Hurt or Injured?

"It’s not broken, just fractured.” I’ve heard that one many times, usually as a signal that the person believes that the injury isn’t as bad as it could be.

OK…I’m going to start with that one. Broken, fractured, they mean the same thing. It’s not like horseshoes or hand grenades—a bone is either broken or it is not. A stress fracture is still a break in the bone. Maybe it only goes through part of the bone but it is still broken. That one is easy.

“Is it hurt or injured?” That one is much more difficult to define. I have heard coaches for years tell their players that they need to decide if something is “hurt” or “injured.” The clear implication is that if something is simply “hurt,” that they can play through it. There is some truth in that. There are a lot of hurts in sports participation.

“Hurt” may be exercise soreness from overdoing it. Overtraining, going too far or too fast, lifting too much or too often, all those can result in pain.

Usually those will go away with a little time and refraining from doing whatever it is that got you there. Most people seem to know what they did and when they did it if it has created pain.

Sore feet from running a lot further than usual. Sore shoulder from throwing too many times. Sore knees from running all those steps.

“Injured” implies damage to tissues.  While usually associated with a specific injury, it doesn’t have to be. In other words, you may not know what you did but damage is done.

It’s easy when you turn your ankle and it hurts on the outside of your ankle. You probably know what you did. And maybe you know pretty much what to do (Rest, Ice, Compression, Elevation) but you might need help in deciding when that ankle is ready to go. That’s where you might need help. More on that in a minute.

Same with knees. If you injure your knee, you usually know when and how. Remember those bits of information—they will become important in deciding how bad it is and what is damaged.

Knees that always hurt and the pain lasts for several days? Something is wrong and you need to get checked. Weightbearing hurts your knee? Get it checked. Something is wrong.

Shoulders can be really complicated. If you pitch a full game (or have a high pitch count), you can expect your shoulder to be sore. Is it injured? Probably not. But you need to take care of it. That means ice on that shoulder within minutes of your last pitch. You can’t wait until you get home and finally find the ice bag. You need to have ice in the dugout and something to hold it on. And you definitely don’t need to cover up the pain with ibuprofen.

If it hurts the next day, something may be wrong. Any pain that just won’t go away needs to be checked.

A lot of people have chronic shoulder pain (LOTS of people). Our world today puts lots of stress on our shoulders. Much of what we do is in front of us. Sitting at a computer is a huge culprit in the development of chronic shoulder problems. I spend a lot of my professional time dealing with those.

But athletes with chronic shoulder pain need to have it checked out. It doesn’t mean that they can’t continue to play their sport. It may just mean that they need to prepare for the sport differently, to do things differently.

That’s where the Athletic Trainer comes in. Athletic Trainers are trained in all this. Athletic Trainers can help decide if it is “hurt” or “injured.” And here’s the good news:  All our schools have Athletic Trainers. All of them.

My final advice—use those Athletic Trainers. They are not there to keep you out of the game but to keep you IN the game.