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Know it all - when should I seek medical care for an injury?

Athletes are particularly prone to injury, and it is important to recognise when you need medical attention in order to return to your normal activity levels safely and quickly. In cases of major injury there may be no doubt that you need medical care, but in other cases the need to see a doctor is not always quite so obvious.

In general, immediately after an injury you should follow the RICE methodology. RICE stands for rest, ice, compression and elevation, and following these steps will help to hasten recovery. Resting will minimise the likelihood of further damage occurring, and the process will generally reduce pain, inflammation and swelling.

If your symptoms do not begin to improve after resting and treating your injury at home you should seek medical assistance. Medical care may also be needed for conditions that affect your training or performance or that may pose a risk to others.

The three main types of condition that can affect activities are medical conditions, acute injuries and injuries caused by overuse.

Medical Conditions

Athletes can suffer from concussion without losing consciousness, so if you have a head injury you should always see a doctor before continuing your activity. If, following a head injury, however minor it seems, you develop symptoms such as headache, blurred vision, disorientation, loss of consciousness, memory loss, nausea or agitation medical attention is essential.

You should also see a doctor if you experience chest pain, shortness of breath, fainting or palpitations as these may indicate heart disease or respiratory problems. Another condition that requires medical care is heat injury. This may take the form of heat exhaustion or heat stroke and symptoms can include nausea and vomiting, muscle cramps, exhaustion and headache. Heat stroke is a medical emergency and needs prompt professional treatment.

Acute Injuries

Acute injuries include strains and sprains, fractures, torn cartilages, dislocations, cuts and bruises as well as herniated disks and pinched nerves. Common symptoms are pain, bruising and swelling, shooting pains, numbness or tingling and joint instability.

The ankle is a common site of injury and can be affected by sprains, damage to ligaments and problems with the Achilles tendon.

Closeup of a sprained ankle being treated with ice showing bruising

A sprained ankle occurs when the ligaments are twisted, stretched or torn causing pain, loss of movement and swelling. It is one of the most common ankle injuries and can be categorised in three levels of severity. If symptoms improve with rest, ice, compression and elevation, the condition can probably be managed at home, but severe sprains may require medical care, possibly surgery and a course of physiotherapy.

Achilles tendonitis or rupture of the Achilles tendon needs to be diagnosed so that appropriate treatment can be implemented. Treatments for a ruptured Achilles tendon include rest, physiotherapy, using a support or brace and possibly surgery, so it is important to obtain an accurate diagnosis.

Acute knee injuries can also affect tendons and ligaments. In many cases, following the RICE protocol will be enough to reduce symptoms in a couple of days, but if there is no improvement you should see a doctor or physiotherapist for a diagnosis and treatment plan. Physiotherapy, sometimes in conjunction with bracing is often the most appropriate treatment, although surgery may be necessary for severe grade three injuries. A professional diagnosis is important to ensure that the appropriate type of brace to protect and support the joint is chosen.

Yellow diamond road sign with the words "warning knee pain" written on it

Another acute injury which is quite common in sportspeople and athletes is a hamstring strain. The hamstring is used in actions such as running and jumping and can be strained or even ruptured. Treatment is often provided through the use of a support, but unless you are sure of the specific condition from which you are suffering, it is wise to seek medical advice before choosing a support. The same is true of other thigh injuries such as strained quadriceps.

You should see a doctor for any acute injury that causes swelling, instability or locking in a joint, or a visible deformity. If you are unable to move an arm, leg or joint, or to stand or walk a medical opinion is required. Other indications that you should seek medical care are neck or back pain, particularly if this is accompanied by weakness, numbness or pain running down the arm or leg.

If you have persistent pain, or pain that prevents you from sleeping or carrying out your daily activities, you should also seek professional advice.

Overuse Injuries

Injuries caused by overuse or repetitive actions can occur over time and pain is often the first symptom you notice. Pain will frequently worsen with activity but improve with rest as will other symptoms such as tightness, localised swelling, weakness or grinding in joints. Initially the symptoms will only be evident following vigorous activity, but as the condition worsens, they can occur with any level of activity and eventually restrict what you are able to do.

Examples of overuse injuries include tendonitis, fasciitis, shin splints, bursitis, compartment syndrome, spondylolysis, stress fractures and many other conditions.

Tennis elbow, properly known as lateral epicondylitis, is one of the most common overuse injuries. The muscles and tendons that control movement of the forearm and hands become damaged by overuse and sufferers feel pain below the elbow or when twisting or bending the arm. Gripping small objects can also cause pain in the arm. Bursitis can also cause pain and swelling in the elbow and other joints, but can usually be successfully treated with rest and ice to reduce the swelling. If the pain persists for more than two weeks you should see your doctor.

Diagram showing tennis elbow in the right arm from the lateral side

Tendons can become damaged through overuse, resulting in tendonitis in the thigh, hip, knee, wrist or elbow. This causes pain, weakness and swelling in the area, and sometimes a grating feeling. Treatment usually consists of rest, ice packs and physiotherapy. Bracing for the affected area is also important to help recovery by providing compression to reduce pain and inflammation.

If you have localised pain that becomes worse over time or when you continue the activity that is causing it, you should check with your doctor. If symptoms such as swelling, weakness, stiffness or pain prevent you from training or undertaking your sports activity, this is another indication that you should obtain medical advice.

As with acute injuries, if your pain or other symptoms persist when you have followed the RICE methodology, or if you are unable to sleep or carry out your daily activities because of the pain, you do need to consult a doctor.

Infographic showing the treatment options you should consider following injury

The major rule of thumb is to obtain medical advice if any injury causes pain or other symptoms that do not go away with standard home treatment. Many conditions can be helped by using sports bracing, but it is important to have a professional diagnosis so that the correct appliance for the condition can be chosen.