Emergency room or not for leg injury while skiing?

December 31, 2019 2:00 PM

I had a bad fall while skiing (on a beginner slope no less!). Pain is mostly right below the knee, not really in the knee itself. Should I go to the emergency room?

The EMT at the ski resort said that it’s good that there is limited pain to no pain in the knee itself. He also said nothing indicates a broken bone and that it’s most likely a sprain and possibly a hairline fracture in the bone. I asked him to wrap it in a compression bandage although he leaned toward splinting it since it’s near the knee. He seemed very competent.

I’m guessing that it’s just a really really bad sprain but worried it could be worse. All of the pain is in the few inches below the knee. Pain is 6 or 7 out of 10 when I move, bad enough that I was involuntarily crying hard anytime my leg was anything less than 180 degrees and straight, at least before going on OTC pain meds. (Learned this the hard way by crying at a restaurant after bending my knee to sit down.) Currently using RICE and it’s ok so far but I haven’t moved since taking pain meds.

I’m a woman and have never actually gotten a physical injury like this so have no context for how bad this is or what my physical pain tolerance is. (The scale of emotional pain, on the other hand, I have a great handle on!) Friend also has no idea. I want to avoid permanent damage. Please help? Do I need to go to the ER asap? Or can I just wait and see? Thank you in advance!

posted by hotchocolate to Health & Fitness (24 answers total)

I'm a jock and have bounced off of many things in my fairly clumsy existence, and this would be at least a "Go to a walk-in clinic with an x-ray machine" level situation for me. If you're in pain so bad you can't control your reaction, and it gets worse when you move, you should a) absolutely not be walking on it and b) get medical attention beyond a surface-level glance. Especially especially since the EMT recommended immobilizing the joint.
posted by restless_nomad at 2:05 PM on December 31, 2019 [12 favorites]

Please go to the ER! The EMT who helped you cannot say what is definitively wrong but the emergency room can. Some injuries get worse without prompt treatment.
posted by corey flood at 2:06 PM on December 31, 2019 [3 favorites]

Can you go to an urgent care clinic?

What you describe is a pretty high level of pain. People (including ourselves) tend to discount women's pain. Please get it checked out, as soon as you can. I would go to urgent care clinic right away, considering tomorrow is a holiday and tonight is probably a bad ER night if things get worse. If tomorrow weren't a holiday and you had a regular doctor that could get you in fast and get X-rays maybe I would say see if you could make an appointment. But given the timing I don't think that would work in this case.

I have had a knee injury while skiing a couple decades ago, and my parents did not take me anywhere except to my pediatrician a few days later when he had an opening. Doc said I probably should have gone to the ER based on the injury.

I injured the same knee a few years ago and went to an urgent care clinic the next day. They did x-rays which didn't show anything, and in fact they were fairly dismissive, but they gave me a brace and a referral to an orthopedist. Which turned out to be a good thing because I had torn my ACL completely and needed surgery.
posted by misskaz at 2:14 PM on December 31, 2019 [12 favorites]

Go get an x-ray. I had a similar injury in my 20s and didn't do anything about it - it still bothers me nearly 20 years later and I've had to do PT but don't hope to have full range of motion back ever. I don't know what they would have done for it at the time but I wish I had at least had it checked out.
posted by peanut_mcgillicuty at 2:21 PM on December 31, 2019 [1 favorite]

Definitely get it checked out. My local ski resort is somewhat morbidly sponsored by a large local orthopedics clinic that has a walk-in center— maybe see if there’s something like that in your area? Best case it’s nothing, worst case you’ll be very happy you addressed it before injuring yourself more.
posted by charmcityblues at 2:26 PM on December 31, 2019

Chiming in, as someone who has broken some bones, to say that I would definitely get imaging today or tomorrow - with the pain you're describing you may want it today. The one day won't make a huge difference if you stay off it (sometimes you'd have to wait for a cast due to swelling) but I wouldn't wait longer than that.
posted by warriorqueen at 2:27 PM on December 31, 2019 [1 favorite]

Any ski town should have an orthopedic walk in clinic or one nearby in the nearest big town. Go there or to an orthopedist asap. An xray is of limited help depending on what the problem is and any er or urgent care is just going to send you to an ortho.

