By Dev K. Mishra, M.D.
“What’s the difference between discomfort and pain? And is it OK for me to keep playing if I just have a little bit?” Those are two ofthe most common questions I’m asked by injured young athletes, and I’m guessing the same is true for our sports medicine colleagues across the country. The answers are different from person toperson, and specific to the type of injury too.
Pro athletes know that there’s risk involved in their sport — their profession. Medication is sometimes used to get an adult, proplayer through a game. I have a very hard time using that approach in a young athlete who has a long lifetime of activity ahead.
There are many factors that go into a decision whether weallow a young athlete to play through some discomfort, whether we recommend that they take time off, or whether we prohibit them from playing. Key amongst the factors is the exact diagnosis of theproblem, and some other factors we consider are the athlete’s age, sport, position, time during the season, and importance of the event or competition.
Knowing the exactdiagnosis is important
We have to start the decision process with the diagnosis. It’s not enough to just say “knee pain,” we need to be specific. One of theproblems I have with certain health practitioners is that decisions about treatment and play are made without a specific diagnosis. See a qualified medical practitioner to get a diagnosis, and thenusing a combination of the other factors a skilled sports medicine specialist will advise in making a decision that allows for safe sports participation.
Understanding again thatindividual decisions need to be made between the player, parents, and physician, there are still a few general comments I can make. Many types of tendonitis can be managed with braces during play andice/stretch/massage after a playing session. Most fractures and stress fractures will require holding the young athlete from play until healing is complete. All hamstring injuries get rehab untilhealed. Ligament injuries to the knee will generally not allow return to play until fully healed, but some ligament injuries around the ankle can allow play with a brace.
Everyonehas a different response to pain
One person’s mild “ache” is another person’s “severe pain.” I usually recommend against playing if the youngathlete tells me he or she needs medication like Advil or Motrin in order to play. To me that’s a sign that we need to get that injury properly healed. For many other injuries it is sometimessafe to continue playing, although performance might suffer.
Sometimes it is safe for the young athlete to play through some discomfort, but start with the exact diagnosis and getguidance from a sports medicine specialist for the proper decision.
(Dev K. Mishra is the creator of the
While this article makes good sense, I’m hesitent to send it to my team families.While caution is noted, it may not be clear or stong enough: The overall ‘grey area’ message may be mistaken as a false ‘OK’ to play, particularly if the injured player can not accurately tell the extent of injury. This may also be particularly dangerous for players who love to play so much that they don’t take injuries seriously enough or can’t control their compulsive urge to play despite pain.