon, ligament, joint, or bone. The injured area may become painful, swollen, bruised, weak, or difficult to move.

It is not always possible to tell the difference between a severe sprain and a broken bone without a professional examination and, in some cases, an X-ray. A person may still have a fracture even if they can move the injured area or place some weight on it.

The safest approach is to stop the activity, protect the injury, check for emergency warning signs, and avoid movements that could cause additional damage.

Understand the Different Injuries

The words sprain, strain, fracture, and dislocation describe different types of injuries.

Sprain

A sprain occurs when a ligament is stretched or torn. Ligaments are strong bands of tissue that connect bones to one another and help stabilize joints.

Sprains commonly affect the:

• Ankles
• Wrists
• Knees
• Fingers
• Thumbs

Strain

A strain occurs when a muscle or tendon is overstretched or torn. Tendons connect muscles to bones.

Strains commonly affect the:

• Back
• Neck
• Thigh
• Calf
• Groin
• Shoulder

A strain is sometimes called a pulled muscle.

Fracture

A fracture is a cracked or broken bone. Some fractures remain properly aligned, while others cause the bone to move out of position. An open fracture occurs when the skin is broken near the fracture or bone becomes visible.

Every suspected fracture requires medical evaluation.

Dislocation

A dislocation occurs when the bones forming a joint are forced out of their normal position. Dislocations can also damage ligaments, nerves, blood vessels, and surrounding tissue.

Do not attempt to push a dislocated joint back into place. Treat it as a serious injury and seek prompt medical care.

Stop the Activity

Have the person stop whatever they are doing.

Do not encourage someone to “walk it off” or test the injury repeatedly. Continuing to move or place weight on the area may worsen damage to the bone, joint, muscles, nerves, or blood vessels.

Help the person sit or lie down in a safe place. Support the injured area in the position you found it.

If the injury occurred in traffic, near machinery, on stairs, or in another dangerous area, move the person only as much as necessary to prevent additional harm.

Look for Emergency Warning Signs

Call 911 or your local emergency number when:

• A bone is visible through the skin.
• The injured limb or joint is severely deformed.
• There is heavy or uncontrolled bleeding.
• The person is unconscious or has difficulty breathing.
• The injury resulted from a major fall, car crash, crushing accident, or other serious trauma.
• A head, neck, back, pelvis, or upper-leg fracture is possible.
• The person cannot be moved safely.
• The injured area is numb, pale, blue, gray, or unusually cold.
• No pulse can be felt beyond the injury when you know how to check.
• The person shows signs of shock, such as pale or clammy skin, confusion, weakness, or rapid breathing.
• Even slight movement causes extreme pain.
• The injury involves multiple body parts.
• The person has another potentially life-threatening condition.

Keep the person still and follow instructions from the 911 dispatcher.

Check Circulation, Feeling, and Movement

When it can be done without moving the injured area, check the fingers or toes beyond the injury.

Notice whether they are:

• Their usual color
• Warm
• Able to move
• Able to feel a gentle touch
• Free from unusual tingling or numbness

Ask whether the person feels:

• Numbness
• Tingling
• Burning
• Increasing pressure
• Severe tightness
• Weakness

Seek immediate medical care if the fingers or toes become pale, blue, gray, cold, numb, or increasingly painful. These changes may mean swelling or the injury is interfering with circulation or nerve function.

Continue checking while waiting for help, especially if the injury has been wrapped or supported.

Signs of a Possible Sprain or Strain

A sprain or strain may cause:

• Pain
• Tenderness
• Swelling
• Bruising
• Muscle spasms
• Weakness
• Stiffness
• Reduced movement
• Pain when placing weight on the area
• A feeling that the joint is unstable

A popping sound or sensation may occur with a significant ligament, tendon, or bone injury. It is not possible to identify the damaged structure based on the sound alone.

Mild injuries may improve with home care. Severe pain, rapid swelling, instability, or loss of function needs medical evaluation.

Signs of a Possible Broken Bone

A possible fracture may cause:

• Severe or focused pain
• Swelling
• Bruising
• Tenderness directly over a bone
• Difficulty or inability to move
• Inability to place weight on the area
• A limb or joint that looks bent, shortened, twisted, or out of position
• A grinding sensation
• Numbness or tingling
• Broken skin near the injury
• Bone visible through the skin

Some fractures cause only moderate pain and no obvious deformity. This is especially true with small fractures, stress fractures, and injuries in older adults.

