Let’s face it—injuries happen. Whether you’ve tripped during a workout, an accidental fall, or conditions out of your control, knowing how serious an injury is can save you a lot of stress. Should you head to the ER, or is some ice and rest enough? This guide breaks it all down so you can figure out what to do next.
Step 1: How Much Does It Hurt?
Pain is often the first and most noticeable indicator of an injury. While pain is a deeply personal and subjective experience that varies from person to person, it can still provide valuable clues about the nature of the injury. Pain is your body’s way of saying, “Hey, something’s not right here!” While pain is different for everyone, the type and intensity of pain can reveal important details about the injury. Here’s a quick guide:
Sharp Pain: If you feel a sudden, intense jolt, it could mean a fracture, ligament tear, or serious muscle strain. Pay attention to where and when it happens.
Dull Ache: Persistent discomfort might signal tendinitis or a mild sprain. Overworked tendons and ligaments may need a progressive strengthening program. Consult a physical therapist to guide recovery.
Burning or Tingling: If it feels like your limb is buzzing or burning, it might mean a nerve is involved, such as with sciatica or a pinched nerve. Sometimes, nerves get irritated when your body isn’t moving quite right. Specific exercises or stretches can help ease the pressure and get things back to normal. A physical therapist can recommend the best movements for your situation.
Throbbing Pain: Often accompanied by swelling, this type of pain is usually linked to a sprain, bruise, or inflammation. While these injuries typically heal with time, following a structured loading progression can promote faster and more sustainable recovery. Seek professional advice if the pain worsens.
Radiating Pain: Pain that spreads beyond the injury site could point to nerve or muscle involvement, or even referred pain from another area of the body. Pinpointing the source is key, so work with your physical therapist to identify and address the underlying issue.
Levels of Pain
Mild Pain: Tolerable discomfort that does not significantly limit movement or daily activities. This level of pain often accompanies minor injuries, such as bruises or light strains, and can usually be managed independently with modified activity.
Moderate Pain: Pain that restricts normal activities or necessitates rest may indicate a more substantial injury, such as a sprain, a minor fracture, or a severe strain. Seeking professional assessment is advisable in these cases.
Severe Pain: Intense, sharp, or persistent pain—especially when accompanied by swelling, deformity, or inability to move the area—suggests a serious injury such as a broken bone or a significant tendon or ligament tear. Immediate professional evaluation is essential.
Step 2: Spot Any Deformities or Weirdness
Compare the injured area to its uninjured counterpart. Here’s what to look for:
Looks Normal: Good news! But internal damage isn’t ruled out yet.
Slightly Off: May indicate a sprain or partial dislocation—worth getting checked out.
Clearly Deformed: A red flag for a broken bone or full dislocation. Head to the ER.
Step 3: What’s Going On with Swelling and Bruising?
Swelling and bruising are the body’s way of saying, “We’re working on it!” But the extent can tell you a lot:
No Swelling/Bruising: Likely something minor.
Some Swelling/Bruising: Probably a sprain or mild injury.
A Lot of Swelling/Bruising: Could mean a fracture, severe sprain, or something more serious. Watch closely.
Swelling, though uncomfortable, is a natural and essential part of the healing process. It occurs as your body increases blood flow and fluid to the injured area to kickstart repair. To alleviate discomfort and manage swelling, apply an ice pack wrapped in a cloth to the affected area for 15–20 minutes at a time, every few hours, \within the first 24–48 hours after the injury. This practice can help reduce inflammation and provide temporary relief. Additionally, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be used to address pain and swelling, but they should be taken as directed and with care, particularly for individuals with specific medical conditions. Remember, the goal is not to eliminate swelling entirely, as it plays a critical role in recovery. For more on managing injuries, refer to the PEACE and LOVE blog.
Step 4: Can You Move It?
Gently assess the movement of the affected area to gain insight into the extent of the injury:
Start with Passive Range of Motion (PROM): This involves moving the joint without engaging the surrounding muscles, often with the help of a friend or by using your hands to support the movement. PROM allows you to evaluate the joint itself and can help identify issues such as fractures or ligament injuries. During this step, assess both normal motions and accessory motion laxity (e.g., rocking or shifting the joint).
