Stop, carry on, wait or book an appointment?
Anyone who plays sport knows that moment. A sharp twinge in the knee as you turn on the padel court, an Achilles tendon that complains when you start running, a shoulder that bothers you every time you serve. Most of the time it is nothing serious. But sometimes it is, and telling the difference in time changes the outcome a great deal.
Not all pain is an injury
Exercise places demands on the tissues, and part of the discomfort is simply adaptation. Muscle soreness appears 24 to 72 hours after a new or intense effort, spreads across the muscles you worked and disappears within a few days. It is normal.
What is no longer normal is pain in one specific spot, that always appears with the same movement, that makes you change the way you move or that gets worse from one session to the next. That is your body warning you that the load has exceeded what the tissue can tolerate.
Pain is not the enemy: it is information. What matters is learning to read it.
A traffic light to help you decide
Carry on, sensibly
Mild discomfort that goes away
Muscle soreness, or discomfort that stays below 3 out of 10, does not change how you move and has gone by the next morning. Adjust the load and keep an eye on it.
Book if it does not improve
Pain that keeps coming back or settles in
It lasts more than one or two weeks despite reducing the load, gets worse session after session, appears at rest or at night, or you feel the joint “give way” or lock.
See someone soon or go to A&E
Signs that cannot wait
Deformity, being unable to bear weight, immediate swelling after a pop, a sudden loss of strength, tingling or a cold or pale foot or hand, or a hot, red joint with fever.
A pop that feels like being “hit by a stone” in the calf, or a knee that swells within a few hours after a twist, needs assessment within days, not weeks. And after a serious injury, go to the emergency department: a scheduled appointment is not the right place.
What to do in the first few days
After a mild or moderate injury, current advice is no longer complete rest:
- Protect the area for one to three days, avoiding whatever clearly makes the pain worse.
- Raise the limb and use compression if there is swelling.
- Start moving again gradually as soon as the pain allows. In many injuries, progressive, well-dosed loading helps recovery, as long as the type of injury allows it.
- Do not self-medicate as a matter of routine. Ask before taking anti-inflammatories for several days.
If you see no clear improvement within one or two weeks, it is time to get it checked.
What happens in the consultation
A good orthopaedic assessment starts by listening: how the injury happened, what you felt, what you can and cannot do, and what you need to get back to. Then comes the examination, which in many injuries gives more information than any test.
Imaging is requested when it can change a decision. For example, after an ankle sprain, a few simple clinical criteria (whether you can take four steps, where it hurts when the bone is pressed) show whether an X-ray is needed and avoid many unnecessary ones.
The MRI is not the diagnosis
This is worth pausing on, because it is one of the most common sources of confusion.
Many findings do not hurt
From a certain age, MRI scans often show meniscus tears, wear or rotator cuff lesions in people who have no symptoms at all.
The image is read alongside the examination
What decides the treatment is how the image, the examination findings and what the person feels and needs fit together.
Many injuries are not operated on
A large share of sports and degenerative injuries resolve with conservative treatment and well-planned rehabilitation.
Surgery when it adds value
When it is indicated, the decision is explained with its benefits, risks and timescales, and linked to recovery from the very start.
Biological treatments, injections or any procedure are considered only after an individual examination, and they never replace well-prescribed rehabilitation.
Returning without relapsing
One of the most common mistakes is going back as soon as it stops hurting. Pain usually disappears before the tissue has regained its full capacity, which is why so many injuries come back.
The return to sport should be guided by criteria, not by the calendar:
-
01
No pain or swelling
In daily life and under increasing loads.
-
02
Full range of movement
Compared with the healthy side.
-
03
Strength restored
Measured, not estimated, and close to the healthy side.
-
04
Sport-specific movements
Jumps, changes of direction or strokes, with gradually increasing intensity.
-
05
Confidence
Feeling ready matters too. Fear of getting injured again is a real risk factor.
That is why at ETRYUM orthopaedics and physiotherapy work with the same goals, the same load limits and the same progression criteria, so you never receive contradictory messages.
An example to make it clearer
Illustrative case
Carlos, 42
He plays padel three times a week. During a turn he feels a pop in his knee and, within a few hours, it has swollen. A week later he walks almost normally, but when he turns he feels the knee “give way”.
It is not an emergency, but it is a case that deserves a prompt consultation. The examination points towards an anterior cruciate ligament injury, and here an MRI is indicated: it can change the decision.
Depending on his age, how demanding his sport is and how stable the knee is, the options range from structured rehabilitation to surgical reconstruction. Both are explained, with their timescales and their limits. And, whichever is chosen, his return to the court will be decided by criteria of strength, stability and confidence, not by how many weeks have passed.
The aim is not just to repair the knee, but for Carlos to play again without fear and without getting injured again.
To finish
Most sports pains are not serious and improve when the load is adjusted. But some need timely assessment, and knowing how to recognise them makes all the difference.
Listening to the pain. Recognising the warning signs. Diagnosing with judgement. Choosing the treatment that adds value. And going back when you are ready.
A good diagnosis does not just tell you what you have: it tells you how to get back.
This article is for general information and does not replace an individual medical assessment.
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