And stop walking on it! The EMT wanted to splint it for a reason. Crutches from a drug store and ortho asap.
posted by fshgrl at 2:27 PM on December 31, 2019 [2 favorites]

If you’re thinking urgent care over ER, call first. When I broke my arm, urgent care people said I needed to go to the ER instead.

I agree this is either urgent care or ER though. With meds masking the pain, you may make it worse without noticing.
posted by FencingGal at 2:31 PM on December 31, 2019 [9 favorites]

You can't walk on it, get it checked out. A hairline fracture is still a fracture. EMTs can get an little ...dismissive...because they see all kinds of injuries and sometimes things are very obviously broken. But they don't actually follow up.

But just because it isn't obvious didn't mean it doesn't warrant further work up. Your body is telling you with pain and movement something is wrong. Get it checked out.
posted by AlexiaSky at 2:40 PM on December 31, 2019

I fell while skating a couple of years ago and my wife dragged me to the ER when my arm was still hurting that night. They took an x-ray and said I had a hairline fracture (not that I could see anything), put me in a sling and gave me an appointment with the fracture clinic the next day. The fracture clinic took a further look at it and told me to make an appointment in some amount of weeks if it wasn't feeling better. By that time it felt fine enough that I didn't bother going back and my arm is fine now.

I still don't know if my arm was actually fractured or if they were being too careful/humoring me but I was reassured that professionals had looked at it and that if there were problems later on then at least they would know what the situation was.

When I was younger my index finger on my non-dominant hand got jammed/dislocated playing rugby and I didn't go to a doctor because my parents would have used that as an excuse to not let me play anymore. The finger is still crooked although it works fine and is pain-free. All in all I'm OK with the trade-off but I wish my parents were more understanding about sports so that I could have played the rest of the season AND have a straight finger now.

I'm in Canada so cost doesn't come into it but my vote would be to go to the ER. A crooked finger is one thing, if your leg doesn't heal properly and you end up with permanent discomfort/pain how would that affect your life?
posted by any portmanteau in a storm at 2:41 PM on December 31, 2019 [1 favorite]

Does your deductible reset at the start of the year? Is it relevant, in this case? If so, go today!
posted by Huffy Puffy at 2:45 PM on December 31, 2019 [9 favorites]

Today today today. I broke my hand many years ago, put off seeing a doctor over the weekend, and ended up having to have it rebroken so it could be properly set. DO NOT RECOMMEND. Go see someone tonight. Good luck!
posted by apparently at 2:53 PM on December 31, 2019 [2 favorites]

A good rule of thumb: if you have to ask this question, you almost certainly need an x-ray, and a doctor to interpret said x-ray.
posted by ivanthenotsoterrible at 3:15 PM on December 31, 2019 [2 favorites]

I broke my leg "tripping" over a bump in the street. I walked on it for a week thinking I'd sprained an ankle. I ended up in a boot for two months.
posted by heathrowga at 3:17 PM on December 31, 2019 [1 favorite]

I would rest it, ice it, elevate it and see how you feel in a few days. I have broken many bones, had several surgeries and various acute injuries. Going to the emergency room won't hurt, but it could cost you in time and money. Waiting with ice, rest and elevation will not cost much at all and could help.
posted by AugustWest at 3:35 PM on December 31, 2019

Echoing yes, this is urgent-care or ER worthy. I'd go to urgent care first (ours did Xray), but you could call ahead to check what they'd say to do.