Being able to move a finger, toe, wrist, ankle, arm, or leg does not rule out a fracture.

Protect the Injured Area

Support the injury in the position in which you found it.

You may use:

• A pillow
• A folded blanket
• Rolled towels
• Clothing
• A cushion
• A commercially manufactured brace or sling, when appropriate

Do not:

• Straighten a bent limb
• Push a joint back into place
• Push visible bone beneath the skin
• Repeatedly test movement
• Pull on the injured limb
• Ask the person to stand on a painful leg
• Massage the injury

Allow trained medical professionals to examine and reposition the injury.

Applying a Cold Pack

A cold pack may help reduce pain and swelling after a sprain, strain, or possible fracture.

To use one safely:

1. Place ice, a cold pack, or a bag of frozen vegetables inside a thin towel.
2. Apply it to the injured area for approximately 15 to 20 minutes.
3. Remove it and allow the skin to return to its normal temperature.
4. Repeat every few hours during the first day or two when needed.

Do not place ice directly on the skin. Do not fall asleep with a cold pack in place.

Check the skin regularly. Stop if the area becomes extremely painful, numb, white, blue, gray, blotchy, or unusually hard.

Ask a healthcare professional before using cold therapy if the person has:

• Diabetes
• Poor circulation
• Reduced skin sensation
• Peripheral neuropathy
• A condition that makes cold exposure unsafe

Cold therapy may reduce discomfort, but it does not repair a torn ligament or rule out a fracture.

Helpful Resources: Browse Burns & Minor Injuries for products, equipment, services, or supplies related to this section.

Compression for a Mild Sprain or Strain

An elastic bandage may help control swelling in a mild sprain or strain.

To apply compression:

• Begin below the injured area.
• Wrap toward the body.
• Overlap each layer.
• Keep the pressure firm but not tight.
• Leave fingers or toes visible when possible.
• Recheck circulation, color, warmth, and sensation.

Loosen or remove the bandage immediately if the person develops:

• Numbness
• Tingling
• Increased pain
• Throbbing
• Cold fingers or toes
• Pale, blue, or gray skin
• Swelling below the bandage

Do not apply compression over an obviously deformed limb, open fracture, or injury with impaired circulation unless directed by an emergency professional.

Compression should support the area, not squeeze it.

Elevating the Injury

Elevation may help reduce swelling.

When comfortable and safe, support the injured arm or leg above the level of the heart using pillows or folded blankets.

Do not force an injured limb into a painful position simply to elevate it. A possible fracture or dislocation should remain supported in the position found.

Rest Without Becoming Completely Inactive

For the first day or two, avoid activities that increase pain, swelling, or instability.

However, prolonged complete rest can lead to stiffness, weakness, and slower recovery. As pain and swelling improve, a healthcare professional may recommend gradually returning to gentle movement.

Do not return immediately to sports, heavy lifting, running, or strenuous work simply because the pain has decreased.

The injured area should regain appropriate:

• Movement
• Strength
• Stability
• Balance
• Endurance
• Ability to perform the activity without pain

A healthcare professional or physical therapist can help determine when it is safe to resume normal activity.

When Home Care May Be Reasonable

Home care may be reasonable for a mild sprain or strain when:

• The injury resulted from a minor movement or activity.
• There is no deformity.
• Pain is manageable.
• Swelling is mild.
• The person can use the area carefully.
• Circulation and sensation are normal.
• Symptoms begin improving within a day or two.

Continue monitoring the injury. Seek professional care if pain, swelling, bruising, or function becomes worse.

When to Visit Urgent Care or a Doctor

Seek prompt medical evaluation when:

• A fracture or dislocation may be present.
• The person cannot place weight on the injured leg.
• The person cannot use the injured arm or hand.
• Pain is severe or focused directly over a bone.
• Swelling develops rapidly.
• Bruising is extensive.
• The joint feels unstable.
• A popping or snapping sound occurred with immediate loss of function.
• Movement is significantly limited.
• The injury crosses a growth plate in a child or teenager.
• Pain or swelling is not beginning to improve within approximately 48 hours.
• Symptoms improve and then become worse.
• The person has repeated injuries to the same area.
• The injury interferes with sleep or normal activities.
• There is an open wound near the injury.

