How can I differentiate between acute and chronic sports injuries during a clinical examination?

Differentiating between acute and chronic sports injuries during a clinical examination primarily relies on the patient's history, particularly the onset and mechanism of injury, alongside specific physical findings NICE CKS.

Acute sports injuries typically result from a sudden, specific traumatic event, such as a fall or direct impact NICE CKS. The onset of symptoms is usually immediate, presenting with sudden pain, swelling, and often bruising at the injury site NICE CKS. Common examples include sprains and strains NICE CKS. During examination, there will likely be immediate tenderness, swelling, and possibly a visible deformity or bruising NICE CKS.

In contrast, chronic sports injuries, often referred to as overuse stress damage, develop gradually over time due to repetitive stress or microtrauma to tissues NICE CKS. The onset of symptoms is insidious, with pain often worsening progressively with activity and improving with rest NICE CKS. Wörtler and Schäffeler (2015) highlight chronic overuse stress damage, particularly in areas like the forefoot and midfoot, as distinct from acute injuries. Patients may report a history of increasing discomfort over weeks or months, without a single identifiable traumatic event NICE CKS. Clinical examination might reveal localized tenderness, but significant swelling or bruising is less common than in acute injuries NICE CKS. Pain may be reproduced with specific movements or activities that involve the affected structure, consistent with repetitive strain NICE CKS.