When Injury Strikes — What to Do Next

For some minor injuries, temporarily modifying activity, using suitable support and allowing symptoms to settle may provide sufficient relief. Others may benefit from short-term medication, depending on the nature of the injury and their individual circumstances.

Common options include:

• Acetaminophen (paracetamol): Used to relieve mild to moderate pain without directly targeting inflammation.
• Non-steroidal anti-inflammatory drugs (NSAIDs): Medications such as ibuprofen and naproxen can reduce pain and inflammation. Some NSAIDs, including diclofenac, are also available in topical formulations.
• Topical pain relief: Certain creams, gels and patches may provide localised symptom relief, depending on their active ingredients.

However, medication isn’t appropriate for everyone. NSAIDs may be unsuitable for people with certain kidney, gastrointestinal or cardiovascular conditions, or those taking medications such as anticoagulants. They should generally be avoided from 20 weeks of pregnancy unless specifically advised by a healthcare professional. Topical NSAIDs also carry precautions and should not automatically be combined with oral NSAIDs.

There is ongoing debate about whether suppressing inflammation immediately after certain soft-tissue injuries could affect aspects of healing. The clinical evidence varies by injury and medication, so blanket recommendations to either use or avoid anti-inflammatories are not justified.

Acetaminophen also carries risks, particularly to the liver when recommended doses are exceeded or multiple products containing the same ingredient are taken together. Always follow product instructions and consult a pharmacist or healthcare professional when unsure. Pain medication should help manage symptoms, not provide an excuse to continue activities that may aggravate an injury.

We covered the major emergency warning signs earlier, but injuries that are persistent, recurrent or failing to improve may also benefit from professional assessment. A physician, physical therapist (physiotherapist) or suitably qualified sports medicine professional can evaluate symptoms, examine the affected area and help determine an appropriate management plan.

An assessment may involve:

• Discussing how and when the injury occurred.
• Reviewing symptoms, medical history and previous injuries.
• Assessing movement, strength, joint stability and functional limitations.
• Performing relevant clinical tests.
• Determining whether imaging, further investigation or specialist referral is necessary.

An accurate diagnosis can help distinguish injuries requiring protection or specific treatment from those that may respond well to progressive rehabilitation.

Not necessarily. Although medical imaging can provide valuable information, many uncomplicated musculoskeletal injuries can be assessed and managed without immediate imaging. The appropriate investigation depends on the suspected injury, clinical examination and whether the findings are likely to influence treatment.

Different investigations serve different purposes:

• X-rays: Commonly used to assess suspected fractures and certain joint abnormalities.
• Ultrasound: Can help evaluate selected muscles, tendons, ligaments and other superficial soft tissues.
• MRI: Provides detailed images of muscles, tendons, ligaments, cartilage, bone marrow and other structures.
• CT scans: May be useful for evaluating complex fractures and certain injuries requiring detailed assessment of bone.

Importantly, an abnormal scan doesn’t always explain the pain we’re experiencing. Some imaging findings, including tendon changes and age-related joint abnormalities, also occur in people without symptoms. Equally, a normal-looking scan doesn’t automatically mean that someone’s pain or functional limitations are insignificant.

Imaging findings should therefore be interpreted alongside the clinical assessment rather than in isolation. The most useful scan is the one that answers a relevant clinical question, not necessarily the most sophisticated investigation available.

Depending on the nature and severity of the injury, different professionals may contribute to assessment and recovery:

• Primary care physicians: Assess symptoms, manage medical concerns and arrange investigations or referrals.
• Sports medicine physicians: Specialise in exercise-related injuries and conditions affecting physical performance.
• Physical therapists (physiotherapists): Assess movement and function, guide rehabilitation and help restore physical capacity.
• Orthopaedic specialists: Manage injuries involving bones, joints and associated structures, including those requiring surgical treatment.

Not every injury needs specialist intervention. Many improve with appropriate conservative management, particularly when the underlying problem is identified and training demands are adjusted.

When we’re desperate to return to training, it’s tempting to search for treatments promising dramatically faster healing. Unfortunately, there are few shortcuts to the biological processes involved in tissue repair and adaptation.

Massage, therapeutic devices, injections and other interventions may have a role in selected circumstances, but their benefits depend on the condition being treated and the quality of supporting evidence. Be cautious of treatments promising guaranteed results, instant tissue regeneration or recovery times that seem too good to be true.

The most effective approach is often less glamorous: an appropriate diagnosis, sensible symptom management, progressive rehabilitation and sufficient time for recovery.

Treat the underlying problem, not simply the pain it produces.