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Sprains, Breaks and Splints

Support the injury, improvise a splint, protect the spine

6 minIntermediateUpdated 2026-10-23 Sprains, Breaks and Splints

You will learn

Tell the likely difference between a sprain and a fracture
Improvise a padded splint that immobilises the joints above and below
Know when to leave a casualty exactly where they are

⚠️ Practise only on a healthy volunteer, never on a real injury unless you are trained.

⚠️ Do not move anyone with a suspected spine injury unless they are in immediate danger.

⚠️ Get suspected fractures checked by a professional, and consider a wilderness first-aid course.

Sprain or break?

Out on a trail you cannot X-ray anything, so treat it as a fracture if in doubt. Suspect a break if there was a heavy fall or impact, a snap was heard, the limb looks bent or shortened, there is severe pain at one spot, the casualty cannot put any weight on it, or bone is visible. Sprains usually swell and bruise around a joint and hurt when moved, but can often bear a little weight. Either way, stop, support the injured part in the most comfortable position and call for help if the casualty cannot move safely on their own.

RICE, with caveats

For sprains and strains, the old advice of rest, ice, compression and elevation still helps in the first day or two. Rest the injury. Cool it with a cold pack or cold water wrapped in a cloth for up to 20 minutes at a time, never ice straight on skin. A firm, not tight, bandage can reduce swelling, but loosen it if fingers or toes go numb, pale or blue. Raise the limb when resting. In the cold, skip the ice: keeping the casualty warm matters more. If pain is severe or does not improve in a few days, get it checked by a professional.

💡 Numb, tingling or pale fingers or toes mean the bandage is too tight.

Improvising a splint

A splint stops broken ends moving, which reduces pain and damage. Use anything rigid: a trekking pole, a rolled sleeping mat, sticks, a rolled magazine. Pad it well with clothing so nothing presses on bone. Immobilise the joint above and the joint below the break: for a forearm, the wrist and the elbow. Tie it with strips of cloth or tape above and below the injury, never over it. A broken arm can go in a sling, and a leg can be tied to the good leg with padding between. After splinting, check circulation beyond it: warm, pink skin and feeling in the fingers or toes. If not, loosen the ties.

Suspected spine injury: don't move them

Suspect a neck or back injury after a fall from height, a diving accident, a high-speed crash, or if the casualty has neck or back pain, tingling, weakness or numbness in the limbs. Do not move them unless they are in real danger, such as rising water or rockfall, or you need to open their airway. Tell them to keep still, kneel behind their head and hold it gently in line with the body. Call your local emergency number (112 in Europe) and wait. Moving a spinal casualty safely takes a trained team. A first-aid course will let you practise splints and head support properly.

Check yourself

When splinting a broken forearm, which joints do you immobilise?

Always the joint above and the joint below, so the broken ends cannot move.

After splinting, the casualty's toes are pale and numb. What do you do?

Pale, numb toes mean blood flow is restricted. Loosen and recheck.

How should you cool a sprain?

Wrap it and limit the time to avoid cold injury to the skin.

A climber fell and has neck pain and tingling hands. The area is safe. What do you do?

Suspected spinal injury: do not move them unless there is danger. Wait for trained help.

Try it for real: Splint a friend's arm

Gather a rolled mat or magazine, some clothing for padding and a few strips of cloth
Splint a healthy volunteer's forearm, immobilising wrist and elbow
Check their fingers are warm, pink and have feeling
Add a sling from a scarf or jacket, then take it all off