Hard Tissue Injury

Hard tissue injury and soft tissue injury are types of injuries discussed in GCSE Physical Education (GCSE PE) lessons as part of the Sports Injuries module.

A hard tissue injury is damage to bone tissue.

A hard tissue injury is also called a "fracture" and is defined as a "loss of continuity in the substance of a bone". Hard tissue injuries, also known as "fractures" are commonly referred to as "broken bones", or perhaps "cracked bones" in the case of stress fractures and hairline fractures.

There are several different types of fractures (broken bones). Some concern bones that have been completely broken (separated) into two of more pieces e.g. simple fractures and comminuted fractures, while others concern damage to bone tissue that is less severe than a complete clean break but may still be painful, e.g. hairline fractures and greenstick fractures.

So,_ What is the difference between hard and soft tissue injuries ?

The difference between hard and soft tissue injuries is that hard tissue injuries involve damage to bone tissue and soft tissue injuries involve damage to other types of tissues e.g. muscular tissue, tendons, ligaments, etc..

Bone fractures, also known as hard tissue injuries, are less common sporting injuries than soft tissue injuries. However, hard tissue injury does sometimes happen during sporting events, especially in the case of certain more "extreme" sports such as downhill skiing, some equine sports and even motor sports. In the cases of the team sports and athletics events popular in schools and colleges, and especially contact sports, hard tissue injuries may be caused by:

  • Contact / impact with another player, e.g. an opponent in a tackle
  • Contact with an object used during the activity, e.g. a hard ball such as a cricket ball striking a hand or face
  • Contact with a hard playing surface e.g. due to a hard fall onto frozen ground or even solid ice if ice-skating.

Symptoms of Hard Tissue Injury

Above: Support provided to facilitate healing of hand bones after a hard tissue injury.

What are the signs that a sports player has or might have sustained a fracture or hard tissue injury ?

Common general indications of some types of fractures (incl. closed fractures, open fractures and compound fractures) include:

  • feeling the bone "break" (in the case of the casualty himself / herself)
  • hearing the sound of a breaking bone
  • abnormal body shape in the affected area e.g. a finger or toe at an obviously unusual angle - that is not normal for that person
  • pain and tenderness in the immediate vicinity of the injury
  • swelling in the vicinity of the injury
  • visibly protruding broken bone - in the case of a severe open fracture

Types of Hard Tissue Injury

There are several types of fractures (see also the additional pages mentioned below for more about fractures).

Students learning about hard tissue injuries as part of GCSE PE or equivalents don't need to know about all possible fractures in detail but may discuss the four main types of bone fractures.

4 Main Types of Fractures (for GCSE PE)


Closed Fracture -

Bone broken but still within the skin, i.e. the overlaying skin has not been broken by the broken bone. This is also known as a simple fracture.


Open Fracture -

Bone broken and an end of the broken bone protrudes through the skin, i.e. the broken bone has also broken through the skin and so may be visible outside the body. This is also known as a compound fracture.


Complicated Fracture -

Broken bone has also damaged surrounding structures or organs, e.g. a broken rib that has punctured a lung. This is also known as a multifragmentary fracture.


Stress Fracture -

Bone is not completely broken but is damaged by cracks that have developed along the length of the bone, often following repeated stress on the bone that has been applied frequently over a long period of time.

Some long distance runners experience stress fractures, which may also be called shin splints or just shin soreness. See also more types of bone fractures and bone fracture healing times.

First Aid courses teach that all hard tissue injuries (= bone fractures) should be seen and treated by a medical expert.

This is the end of the page about hard tissue injury for GCSE Physical Education (GCSE PE).
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