An X-ray may be needed to identify a fracture. Other imaging may be used to evaluate ligaments, tendons, muscles, cartilage, or stress injuries.

Mayo Clinic notes that an examination and X-ray may be necessary to distinguish a sprain from a fracture or other bone injury. Mayo Clinic: Sprains—Diagnosis and Treatment

Open Fractures

An open fracture is a medical emergency. The bone may be visible, or the skin may simply be broken near the suspected fracture.

Call 911.

While waiting:

1. Keep the person still.
2. Control bleeding by applying pressure around the wound.
3. Do not press directly on exposed bone.
4. Do not push the bone back inside.
5. Do not wash or probe deeply into the wound.
6. Cover the area loosely with a sterile dressing or clean cloth.
7. Watch for changes in breathing and responsiveness.
8. Follow the dispatcher’s instructions.

Do not give the person food or drink because surgery or sedation may be necessary.

Splinting a Possible Fracture

A splint helps prevent movement and may reduce further damage. However, applying one incorrectly can increase pain or interfere with circulation.

If emergency help will arrive quickly, support the injured area and allow trained responders to splint it.

Consider applying a temporary splint only when:

• You have been trained.
• The person must be moved for safety.
• Professional help will be significantly delayed.
• The dispatcher or another qualified professional instructs you to do so.

A splint should generally support the joints above and below the suspected fracture. Pad it well and secure it without making it tight.

Check circulation, warmth, color, movement, and sensation before and after splinting. Loosen or remove the splint if the fingers or toes become cold, pale, blue, gray, numb, or increasingly painful.

Never attempt to straighten or realign a severely deformed limb unless a qualified emergency professional specifically directs you to do so in an exceptional situation.

Using a Sling

A sling may support an injured arm, wrist, elbow, shoulder, or collarbone.

Use a sling only when it can be placed without forcing the arm into a painful position. Support the entire forearm and keep the hand slightly elevated when comfortable.

Check the fingers for:

• Normal color
• Warmth
• Sensation
• Movement
• Increasing swelling

A sling that is too tight around the neck or wrist can cause additional problems. Seek professional evaluation for any injury serious enough to require continued sling use.

Do Not Test the Injury

People sometimes try to decide whether a bone is broken by pressing, bending, twisting, or asking the person to walk.

Do not:

• Press repeatedly over the painful area
• Pull on the limb
• Rotate the joint
• Ask the person to jump
• Force the fingers or toes to move
• Compare strength by pushing against resistance
• Continue an activity to see whether the pain improves

These tests can worsen an injury and are not reliable substitutes for a professional examination.

Pain Medication

A nonprescription pain reliever may help with a mild injury, but these medications are not safe for everyone.

Ask a healthcare professional or pharmacist before taking pain medication if the person:

• Takes blood-thinning medication
• Has kidney, liver, stomach, or heart problems
• Has a bleeding disorder
• Has medication allergies
• Is pregnant
• Is a child
• Takes other prescription or nonprescription medications

Follow the label and do not take more than the recommended amount. Check combination products to avoid accidentally taking the same ingredient twice.

Pain relief should not be used to push through an activity that may worsen the injury.

Injuries in Older Adults

Older adults may experience a fracture after a relatively minor fall, especially when osteoporosis or another bone condition is present.

Seek professional evaluation after a fall when an older adult has:

• New hip, groin, back, wrist, or shoulder pain
• Difficulty standing or walking
• A shortened or outward-turned leg
• Sudden loss of function
• Significant bruising or swelling
• Pain that continues after the fall
• A head injury
• Confusion or unusual sleepiness

A person with a hip fracture may occasionally still be able to stand or take a few steps. Do not assume that walking rules out a fracture.

If the person cannot get up safely after a fall, call 911. Do not attempt to lift them alone.

Injuries in Children

Children’s bones contain growth plates that affect future bone development. An injury near the end of a long bone or close to a joint may need medical evaluation even when it does not look severe.

Seek professional care when a child:

• Refuses to use an arm or leg
• Cannot bear weight
• Has significant swelling or bruising
• Has focused tenderness over a bone
• Has an obviously deformed limb
• Continues complaining of pain
• Injured a joint or growth-plate area
• Has an open wound near the injury

Do not tell a child to continue playing through pain.

