For too long, the musculoskeletal health industry has blurred the lines between actual injuries, functional movement problems, and systemic conditions (like neurological or medical issues). Even healthcare professionals sometimes struggle to tell them apart. The problem? Mislabelling pain as an “injury” when there’s no real tissue damage can lead to wasted time, unnecessary rest, unnecessary procedures and delayed recovery of normal function.
What Counts as a bona fide Injury?
A true injury involves traumatic tissue damage—think a broken bone or a ripped ligament or muscle. These come with:
- Localised bruising (visible bleeding within the tissues)
- A predictable healing timeline (because cells need time to repair)
- Gradual, consistent improvement (pain decreasing day by day)
In these cases, some relative rest helps protect the area while healing happens and it’s essential to keep the surrounding tissues active and resilient. But here’s the kicker: nothing speeds up biological healing—not massage guns, not ultrasound, not electrical stimulation. Good nutrition, sleep, and avoiding re-injury? Yes. Gimmicky or age-old therapeutic gadgets? No. (And if anyone claims otherwise, I’d love to see quality research!)
What can slow healing?
- Poor nutrition
- Smoking
- Diabetes
- Anti-inflammatory use (yes, really!)
When It’s Not an Injury
Many painful conditions aren’t tissue damage—they’re mechanical issues, systemic problems, or even neurological conditions. Clues that your pain isn’t an injury requiring simple rest:
- No clear traumatic cause (e.g., “No damaging event”)
- No bruising local to the pain (swelling isn’t unique to injuries)
- Unpredictable symptoms (better one day, worse the next)
- Pain lingers unchanged or worsens with time (instead of fading)
- Worse pain after activity than during (later that day, at night or the next day)
- Pain coinciding with unexplained weight loss (Don’t delay seeing your doctor)
Sometimes, an injury can coincide with a mechanical issue e.g., if you sprain your ankle, the ligament may be injured while the joint movement also stiffened up. The key is tracking how your pain behaves over time because the ligament will heal, and the joint may remain persistently stiff and painful beyond the healing process.
Why Does This Matter?
If you treat a functional or systemic problem like an injury (resting endlessly, waiting for “healing”), you waste time while missing the real issue and potentially let it worsen.
The takeaway?
- True injuries improve predictably with time and may require modified exercises during healing or in severe cases, may need surgery.
- Non-injury pain needs different approaches depending on the cause: movement retraining / medical investigation / specialist care.
If your pain doesn’t fit the “injury” pattern, it’s worth digging deeper. As physios, our job isn’t to treat pain—it’s to figure out why it’s there in the first place and then advise or treat accordingly.
Your health and wellbeing deserve informed, personalised care. For tailored support, please discuss any questions or concerns with your physiotherapist of choice.
Image designed by Freepik.com