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An Acute Trauma Doesn't Necessarily "Just Need Time"

8/15/2020

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Just because something happened recently does not necessarily mean it needs to “settle down” or “take some time” to get better. We can do better than making assumptions that the time frame alone of an injury tells us the diagnosis and, therefore, the prognosis. Time frame is just one factor. Why assume the remedy is time when you can investigate to see if there is a more appropriate (and faster) solution?

In general terms, when I diagnose problems, there are three main categories: joint problems, tissue problems (capsules, tendons, and muscles), and other problems. Within the “other problems,” which encompasses many distinct issues, each a small overall percentage, is “acute trauma.”

For me to arrive at the diagnosis of "acute trauma,' I have to rule out other diagnoses. I don’t assume that since you hurt your hip playing soccer four days ago, that your pain and limitation is automatically a result of its acuteness. Most significantly, I need to rule out that you have a joint disturbance - especially given joint disturbances are the rapidly resolvable problems. There’s a good chance that your hip joint could respond favorably to directional preference exercise. In that case, you don’t need to just wait for time to run its course - you can fix it quickly, sometimes within a day or two. If a structural compromise (like a fracture or major tear) is suspected, that may also be further investigated at the appropriate time to rule in/out.

If I do actually diagnose a problem as “acute trauma,” which, importantly, means it’s not something else (or something else yet), then treatment is geared more toward non-provocative mid-range movements and general movements (like walking) that similarly do not exacerbate symptoms. Anti-inflammatory intervention may provide some help, but not always. The plan in this case is to give it a few more days (because acute trauma by definition does get better with time) and then reassess to try to determine a more specific diagnosis. -- Laura
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