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Muscle and Bone
Injuries
Jennifer L. Doherty, MS, ATC, LAT, CIE
Academic Program Director, ATEP
Florida International University
Management of Medical Emergencies
Introduction
 Muscle and Bone injuries are often
painful but rarely life threatening
 When not recognized, muscle and bone
injuries may have serious consequences
 Some muscle and bone injuries could
result in permanent disability
Musculoskeletal System
Review
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206 bones in the body
Bone consists of hard, dense tissue
Contain blood vessels and nerves
Functions:
 Protection
 Locomotion
Musculoskeletal System
Review
 Over 600 muscles in
the body
 Skeletal muscles
attach to bones
 Contain blood
vessels and nerves
 Function to produce
movement via
contraction/relaxation
Common Signs and
Symptoms
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Pain
Swelling
Deformity
Discoloration
Loss of function
Audible “pop” or
“snap”
 Call 911 immediately
if the injury….
 Involves protruding
bone fragments
 Impairs breathing
 Involves multiple
muscle and bone
injuries
General Treatment
 Rest
 Ice
 Compression
 Elevation
General Treatment
 Treat serious injuries
as if there is a
possible fracture
 Immobilization
Bone Injuries
 Comminuted
Fracture
 3 or more fragments
 MOI:
 Hard, direct blow
 Fall in awkward
position
Bone Injuries
 Depressed
Fracture
 Often occurs in flat
bones
 MOI:
 Falling on hard,
immovable surface
 Hit with a hard object
Bone Injuries
 Greenstick
Fracture
 Incomplete break
 Occurs in immature
bone that has not
completely ossified
Bone Injuries
 Impacted
Fracture
 Bone is compressed
 MOI:
 Fall from a height
 Immediate splinting
and traction are
required
Bone Injuries
 Longitudinal
Fracture
 Bone splits along its
length
 MOI:
 Jumping from a
height
Bone Injuries
 Oblique
Fracture
 Twisting injury
 MOI:
 Twisting on end of the
bone while the other
end is stabilized
Types of Fractures
 Serrated Fracture
 Two bone fragments have a sawtooth,
sharp-edged fracture line
 MOI:
 Direct blow
 Extensive internal damage may result
 Severed blood vessels and/or nerves
Types of Fractures
 Spiral Fracture
 S-shaped separation
of bone
 MOI:
 Foot is firmly planted
and the body is
rotated in the
opposite direction
Bone Injuries
 Transverse Fracture
 Straight fracture line at a right angle to
the bone shaft
 MOI:
 Direct blow
Bone Injuries
 Contrecoup
Fracture
 Fracture that occurs
on the side opposite
of the trauma site
Bone Injuries
 Stress Fracture
 Exact MOI is unknown
 Possible MOIs:
 Overload caused by muscle contractions
 Altered stress distribution in bone due to
muscle fatigue
 Change in ground reaction forces
 Performing rhythmic, repetitive movements
Bone Injuries
 Treatment of Bone Injuries
 When in doubt, treat the injury as a possible
fracture
 Splint and support to prevent further injury
 Refer
Muscle Injuries
 Contusions
 First degree
 Acute muscle injury
 MOI:
 Second degree
 Direct blow
 S/S
 Hematoma
 Pain
 Ecchymosis
 Mild ↓ in ROM
 Moderate ↓ in ROM
 Third degree
 Severe ↓ in ROM
Muscle Injuries
 Strain
 Stretch, rip, or tear in
a muscle or tendon
 MOI:
 Too forceful a
contraction
 Overstretching
Muscle Injuries
 First Degree
Strain
 Second
Degree Strain
 S/S
 S/S
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Local pain
Minor loss of strength
Mild edema
Mild ecchymosis
 Impaired muscle
function
 Moderate loss of
strength
 Moderate edema
 Moderate ecchymosis
Muscle Injuries
 Third Degree Strain
 S/S
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Loss of muscle function
Palpable defect in the muscle
Severe loss of strength
Severe edema
Sever ecchymosis
Muscle Injuries
 Muscle Cramp/Spasm
 A painful involuntary contraction
 MOI:
 Lack of salt or other minerals
 Muscle fatigue
 Trauma
Muscle Injuries
 Acute Onset Muscle Soreness
 Over-exertional muscle problem
 MOI:
 Impeded circulation causing ischemia
 Lactic acid and K+ build-up
 S/S subside immediately after exercise
has ceased
Muscle Injuries
 Delayed Onset Muscle
Soreness (DOMS)
 Over-exertional muscle problem
 MOI:
 Muscle fiber damage
 S/S increase in intensity for 2-3 days
after exercise
 S/S usually subside within 7 days
Muscle Injuries
 Treatment
 Rest
 Ice
 Compression
 Elevation
Joint Injuries
 Sprain
 Injury to ligamentous or capsular tissue
 A tendon may also be involved
 MOI:
 Overstretching and tearing of ligamentous or
capsular tissue
Joint Injuries
 First Degree
Sprain
 S/S
 Mild pain/point
tenderness
 Mild ↓ in function
 Little or no edema
 Normal ROM
Joint Injuries
 Second Degree
Sprain
 S/S
 Moderate pain/point
tenderness
 Moderate ↓ in function
 Moderate edema
 Slight-to-moderate joint
instability
Joint Injuries
 Third Degree
Sprain
 S/S
 Severe pain/point
tenderness
 Severe ↓ in function
 Severe edema
 Severe joint instability
 May involve a
spontaneously reduced
subluxation
Joint Injuries
 Treatment for Sprains
 Rest
 Ice
 Compression
 Elevation
 Therapeutic rehabilitation
 Surgery
Joint Injuries
 Dislocation
 Result due to forces that cause the joint
to go beyond its normal anatomical limits
 Two classes:
 Subluxations
 Luxations
Joint Injuries
 Subluxation
 Partial dislocation
 Incomplete
separation between 2
articulating bones
Joint Injuries
 Luxation
 Complete
dislocations
 Total separation
between 2 articulating
bones
Joint Injuries
 S/S of Dislocations
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Loss of limb function
Deformity
Edema
Point tenderness
May involve damage to the ligamentous and
tendinous tissues surrounding the joint
Joint Injuries
 Treatment of Dislocations
 First time dislocations should be treated
as a possible fracture
 Splint and support to prevent further
injury
 Refer