Watch for Worsening Symptoms

During the first several days, monitor:

• Pain
• Swelling
• Bruising
• Skin color
• Temperature of the fingers or toes
• Numbness or tingling
• Ability to move
• Ability to place weight on the area
• Stability of the joint

Seek prompt medical care if:

• Pain or swelling is increasing.
• The area becomes very tight.
• Fingers or toes change color or temperature.
• Numbness or weakness develops.
• A bandage, brace, or splint feels increasingly tight.
• The person develops fever or drainage from an open wound.
• The injury is not improving as expected.

Returning to Normal Activity

Recovery time depends on the type and severity of the injury.

Before returning to normal activity, the person should generally be able to:

• Move the area without significant pain
• Use the limb normally
• Place weight on it when appropriate
• Perform daily tasks without instability
• Demonstrate strength similar to the uninjured side
• Complete the activity without symptoms becoming worse afterward

A severe sprain can require weeks or months to heal. Returning too quickly increases the risk of reinjury.

Follow the treatment plan provided by the doctor, physical therapist, athletic trainer, or other qualified professional.

Preventing Future Injuries

You may reduce the risk of sprains, strains, and fractures by:

• Wearing supportive, properly fitting shoes
• Keeping floors and walkways clear
• Using handrails
• Improving lighting
• Warming up before exercise
• Building strength and flexibility gradually
• Using protective equipment
• Learning correct lifting techniques
• Taking breaks during repetitive work
• Avoiding activity when overly tired
• Having vision checked regularly
• Discussing balance problems with a healthcare professional
• Addressing bone-health risks such as osteoporosis
• Following restrictions after a previous injury

Many injuries occur when someone returns to activity before strength, balance, or stability has fully recovered.

Common Mistakes to Avoid

Try not to:

• Continue using the injured area because it is “probably only a sprain.”
• Assume movement or weight-bearing rules out a fracture.
• Attempt to straighten a deformed limb.
• Push a dislocated joint back into place.
• Place ice directly on the skin.
• Wrap an elastic bandage too tightly.
• Ignore numbness, coldness, or a color change.
• Massage a newly injured area aggressively.
• Test the injury by twisting, jumping, or lifting.
• Remove a shoe or protective equipment forcefully when doing so causes significant pain or movement.
• Move someone with a possible head, neck, back, pelvis, or upper-leg injury.
• Return to sports or strenuous activity too soon.
• Ignore pain or swelling that is not improving.

A Simple Injury Checklist

When a sprain, strain, or possible fracture occurs:

1. Stop the activity.
2. Help the person remain still and safe.
3. Look for deformity, severe bleeding, and other emergency signs.
4. Check color, warmth, feeling, and movement beyond the injury.
5. Call 911 for a major injury or circulation problem.
6. Support the area in the position found.
7. Apply a wrapped cold pack for 15 to 20 minutes when appropriate.
8. Use gentle compression only for a mild sprain or strain.
9. Elevate the area when it can be done comfortably.
10. Arrange professional evaluation when a fracture or serious soft-tissue injury may be present.
11. Continue watching for worsening pain, swelling, numbness, or color changes.
12. Return to activity gradually and follow professional guidance.

You do not need to determine the exact diagnosis at the scene. Protecting the injury and recognizing when professional care is needed are the most important first steps.

Suggested Guides

• First Aid Basics: What Everyone Should Know
• Treating Minor Cuts, Scrapes & Puncture Wounds
• What to Do After a Fall
• Choosing Between Your Doctor, Urgent Care & the Emergency Room
• Recognizing When a Problem Is an Emergency
• Using Over-the-Counter Medications Safely

Important Health & Safety Notice

The information in this guide is provided for general educational purposes only. Independence Answers is not a medical provider, and this content is not a substitute for professional medical advice, diagnosis, treatment, or supervision. Always follow the instructions of your doctor, pharmacist, or other qualified healthcare professional, especially if you have a medical condition, take medication, or are unsure whether an action is safe for you.

Do not ignore or delay seeking professional care because of something you read here. If you believe someone may be experiencing a serious or life-threatening emergency, call 911 or your local emergency number immediately.