Commentary

How to determine when to see a doctor

By Dev Mishra, M.D.

One of the most common questions I'm asked by friends or by parents of players at events is "do we need to go see a doctor?"

This isn’t always easy to answer, as some simple injuries don’t need to be seen by a professional, and in other instances waiting too long to see a doctor can result in making a simple injury a potentially permanent problem. So let’s look at a few scenarios.

First: See A Physician If You Have Something You’re Just Not Sure About

I’ll start off with a very broad statement: go see a physician if you’re just not sure about something. This could be anything from a headache that doesn’t go away, a lingering cough, or even vague nagging joint pain. Many things are treatable, and it all starts with a diagnosis from a skilled clinician.

Second: Some On-Field Injuries Will Need Immediate Evaluation

Sideline Sports Doc, in teaching coaches how to perform basic on-field evaluation of injuries, uses what we call The SAFE Method. It involves an assessment of the Story, Appearance, Feel, and Effort.

In each of these categories are some red flags that would signal the need for immediate attention.

For example, in "Story", if there are complaints of significant pain, you’d be wise to see a physician immediately.

Under the "Appearance" category you’d look for things such as immediate bruising or swelling. If either of those happens in the first minute or two, you’ll likely need to go to the local emergency room.

With "Feel" we are asking you to press lightly on the injured area, and if this produces considerable pain with light touch -- that warrants immediate evaluation.

And finally with "Effort" you’ll check for the ability of the injured athlete to move the injured area on their own. If this effort is painful or if they are unable to move the area at all, then get to a physician urgently.

Third: Ongoing Pain, Discomfort, or Poor Sport Performance Could Benefit From Proper Evaluation And Treatment

This is sometimes a tricky decision. The young athlete often hides ongoing or nagging injuries from their parents or coaches out of fear that something will be discovered that keeps them out of play for an extended time. And they might be right. But more often than not, proper diagnosis will allow some treatment that can actually shorten the recovery time and at the same time allow for continued modified activity.

After physician evaluation there might be treatments such as short-term medication, bracing, physical therapy, or working with an athletic trainer that can really help. My advice is that if you have discomfort or pain that causes you to come out of a practice or game then you should see a sports physician. And similarly if you are noticing decreases in performance that’s not corrected by proper form or training, it could mean there’s an underlying physical problem. Good evaluation, proper treatment, and perhaps a short time off can make a huge difference in the long run.

Key Points:
• Very broadly speaking, see a physician if you have a nagging physical ailment that you’re just not sure about.
• For acute injuries on the field of play there are some “red flag” situations that often need immediate evaluation.
• And finally, for ongoing problems you’ll need to be on the lookout for decreases in sport performance or chronic painful movements. These may indicate an underlying physical problem. Proper evaluation and treatment can often shorten the recovery time and improve performance while still allowing modified play during healing.

(Dr. Dev K. Mishra is the creator of the SidelineSportsDoc.com injury management program for coaches. He is a Clinical Assistant Professor of orthopedic surgery at Stanford University. Mishra writes about injury management at SidelineSportsDoc.com Blog, where this article first appeared.)

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