When to See a Doctor (Care of the Young Athlete)

A safe and speedy return to activity following a sports injury or an illness depends on early recognition and treatment. Knowing when to see your doctor is an important step in this process. With major injuries or illnesses, there is little doubt about the need to seek medical attention. However, it is much more difficult to know when to seek help if there is no obvious trauma or if the symptoms don't get in the way of playing. Many overuse injuries, such as tendonitis or stress fractures, happen over time and often have subtle symptoms. The result can be a delay in diagnosis and treatment, and delays can lead to a more serious or disabling injury.

General comments

Athletes should see a doctor for

Symptoms that do not go away after rest and home treatment
Any condition that affects training or performance that has not been given a diagnosis or has not been treated
Any condition that may be a risk to other teammates or competitors

Types of conditions

There are 3 types of conditions in which an athlete may need to see a doctor: acute injuries, overuse injuries, and medical illnesses or conditions.

Also, any athlete with a chronic injury or medical condition should see a doctor and be approved to participate in sports. Even if a pre-sport physical is not required, it is a good idea for all athletes to have an annual medical checkup before the sports season begins. This is especially true if there is any history of medical problems, injury, or regular use of medicines, or if there are questions about training.

The following are examples of these 3 conditions, their typical symptoms, and when to check with the doctor.

Acute injuries

Examples	Symptoms	When to Check With Your Doctor
Sprains, strains, fractures, dislocations, growth plate separation, torn cartilage, bruises, cuts, scrapes, pinched nerves, herniated disks	Pain (other symptoms that restrict sports activity and affect daily activity), swelling, bruising, deformity, spasm, restricted or locking joint, instability, numbness, tingling, shooting pains	Joint swelling, locking, or instability Visible deformity or mass in arms, legs, or joints Inability to fully move a joint, arm, or leg Inability to stand or walk Back or neck pain—especially if there is also numbness, weakness, or pain that runs down the arm or leg Pain that does not go away Pain that disrupts daily activity or sleep

Overuse Injuries

Examples	Symptoms	When to Check With Your Doctor
Tendonitis; shin splints; stress fractures; growth plate problems like Osgood-Schlatter, Sever's disease, or Little League elbow; bursitis; fasciitis; compartment syndrome; nerve entrapment; spondylolysis	Pain (or other symptoms that get worse with activity but go away with rest); tightness, popping, or grinding in joints; mild or localized swelling; weakness At first, symptoms are noticeable after vigorous activity. As the condition gets worse, symptoms occur with any activity and, eventually, the symptoms restrict activity.	Localized pain that gets worse over time or increases with continued activity Pain, swelling, stiffness, and/or weakness that gets in the way of training or sports activity Pain or other symptoms that do not go away even with treatments such as rest, ice, or use of pain medicines Pain that gets in the way with daily activity or disrupts sleep

Examples

Symptoms

When to Check With Your Doctor

Tendonitis; shin splints; stress fractures; growth plate problems like Osgood-Schlatter, Sever's disease, or Little League elbow; bursitis; fasciitis; compartment syndrome; nerve entrapment; spondylolysis

Pain (or other symptoms that get worse with activity but go away with rest); tightness, popping, or grinding in joints; mild or localized swelling; weakness

At first, symptoms are noticeable after vigorous activity. As the condition gets worse, symptoms occur with any activity and, eventually, the symptoms restrict activity.

Localized pain that gets worse over time or increases with continued activity
Pain, swelling, stiffness, and/or weakness that gets in the way of training or sports activity
Pain or other symptoms that do not go away even with treatments such as rest, ice, or use of pain medicines
Pain that gets in the way with daily activity or disrupts sleep

Medical illness/conditions

Examples	Symptoms	When to Check With Your Doctor
Concussion	Headache, disorientation, loss of consciousness, blurry vision, nausea, memory loss, dizziness, lethargy, agitation, vomiting, fatigue, moodiness It is possible to have a concussion without loss of consciousness.	Check with a doctor before return to play with any concussion or if any of these symptoms develop after a head injury.
Fever	Other symptoms depend on cause of fever.	Any fever ≥101°F for >4 hours. Playing with a fever may increase the risk of heat illness.
Skin infection (impetigo, herpes, ringworm, measles)	Rashes that are raised, open, draining or with a discharge; have small blisters; or are cracked and bleeding	These types of rashes should be checked and treated before returning to sports, particularly for athletes in contact or collision sports.
Abdominal (stomach) pain	Pain, nausea, vomiting, diarrhea, constipation, appetite loss, decreased fluid intake	If symptoms persist, they should be checked. Liver and spleen can be enlarged with mono or other flu-like illnesses. This is most important for athletes in contact or collision sports. These symptoms increase the risk of dehydration, which can negatively affect performance and increase the risk of heat-related illness.
Cardiac (heart) disease (myocarditis, pericarditis, endocarditis, cardiac contusion, dysrhythmia)	Chest pain, shortness of breath, palpitations, feeling light-headed or passing out with exercise	See a doctor if any of these symptoms develop.
Respiratory (breathing) disease (asthma, bronchitis, pneumonia), laryngeal contusion/fracture, pneumothorax (collapsed lung), choking	Shortness of breath, cough, wheezing, chest pain, stridor (noisy breathing), absent breath sounds	See a doctor if any of these symptoms develop.
Heat injury (heat exhaustion, heat stroke)	Exhaustion, muscle cramps, nausea, vomiting, headache; consider heat stroke if body temperature increases	For heat exhaustion—check with a doctor before returning to play. For heat stroke—call 911.