Is it a big deal or isn't it? - Sports injury edition

January 29, 2015 2:07 PM

My question is mainly about exercise-related injuries but it probably applies to all sorts of injuries. How do you know whether it's a deep bruise or a muscle strain? A skeletal issue or a problem tendon? A sprain or a pinched nerve? Something that requires a trip to a specialist, can be handled by a physical therapist, or will get better on its own with rest?

I work out pretty vigorously and frequently, and let's face it, I'm not getting any younger. It's not uncommon, and will certainly become more common as I age, that I notice some pain after working out. It's to be expected, I guess, but I find myself very frustrated by not having a clue what's wrong so I don't know how to take care of it. And I don't want to run to the doctor all the time; I'll go willingly if I know it's needed, but I want to be able to figure out when it's needed.

So, all you exercise junkies, sports experts, or medical professionals out there, please give me some hints about how I can figure out what's wrong beyond just saying "ow, that hurts!".

posted by DrGail to Health & Fitness (7 answers total)

For me, I'd love to say that I stick to a rule of "if it hurts while resting for 2 weeks or more, go to the doctor" but in practice I will let pain go on for like a year before I finally say UGH FINE and go to the doctor. This is a bad thing that works out badly for me, each and every time. BUT in general if it's something that sticks around even after the usual stretching and/or foam rolling and RICE stuff, and it's bothering you even when you're not active, and it's been 2 weeks or more since the initial injury, then it's doctor time.

In general even my worst post-workout muscle aches are gone within 24-36h, and a lot quicker if I'm stretching and being mildly active. The stuff that's still bothering me long enough that I can't quite remember when it started? That's always the stuff to pay attention to.
posted by poffin boffin at 2:20 PM on January 29, 2015 [4 favorites]

(by "hurts while resting" i mean something that still hurts when you're not doing the thing you did to cause the hurt, not that you should just lay down for 2 weeks and see hw you feel)
posted by poffin boffin at 2:22 PM on January 29, 2015

If it is persistent pain or very sharp and intense pain or there is a lot of swelling, I visit my doctor, because she's got the degree, experience and resources to do a much better job than me in figuring it out. Seriously, if this is more than transitory pain, be safe rather than sorry.
posted by bearwife at 2:31 PM on January 29, 2015 [1 favorite]

If it pops and gives out, GET THEE TO THE DOCTOR.
posted by Ms Vegetable at 3:22 PM on January 29, 2015 [1 favorite]

My rule is fairly similar to what's mentioned above.

Extremely sharp, sudden pain, especially in the knee or ankle? Stop. Go to the doctor as soon as possible.

Nagging, annoying pain but I can still function and get through my day? Rest. Ice. Ibuprofen et al. If it doesn't go away after a couple of weeks, I go to the doctor.

I'm in the middle of implementing my rule right now with a pretty annoying tendon injury in my foot... it hurts every step I take. Some days have been worse than others since it happened (and I know what caused it). If it doesn't get any better in the next week, I'm scheduling a doctor trip, and I can tell the doctor "I've already tried ibuprofen, and rest, and icing it, and still no improvement."
posted by Old Man McKay at 5:16 PM on January 29, 2015

Honest answer ? Experience. Experience gained through having injuries that required docs visits, PT, and 6 months to a year off various sports/exercises. Once you've got a few under your belt, you start asking a handful of questions to gauge things:
- the stand-by 1-10 pain scale
- is something swollen/inflamed, hot to the touch etc.
- what drugs/NSAID have I taken, and did that help
- how long did I take off/rest and no change
- is this really screwing with my normal day-to-day activity/life (not my workouts, my normal day to day stuff) ? (or can I not make it through the day w/o taking advil/alleve/etc ?)

That last question is most important. Any time that is a yes, I'm calling the doc. Might take me a day or two to get to answering yes, but ..
posted by k5.user at 8:13 AM on January 30, 2015 [1 favorite]

In my experience, general soreness or the usual aches and pains are no biggie. (Though you shouldn't be in a lot of pain all the time. If you are, you need to reevaluate your workouts.) Sudden onset new pain, decreased range of motion, inability to bear weight, significant bruising and/or obvious inflammation indicate something more serious. Once you've been exercising for a while, you'll get to know what are normal aches and pains for you and what's beyond normal.

Once you've determined if it's something more serious than the usual aches and pains, you can evaluate the level of damage and decide if you need medical attention. If you're in extreme pain, obviously you'll need to see a doctor. If you're in chronic pain (pain lasting more than a week or two with no signs of improvement), see a doctor. If your range of motion is severely compromised (as in, can't lift your arm, suddenly can't bend over at all, etc.), see a doctor regardless of pain levels because you may need physical therapy to restore function.

If you're the kind of person that does well with more information, you can google around for signs and symptoms of common sports injuries so you'll know what to look out for. However, if you're the kind of person who will then become convinced you are dying, I don't recommend that.

Trust your gut. You'll know when you need to see a doctor. After experiencing a minor hamstring tear that I was able to rehab myself, I have to say that if it's serious enough to really need a doctor, I'm certain you will know. When in doubt, see a doctor anyway - it probably won't hurt.
posted by geeky at 11:19 AM on January 30, 2015