My somewhat experienced scale of pain is something like:
10 (reserved for total incoherence)
9 screaming
8 crying, gasping
7 holding breath, muttering
6 trying not to move
5 wince
4 strong ache

In my experience, tylenol or advil can relieve up to about a 6, maybe a 7.
posted by Dashy at 4:07 PM on December 31, 2019 [2 favorites]

AEMT/fireman for over a decade here. Go to the urgent care and they’ll probably recommend an x-ray and possibly physical therapy. If it’s something they can handle, they also might be able to do a little something for the pain. If it’s not something they can fix, they won’t hesitate to recommend the ER.

I say this because a) the ER is for life-threatening/potentially life-threatening situations b) the ER on NYE is generally a shitshow no matter where you are C) if they’re backed up with ER bullshit (stabbings, STEMIs, gunshot wounds, people being stupid) a fracture will wait a very, very, very long time in triage while you will be seen at an urgent care much more quickly.
posted by sara is disenchanted at 4:35 PM on December 31, 2019 [4 favorites]

Exactly the same thing happened to me three years ago. Ski patrol said it looks fine - went to local suburban clinic which said it seems ok but that I need a CT scan. By the time I got around to a specialist, he said I had torn my ACL, PCL, and MCL. He also said I needed immediate surgery (like, within a day or two) and that if I had waited 48 hours my life long mobility would have been drastically different.

Now after three years I am normal and running around. But my PT, when they saw my scans, was amazed and said I absolutely made the right call to get immediate surgery.

Don’t fuck around with this stuff. Go to urgent care and if you can swing it try to see a knee specialist in case too.

(For reference I could not bear weight on it)
posted by pando11 at 6:46 PM on December 31, 2019 [1 favorite]

A minor pain that I didn't think was a big deal wound up being a torn meniscus. I was very lucky not to need surgery, but I did have to do a LOT of PT.

Get it checked out. Better safe than sorry.
posted by Tamanna at 7:14 PM on December 31, 2019

My husband broke his leg a couple of years ago, and your pain sounds more severe than his.

The emergency room experience can vary a lot depending on your location. It sounds like you're at a ski resort, so the nearest ER may be much calmer and less crowded than what you would find at a big city hospital. If you went to the ER at the hospital near me (which is the hospital closest to a couple of ski resorts), you would probably find that it was not busy and you would be seen right away by calm, friendly people, even on New Year's Eve. There aren't a lot of stabbings or shootings around here.
posted by Redstart at 7:17 PM on December 31, 2019 [2 favorites]

Yes.
posted by sixswitch at 7:30 PM on December 31, 2019

I hope you’re getting it checked and I hope it’s a quick recovery.

As a woman it’s sometimes hard for me to get others to understand my level of physical pain, and I find myself sometimes feeling like I should downplay or minimize it. It’s helpful for me to picture the FACES scale when I need to quantify a pain level. If I was involuntarily crying hard due to pain, I wouldn’t hesitate to call that an 8 or 9. If you say 6 someone might think it’s not that bad. You deserve to have your needs taken seriously by professionals.
posted by beandip at 7:13 AM on January 1, 2020 [1 favorite]

Get it checked out. My mother walked around on a broken leg in agony for a week before getting help & made the healing of it so much longer & more painful by waiting as she caused more damage. Better safe than sorry.
posted by wwax at 8:59 AM on January 1, 2020

I hope you got it checked out. If not, please do so.

FWIW, a competent ER should treat pain as bad as yours seriously, unless they're inundated with trauma cases. I had to go to the ER yesterday afternoon for leg pain (turned out to be DVT...), and I was checked in immediately, saw a doctor within 30 minutes, had an ultrasound not long after that, and was out the door with a treatment plan and prescription within 3 hours.

Also, if your leg spends a lot of time immobilized as a result of this injury, please ask your doctor what you can do to avoid blood clots forming in the leg, especially if you're going to be flying or doing a long drive.
posted by brianogilvie at 10:52 AM on January 1, 2020