Introduction to Basic First Aid

Lessons

Senior 6 · Physical Education

Introduction to Basic First Aid

4 lessons

Lesson 2 of 4

Common sports injuries and how to recognise them

25 min

Name it before you treat it

A first aider cannot see inside a swollen ankle. What you can do is ask how it happened, look, and listen to what the player tells you, and from those clues decide which kind of injury is most likely and how serious it may be. A twist on landing suggests a sprain; a sudden pain at full sprint suggests a strain; a blow to the head followed by confusion suggests concussion. This lesson sorts the injuries you are most likely to meet in school sport, and the signs that tell you when an injury is more than minor.

Definition

Acute injury: an injury caused by one sudden event, such as a fall, twist or collision. Overuse injury: an injury that builds up from repeated stress over days or weeks, such as shin pain in runners.

Soft-tissue injury: damage to muscles, tendons, ligaments or skin. Hard-tissue injury: damage to bone or teeth.

Sprain: a stretched or torn ligament, the tissue that joins bone to bone at a joint. Strain: a stretched or torn muscle or tendon.

Fracture: a broken or cracked bone; open if the skin over it is broken, closed if not. Dislocation: the bones of a joint forced out of their normal position.

Concussion: a brain injury caused by a blow or jolt to the head or body that disturbs how the brain works, usually for a short time.

Sprain or strain?

The common sports injuries

Injury	Typical cause in sport	Signs
Sprain (ankle, knee, wrist)	Landing awkwardly, twisting, a tackle on the joint	Pain at the joint, swelling, later bruising, difficulty moving or bearing weight
Strain (hamstring, calf, groin)	Sprinting, overstretching, poor warm-up	Sudden sharp pain in the muscle, tenderness, weakness, sometimes a gap felt in the muscle
Contusion (bruise)	A blow from a ball, boot or another player	Pain, swelling, blue-purple discolouration
Abrasion, cut, blister	Sliding on hard ground, studs, friction from shoes	Scraped or broken skin, bleeding; fluid-filled bubble (blister)
Fracture	Heavy fall, direct blow, twisting under load	Severe pain, swelling, deformity or unusual angle, unable to use the limb, sometimes a grating feeling; bone visible in an open fracture
Dislocation (shoulder, finger)	Fall on an outstretched arm, ball hitting a finger	Obvious deformity at the joint, severe pain, unable to move it
Concussion	Head clash, fall, blow to the head or a heavy jolt to the body	Headache, dizziness, nausea or vomiting, blurred vision, sensitivity to light or noise, confusion, memory problems, unusual sleepiness, changed behaviour, loss of responsiveness
Muscle cramp	Fatigue, heat, long exercise	Sudden, painful, hard tightening of a muscle that eases with gentle stretching
Heat exhaustion and heat stroke	Hard exercise in hot weather	Heavy sweating, weakness, headache; in heat stroke, a very high body temperature with confusion, agitation, seizures or unresponsiveness: an emergency
Overuse injuries (shin pain, tendon pain, stress fracture)	Increasing training too fast, hard surfaces, poor footwear	Pain that comes on gradually, worse with activity, and keeps returning

Red flags: when to call 912

Not responding or not breathing normally; a seizure; collapse during exercise.
Life-threatening bleeding.
A suspected neck or back injury, or a serious head injury with worsening symptoms.
A suspected fracture of the thigh, an open fracture, or an obvious deformity.
Suspected heat stroke.

Worked example

Worked example 1: sprain or fracture? A basketball player lands on a team-mate's foot and her ankle turns inwards. Decide what is most likely in each case.

She can put some weight on the foot; there is swelling and pain just below the outer ankle bone, but the shape of the ankle is normal. Most likely a sprain.
She cannot put any weight on it, the foot points at an odd angle and she felt a crack. Treat as a fracture or dislocation: do not try to straighten it; support it as it lies and get medical help.
When in doubt, treat the more serious possibility. A sprain treated as a fracture comes to no harm; a fracture treated as a sprain can.

Worked example

Worked example 2: reading injury data (illustrative). A school records its injuries over one football season: 12 injuries in 3,000 player-hours, of which 5 were ankle sprains, 3 thigh strains, 2 bruises and 2 cuts.

