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 ¹.

Acute sports injuries typically result from a sudden, specific traumatic event, such as a fall or direct impact ¹. The onset of symptoms is usually immediate, presenting with sudden pain, swelling, and often bruising at the injury site ¹. Common examples include sprains and strains ¹. During examination, there will likely be immediate tenderness, swelling, and possibly a visible deformity or bruising ¹.

In contrast, chronic sports injuries, often referred to as overuse stress damage, develop gradually over time due to repetitive stress or microtrauma to tissues ¹. The onset of symptoms is insidious, with pain often worsening progressively with activity and improving with rest ¹. 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 ¹. Clinical examination might reveal localized tenderness, but significant swelling or bruising is less common than in acute injuries ¹. Pain may be reproduced with specific movements or activities that involve the affected structure, consistent with repetitive strain ¹.