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Describing an Injury to your Physiotherapist


For those of you who haven’t seen a physiotherapist before or often and would like to know what to say when describing your injury, here is a breakdown (complied from an excellent questionnaire by Viljoen et al., 2021) to help you describe what you are experiencing.


  • Concussion symptoms include disorientation, dizziness, loss of memory, nausea or vomiting due to a blow to the head.   

  • A fracture is a traumatic broken bone caused by sudden impact. Symptoms include severe pain, swelling, deformed appearance of the limb, skin bruising or bleeding. Possibly a snapping sound heard when bones break.

  • A stress fracture is as a result of overuse and is a fracture in a weight bearing bone caused by repetitive stress (e.g. running). A stress fracture in one of the small bones in the foot will typically cause severe pain at the beginning of a run, moderate pain during the run and severe pain at the end and after the run.

  • Other bone injuries include dislocation, subluxation which is the total or partial displacement or misalignment of bones in a joint, most often caused by a sudden impact to the joint. Pain and swelling around the affected joint: a sensation of joint instability, limited mobility, or a loss of range of motion, temporary numbness (usually), and bruising.

  • Tendon rupture is the tearing of a tendon that occurs when the forces placed upon the tendon exceed its tensile strength. Snap or Pop Sensation: When a tendon ruptures, you might hear or feel a sudden snap or pop. This is often one of the initial signs. The symptoms are severe pain, bruising, weakness, inability to move, swelling or deformity.

  • Tendinosis / tendinopathy is all non-inflammatory and inflammatory conditions affecting a tendon, "tendinitis". You may experience localised burning pain and swelling, worsening pain during and after activity, stiffness in the joint, restricted joint movement.

  • Ligamentous rupture is the tearing of the bands of fibrous tissue connecting bones or cartilages, serving to support and strengthen joints. Some of the signs include pain and tenderness to the touch in the affected area, swelling and bruising around the joint, difficulty moving the joint due to pain and instability, trouble putting weight on the affected joint, symptoms may worsen over time if untreated.

  • A sprain is a wrenching or twisting of a joint, with partial rupture of its ligaments, accompanied by severe pain, impaired function, swelling, heat and discolouration of the skin.  

  • Meniscus or cartilage injury refers to injuries of meniscus (knee) or joint surfaces results in swelling or stiffness, pain (especially when twisting or rotating your knee). difficulty straightening your knee fully, feeling as though your knee is locked in place when you try to move it and / or feeling of your knee giving way

  • Muscle strain occurs when a muscle or tendon is overstretched. It can range from mild to severe and involves tearing of muscle fibres. These injuries can happen within the muscle belly itself or within the tendons that connect the muscle to bone.

  • Muscle rupture or tear refers to the damage or tearing of muscle fibres. Muscles are bundles of fibres that work harmoniously to facilitate movement. When these fibres are subjected to excessive force or stretched beyond their capacity, they can sustain microscopic or macroscopic tears.

  • Contusion / haematoma / bruise is a localised collection of blood in the tissues of the body outside of the blood vessels. Also called a contusion or “black and blue mark,” a bruise is a discoloration of the skin that is a result of leakage of blood from capillaries into the skin.

  • Arthritis / synovitis / bursitis is inflammation of any part of a joint or structures near the joint, characterise by pain on movement, tenderness, heat and swelling.  

  • Fasciitis / aponeurosis injury is inflammation or injury of a sheet like tendinous expansion, e.g. plantar fasciitis. Plantar fasciitis is a common cause of heel pain - pain and stiffness in the morning that worsens as the day progresses and aggravated with activity.

  • Impingement is compression of a nerve, blood vessel, tendon, ligament or muscle through a constricted space, e.g. a sudden pain in the shoulder such as when in the shoulder when lifting the arm overhead or backward, constant arm pain, radiating pain, pain tends to worsen at night, shoulder, or arm weakness.

