Beware of FOOSH Injuries

Falls On Outstretched Hand Injuries

Thinking about decking the halls this holiday season? Proceed with caution as you climb the ladder to get lights and decorations up as it can lead to unexpected injuries. A study by the Consumer Product Safety Commission showed that over the holidays in 2019, 14,800 people were treated in emergency rooms for decorating-related injuries. 

FOOSH Injury explained by JOI RehabFOOSH Injuries at the holiday season

Most of these injuries were related to falling off a ladder. Many injuries involve wrists, elbows, legs, and hands, but more severe injuries could occur including head injuries and spine injuries. The most common injuries from falls are FOOSH injuries. Dive in to find out how a FOOSH injury could affect your Holiday season. 

What is a FOOSH Injury?

FOOSH stands for falling on outstretched hand. When you fall the initial reflex is to put your hands out to break your fall. When this happens, this can lead to multiple types of injuries including strains, sprains and fractures of the hand, wrist, elbow, and shoulder. Here are some of the most common FOOSH injuries.

Scaphoid Fractures

The scaphoid bone sits at the base of your hand and wrist. Scaphoid fractures present with pain at the thumb and can sometimes have swelling and bruising. This fracture requires timely attention as it can lead to future complications if left untreated. Treatment for this injury varies from casting and splinting to in some cases surgery. You may be referred to physical or occupational therapy for treatment.

Scaphoid Fractures by JOI Rehab FOOSH Injury Scaphoid Fracture

Distal Radius Fractures

Distal radius fractures are when the long bone of your arm breaks where it meets your wrist. This injury will cause extreme pain in the wrist that may radiate up the forearm, swelling, bruising, and pain with wrist movement. Sometimes these can be treated with casting, however it is common for the bone to be displaced with this kind of fracture. Depending on the severity of the injury you may need to undergo an open reduction with internal fixation. This is a surgical procedure where your physician will make an incision and realign the bones and fix them in place with a number of screws and plates. These surgeries require physical and/or occupational therapy following surgery to regain strength and range of motion.

Radial Head Fractures

The radius bone can also fracture at the radial head, which is just below the elbow. These fractures can present as pain in the elbow, wrist, or both. If you are unable to move your elbow after a fall, seek medical attention as you may have a radial head fracture. If the fracture is severe, it may require surgery but often this injury is treated with splinting. Once the bone is healed, elbow movement is crucial for recovery of this injury. You may be referred to physical therapy to regain full strength and range of motion. 

Shoulder Dislocation

When falling on an outstretched hand it is possible to dislocate your shoulder joint. The dislocation itself is painful and requires emergency medical attention to reduce the dislocation. Resultant injuries that can occur due to a shoulder dislocation include labrum tears, AC joint sprains, collar bone fractures, rotator cuff tears, and proximal humerus fractures. These have a variety of treatment options including surgery, therapy, and splinting. Many of these injuries can be severe and can result in permanent impairment in range of motion and strength.

Shoulder Dislocation FOOSH Injury by JOI RehabFOOSH Injury Shoulder Dislocation

How do I Avoid these Injuries?

The best way to avoid a FOOSH injuries is to set up your ladder safely. Heed manufacturer warnings and make sure your ladder is secure before climbing it. Find a level surface to base your ladder. Always make sure someone is there with you. If you’re hanging lights or garlands outside of your house don’t climb higher than you feel comfortable, and don’t stand on the very top step. Be sure not to reach out too far as to lose your balance. If you are uncomfortable ask for help or hire a service. Heed these helpful tips to avoid a trip to the ER and keep your holidays happy. 

Written By: Victoria Hernandez, PT, DPT and Timothy R. Hastings, MD

Dr. Hastings is an Orthopaedic Physician at the JOI Beaches Location. 

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Book an Appointment with The Jacksonville Orthopaedic Institute Today!

If you have an injury, the Jacksonville Orthopaedic Institute can help. To schedule to see a JOI Orthopedic/Sports Doctor, call (904)JOI-2000.  To see a JOI Rehab Therapist in 1 of our convenient locations, call (904)858-7045.


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