From strains to breaks, when to see an orthopaedic specialist

Injuries can happen, especially for athletes and anyone engaged in a sport or game.

Whether it’s an ankle tweak on a pickleball court or what feels like shin splints after a few long runs, knowing what you are dealing with is the first step to successfully treating an injury. How do you know if it’s broken or sprained — and if it’s time to see a physician?

Endeavor Health sports medicine specialist Daniel Kelley, MD, offers guidance to weekend warriors and serious athletes alike. First, be on the lookout for these symptoms:

• Pain. “When you experience very severe pain with an injury and the pain lingers more than an hour without any improvement it should be checked out,” suggested Dr. Kelley. 

• Unable to bear weight. Similarly, when you are unable to put weight on a joint like a newly injured ankle or knee, or you’re walking with a significant limp, that also signals a potentially serious injury that should be seen by a physician.

• Pop or crack. “If you feel a pop or hear a loud crack that’s accompanied by pain that’s another sign you need to come in and be checked out,” said Dr. Kelley. A pop that’s related to muscle or ligament damage suggests a higher grade injury, he added. 

• Swelling. Significant swelling or bruising (not the run-of-the-mill contusion from a fall or impact) can also suggest a ligament or muscle tear or a fracture. Knee injuries and knee pain are frequent complaints of many athletes, especially aging individuals dealing with arthritis flairs. “Any swelling at and around the top part of the kneecap could indicate swelling in the joint, which should be evaluated,” he said.

While many injuries will not require surgical repair, it’s best to know the extent of the injury and make sure the limb function is still intact with a physician who can help develop a plan for physical therapy or other appropriate treatment.

“Although some fractures, like a lateral malleolus avulsion fracture at the ankle are not treated operatively, many people chalk it up to a bad sprain and if they don’t let it heal properly it can lead to chronic pain or instability in the ankle,” said Dr. Kelley.

It’s common for patients to come in for treatment after dealing with weeks or months of pain and, in some cases, playing through pain has significantly worsened their condition, he said. Athletes at all levels often don’t want to take time off from their sports or training for competitions, but can end up with a bigger setback by waiting too long to be seen.

“For many overuse injuries like bone stress injuries, rest is the best initial treatment. And when those injuries are ignored, the worst-case scenario is they can progress to a true fracture,” explained Dr. Kelley.

For less severe injuries that don’t need immediate attention from a physician, RICE (rest, ice, compression, elevation) is generally a good plan, but Dr. Kelley cautions against stopping all movement. 

“If you can bear weight comfortably for lower extremity injuries, go ahead and walk and maintain some activity. If you don’t work it and decide to sit on the couch for a week or a month, you put yourself at risk of a blood clot and you are slowing the rehabilitative and recovery process,” explained Dr. Kelley.