Pain, injury and availability
The vocabulary to describe a problem accurately, and who decides what.
Pain is information, not a verdict
Pain does not map neatly onto tissue damage. You can have significant pain with healthy tissue, and structural change with no pain at all. This is why a physio asks about behaviour over 24 hours, irritability, and what makes it better or worse, rather than just where it hurts.
How to describe it
| Question | Why the clinician asks |
|---|---|
| Where exactly, and can you point with one finger | Localised pain narrows the structures involved |
| Onset: sudden or gradual | Sudden suggests a discrete mechanical event, gradual suggests a load tolerance problem |
| What brings it on, how long to settle | This is irritability, and it drives how much you can do |
| Morning stiffness | A tendon that is stiff on waking and warms up behaves differently to joint pain |
| Night pain, pins and needles, weakness | These change the priority of an assessment |
Terms you will hear, used correctly
| Term | What it means |
|---|---|
| Tendinopathy | A painful tendon with reduced load tolerance. Not simply inflammation, which is why the older word tendinitis has largely been dropped. |
| Lateral epicondylalgia | Pain at the outside of the elbow, usually the common extensor tendon. Commonly called tennis elbow, and more common in club players than professionals. |
| Medial epicondylalgia | Pain at the inside of the elbow, usually the common flexor origin. Associated with serve and forehand loads in tennis. |
| Rotator cuff related shoulder pain | An umbrella term for shoulder pain involving the cuff and surrounding structures. Preferred to impingement, which describes a mechanism rather than a diagnosis. |
| GIRD | Glenohumeral internal rotation deficit. Reduced internal rotation on the dominant shoulder, common in overhead athletes and worth monitoring. |
| Lumbar extension load | The repeated arching of the lower back in the serve. Relevant to bone stress in adolescent spines. |
| Apophysitis | Irritation at a growth plate where a tendon attaches. Sever's at the heel and Osgood-Schlatter at the knee are the common ones in juniors. |
| Bone stress injury | A spectrum from stress reaction to stress fracture. Progressive, load related, and a reason to stop and be assessed rather than push through. |
| DOMS | Delayed onset muscle soreness. Peaks 24 to 48 hours after unfamiliar work. Normal, self limiting, and different to injury pain. |
Why adolescents are a special case
Growing athletes have open growth plates, and the cartilage at those sites tolerates repeated load less well than mature bone. During a growth spurt, bones lengthen before muscles and tendons catch up, which transiently reduces flexibility and changes mechanics. Pain near a growth plate in a growing athlete is always worth a proper look, not a wait and see.
Return to play is staged, and it is not the coach's call
Return to play moves through criteria, not dates. A typical progression runs from settling symptoms, to restoring range and basic strength, to loading the tissue progressively, to sport specific volume, to full unrestricted play. Each stage has entry criteria the physio checks.
In Athlivate, staging and clearance are physiotherapist only actions. A coach sees availability status and nothing clinical. There is no override, and no automation.
Availability
- Available. No restriction.
- Modified. Training with specific limits the physio has set, such as reduced serve volume.
- Unavailable. Not training or competing.
Availability feeds readiness and warns on session assignment, which is why it is in the product from day one rather than added later.