  • The signs of nerve injury or damage, e.g., pinched nerve, include tingling, pins-and-needles sensation, numbness, sensitivity to touch, weakness. Symptoms may also include; muscles get smaller, colour change in the skin, and changes to the amount of sweat in certain areas.  

  • Spinal cord injury can include damage to nerves at the end of the spinal cord, known as the cauda equina. The spinal cord sends and receives signals between the brain and the rest of the body. A spinal cord injury often causes permanent changes in strength, feeling and other body functions below the site of the injury.

  •   Muscle cramps or spasm are both involuntary contractions of muscles. Muscle feels very tight, like a knot in the muscle – muscle contracts without control. Pain can be severe and intense. Muscle does not relax, remaining tense and uncomfortable. (Viljoen et al., 2021) - See the note at the end of this blog


Be sure to tell your physiotherapist the location on your body where your injury is and if your symptoms extend beyond the original location. Describe the level of pain you are experiencing, i.e., mild to severe.


Describe how has this injury has impacted your training, work and participation in general life activities and give the physiotherapist a rating of this, i.e., minor extent to not able to participate at all. This is so the physiotherapist can fully understand what this injury means to you.


Go into detail about how your injury affects your sports performance and general movements, such as standing up from a chair or prolonged sitting ability. It can add how you have modified your movements and activities to cope with the injury and how you have treated your injury yourself. Is your injury improving or worsening.


It helps to think back and remember when you first noticed the injury. Did your injury have a gradual of sudden onset? Was your injury due to a specific action - fall, jump, landing, increased pace, overstretch, collision, etc.?


Describe how your injury makes you feel psychologically: are you cautious to train or move, does your injury make you feel down, are you anxious about recovery and the time it may take to recover, are you worried whether your injury would become worse, if it will make a successful recovery or not recover at all?


It is important for your physiotherapist to know your current level of sport’s performance, how long you have trained for and future ambition in this sport. The same applies to general life plans like an upcoming road trip across Africa or an international holiday.


Do you have another injury to record? Be sure to tell your physiotherapist all your injuries. They may find a pattern. The same goes for your general health and the medication you take. Some chronic medications can cause pain, e.g., medication for thyroid conditions has a side effect of shoulder pain.


Sometimes we don’t know how an injury happened and even the pain can be vague, widespread, shifting and changing. The injury can worsen but we don’t know why, and it can ease off also without us realising why. These are all perfectly normal experiences of an injury, and your physiotherapist is trained to interpret what your body is saying and knows what each of these factors mean. On the rare occasion, injury symptoms don’t fit what medical circles call the ‘box’, i.e., there isn’t a recognisable presentation or pattern to the symptoms you give. When this happens, medical science has specialists who have access to special investigations, e.g., MRI’s, Your physiotherapist is part of the medical network and will liaise with your doctor about the best way forward or can refer you to these specialists.


Never feel like you are giving your physiotherapist too much information. They need to get a comprehensive picture of what happened, how it happened, what injuries you have had in the past, how the physical pain feels, how it is affecting the way you move and go about your daily activities as well as how it makes you feel emotionally.

 

To book an appointment, please phone Michelle on 031 765 8898 or book online via the website.

 

Note: Professor C Viljoen is the head of the Department of Physiotherapy at the University of Pretoria and Professor C Janse van Rensburg is the head of the Section Sports Medicine at the University of Pretoria.

 

Reference:

VILJOEN, C. T., JANSE VAN RENSBURG, D. C., JANSEN VAN RENSBURG, A., BOOYSEN, E., CHAUKE, S., COETZEE, P., HURLIMANN, A., JOOSTE, M., NIBE, Y., SCHULENBURG, C., KORKIE, E., RAMAGOLE, D., GRANT, C. & CRONJE, T. 2021. One in four trail running race entrants sustained an injury in the 12 months training preceding the 2019 SkyRun race. Physical Therapy in Sport, 47, 120-126.

 

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