A Common Sports Medicine Question: “If I try and play through the pain, will it make the injury worse?”

June 10, 2019

By: Dr. Drew Burleson
Published: 6/10/2019 2:19 PM

As sports medicine specialists, we are often asked, “Can I play with this injury?” It is part of our job to determine which injuries our athletes can play through, and which ones require shutting down competitive play and practice and focusing on complete rehabilitation. For professional athletes these decisions are extremely important and can have devastating consequences on the outcomes of seasons and ultimately, the athletes’ career.

Kevin Durant sustained, what was reported to be a Grade 1 right calf strain roughly 4.5 weeks ago in the Western Conference Finals against the Houston Rockets. Early hopes were that he would be able to return to the court in 2-3 weeks, but as the Warriors have fallen behind 3 games to 1, Kevin Durant has been unable to return to game action. Muscle strains are extremely ambiguous injuries and can vary from person to person as well as situationally.

A muscle strain is a partial tear to muscular belly portion of a muscle, not to be confused with a tendon injury which is the muscles attachment to the bone. Muscle strains are graded from 1-3 with a Grade 1 strains being a mild injury to the muscle, involving less than 10% of the muscle. Grade 2 strains involving up to 50% of the muscle, and a Grade 3 being a complete rupture of the muscle. With a Grade 1 strain players can typically return to game competition at 2-3 weeks, 6-12 weeks for a Grade 2, and Grade 3 strains/ruptures may potentially require surgery.

The question that all sports medicine patients want to know about their injury, and is extremely poignant in the case of Kevin Durant with his impending free agency is, “If I try and play through the pain, will it make the injury worse?” In the case of a muscle strain, this is definitely true, and this is why if Kevin Durant is currently not 100%, he will likely not return for this series. Regardless of what the current standing of the series, or the impact another championship would have on Kevin Durant’s legacy, his right calf does not care, and playing on his injured calf could risk further damage, and potentially impact his future career.

Kevin Durant’s injury can be contrasted with the rib fracture sustained by teammate Kevon Looney. Looney has a non-displaced fracture (broken bone that has not moved) of the first costal cartilage (upper rib cartilage). With these types of injuries, as well some other types of bone injuries, it is unlikely to cause any further damage if you continue to play on it, and is more of a question of pain control. These injuries can be numbed up with local anesthetics which allows playing to be tolerable. Numbing up a muscle is not possible without affecting the function of the muscle. Numbing of the muscle would also make it impossible to know if further damage is being done.

Knowing which injuries you can play with and which ones you can’t is imperative for the success of the athlete and the success of the team. As sports medicine specialists in Cincinnati and Dayton, we can help guide you through the process and be an advocate for an athlete to do what is in their best interest long term. Sometimes we even need to advocate for the athlete against themselves. Athletes are competitive and want to be on the court, field and ice no matter what, but need our help to deter further and sometimes even far worse injury.