Progress to Active Range of Motion (AROM): Gently try moving the injured joint yourself, focusing on slow and simple movements. This step helps assess the health of the muscles. Consider performing these motions in different positions—for example, raising your arm overhead while standing versus lying on your back. If your response varies significantly between these positions, it could indicate the severity of a muscle injury.
Compare with the Healthy Side: Always compare the injured area’s movement and stability to the uninjured side. For instance, if the affected joint rocks, shifts, or slides noticeably more than the healthy joint, it may suggest a ligament injury.
By carefully observing these aspects of mobility, you can better understand the nature and severity of the injury. A complete lack of mobility is a red flag for a serious issue that needs immediate medical attention.
Step 5: Can You Put Weight on It?
Inability to bear weight in a red flag for a potential fracture or severe injury. These signs warrant a professional evaluation, including imaging such as an X-ray. These injuries often require immediate medical attention.
For ankle and foot injuries, this includes an inability to bear weight immediately after the injury or walk four steps after a period of time (think average time from injury to ER). Tenderness in specific areas, such as the distal posterior 6 cm of the tibia or fibula, the medial or lateral malleoli, the bones in the arch of the foot, or the lateral edge of the foot, can also indicate a fracture. (Ottawa ankle rules)
For knee injuries, along with inability to bear weight, indicators for an X-ray include tenderness at the fibular head (posterolateral area of the knee), tenderness directly over the kneecap, or an inability to bend the knee past 90 degrees. (Ottawa knee rules)
If you suspect a hip injury, fractures or dislocations are typically associated with significant trauma and an inability to bear weight.
Step 6: Watch for Other Warning Signs
Certain symptoms can indicate a more severe injury or medical condition:
Numbness or Tingling (nerve problems)
Cold/Pale (possible blood flow issues)
Extreme weakness (generally not a good sign)
Dizziness or Fainting (shock)
When Should You See a Doctor?
If you’re on the fence, here are some clear reasons to get help:
Pain that’s unbearable or won’t go away with rest.
Symptoms (swelling, bruising, etc.) that linger beyond a few days.
Signs of infection: redness, warmth, pus, or fever.
Head injuries with confusion, loss of consciousness, or ongoing headaches.
Avoid alcohol, screens, over stimulation
If accessible, some research does show a benefit to entering a hyperbaric chamber after experiencing a concussion or traumatic brain injury (Harch)
Conclusion
Being able to assess the severity of an injury is an invaluable skill that empowers you to respond appropriately when accidents occur. Having a few "tools in your toolbelt" to gauge the seriousness of an injury—especially when a medical professional isn’t immediately available—can help prevent complications and support proper healing. Understanding when you can manage an injury independently versus when to seek professional help can save you both time and money. Above all, remember that your health and safety come first. When in doubt, err on the side of caution and consult a healthcare professional.
References
Harch, Paul G. “Systematic Review and Dosage Analysis: Hyperbaric Oxygen Therapy Efficacy in Mild Traumatic Brain Injury Persistent Postconcussion Syndrome.” Frontiers in Neurology, vol. 13, Mar. 2022, https://doi.org/10.3389/fneur.2022.815056.
The Royal Australian College of general Practitioners. “The Ottawa Knee Rules.” Australian Family Physician, www.racgp.org.au/afp/2012/april/the-ottawa-kneerules#:~:text=The%20Ottawa%20knee%20rules%20(OKRs,trauma%20without%20compromising%20patient%20care.&text=The%20rules%20are%20outlined%20in,have%20knee%20radiographs%20safely%20deferred.&text=Knee%20X%2Dray%20indications%20after,limping)%20immediately%20and%20at%20presentation.
Wang, Xin, et al. “Clinical Value of the Ottawa Ankle Rules for Diagnosis of Fractures in Acute Ankle Injuries.” PLoS ONE, vol. 8, no. 4, Apr. 2013, p. e63228. https://doi.org/10.1371/journal.pone.0063228.
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