Injury rate: $\frac{12}{3000} \times 1000 = 4.0$ injuries per 1,000 player-hours.
Ankle sprains: $\frac{5}{12} \times 100 = 42\%$ of all injuries; strains $\frac{3}{12} = 25\%$ .
Analysis: soft-tissue injuries of the lower limb make up $\frac{8}{12} = 67\%$ . The school would gain most from balance and landing training, a proper warm-up and checking the pitch for holes. (These figures are illustrative, not from a real study.)

Worked example

Worked example 3: the runner who stopped making sense. On a hot afternoon, a pupil finishing a 5,000 m race stumbles, cannot say where he is and feels very hot to touch. What is the likely problem and how urgent is it?

Hard exercise, hot weather, a very hot body and confusion together point to heat stroke.
Heat stroke can kill: call 912 at once.
Move him out of the heat into shade, remove excess clothing and cool him actively with whatever is available, such as cold water poured over the body and fanning (ERC 2025). If he becomes unresponsive and stops breathing normally, start CPR.

Tip

Ask "How did it happen?" The mechanism is your best clue: twist at a joint (sprain), sudden pain in a muscle at speed (strain), direct blow (bruise or fracture), head contact (concussion), long effort in the heat (heat illness).

Warning

Concussion. You do not have to be knocked out to have a concussion. The ERC says that a person with suspected concussion must be removed from physical activity and referred to a health professional, and the international consensus on concussion in sport adds that the player must not return to play on the same day. "He seems fine now" is not a reason to send a player back on.

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Practice

Distinguish between an acute injury and an overuse injury, with an example of each.
What is the difference between a sprain and a strain?
Give four signs of concussion.
What is the difference between an open and a closed fracture?
A sprinter pulls up clutching the back of her thigh. Name the most likely injury.
List three red flags that mean you must call 912.
A volleyball club has 9 injuries in 1,500 player-hours. Calculate the injury rate per 1,000 player-hours and compare it with the football figure in Worked example 2.
A coach says, "If a player can still walk, it can't be broken." Evaluate this statement.

Show answersHide answers

Acute: caused by one sudden event, such as a sprained ankle from a fall. Overuse: builds up from repeated stress, such as shin pain from running too much too soon.
A sprain injures a ligament (bone to bone, at a joint); a strain injures a muscle or tendon.
Any four: headache, dizziness, nausea or vomiting, blurred vision, sensitivity to light or noise, confusion, memory problems, unusual sleepiness, changed behaviour, loss of responsiveness.
In an open fracture the skin over the broken bone is broken (bone may be visible); in a closed fracture the skin is intact.
A hamstring strain.
Any three: not responding or not breathing normally; collapse during exercise or a seizure; life-threatening bleeding; suspected neck or back injury; worsening head injury; open fracture or obvious deformity; suspected heat stroke.
$\frac{9}{1500} \times 1000 = 6.0$ per 1,000 player-hours, higher than the football figure of 4.0 (both illustrative).
Wrong. Some fractures, for example of a small bone in the foot or wrist, still allow walking or movement. Deformity, severe pain, a crack heard or felt, or pain on one spot of a bone mean a fracture is possible, and the injury should be supported and checked by a health worker.

Remember

Sprain = ligament; strain = muscle or tendon.
Fracture and dislocation: deformity, severe pain, loss of use. Do not straighten.
Concussion: remove from play, refer, no return that day.
Heat stroke: hot, confused or unresponsive after exercise in heat: call 912 and cool.
When in doubt, treat the more serious injury.

Sources and credits

European Resuscitation Council Guidelines 2025: First Aid, Djärv T and others, Resuscitation 215 (2025) 110752: concussion, heat stroke and cervical spine sections, summarised.
Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022, Patricios JS and others, British Journal of Sports Medicine 57 (2023) 695–711: no return to play on the day of a suspected concussion.
European Resuscitation Council Guidelines 2021: First aid, Zideman DA and others, Resuscitation 161 (2021): do not straighten an angulated fracture.
Photo: Schwellung Bluterguss Baenderirss, Usien, Wikimedia Commons, licensed under CC BY-SA 3.0.
Sprain and strain diagram, injury table, worked examples and practice: written by Ganzaa.

This lesson adapts CC BY-SA material and is shared under CC BY-SA 4.0.

1Name it before you treat it

2Sprain or strain?

3The common sports injuries

4Red flags: when to call 912

Name it before you treat it

Sprain or strain?

The common sports injuries

Red flags: when to call 912