When to see a doctor

Emergencies first

This page is about knowing when to involve a health professional. It is not a way to decide whether something is serious. If something looks or feels like an emergency, such as someone collapsing, struggling to breathe, being confused after a blow to the head, or a limb that looks badly out of shape, call your local emergency number straight away rather than reading further.

For everything else, the sources below point to a few clear situations where a teen should see a doctor or other health care provider, and a few habits that make those visits more useful.

Before starting

MedlinePlus, the National Library of Medicine's health site, lists getting a physical, a check-up to make sure you are healthy, as one of the first steps before starting a sport. Many schools and clubs ask for one anyway. It is a good moment to mention plans to start strength training.

The American Academy of Pediatrics (AAP) names some conditions where strength training is not recommended or needs a specialist's approval first: uncontrolled high blood pressure, seizure disorders, a history of childhood cancer treated with chemotherapy, and complex congenital heart disease, where it advises approval from a pediatric cardiologist. A teen with any of these, or with any other ongoing health condition, should talk to their doctor before starting.

The same applies after a recent injury or illness, or if a teen takes regular medication. NIAMS, part of the National Institutes of Health, notes for example that some medicines, including a class of antibiotics called fluoroquinolones, have been linked with tendon problems. A doctor or pharmacist can say whether anything in a teen's own situation matters for training.

Pain during or after training

The AAP's advice is simple: stop lifting at once if there is pain. MedlinePlus says the same about sport in general: if you get hurt, stop playing, because continuing can cause more harm.

It helps to tell apart two kinds of feeling. Muscles that feel tired or a little stiff for a day or two after a new kind of exercise are a common response to unfamiliar effort. Sharp pain, pain in a joint, pain that changes how someone moves, or pain that keeps coming back is different, and is a reason to stop and get it checked. When in doubt, treat it as the second kind.

Injuries that need a provider

NIAMS explains that many minor sports injuries can be managed at home with rest, ice, compression and elevation, but that severe injuries need a health care provider. It singles out some situations:

• Possible broken bones. Most sudden fractures need an immediate visit to a health care provider. A break where bone comes through the skin is especially serious because of the risk of infection.
• Dislocations. A joint that has come out of place typically needs immediate medical treatment.
• Sprains and strains. These range from minor stretches to complete tears of ligaments, muscles or tendons. Severe ones need assessment.

Signs that are generally worth getting checked include severe pain, a lot of swelling, numbness, not being able to put weight on a limb or use a joint, a joint that feels unstable, or an old injury that starts to hurt or swell again. A parent or carer should be told about any injury, even one that seems minor.

Growing bones and overuse

NIAMS explains that growth plates, the areas near the ends of long bones that let them lengthen, are more vulnerable to injury than mature bone until they close, typically by or around age 18. Growth plate fractures are unique to children and teens who are still growing, and can result from a single fall or from repeated stress and overuse.

NIAMS also describes chronic, or overuse, injuries that build up gradually, such as stress fractures and tendinitis. Pain that appears with activity and builds over weeks, especially near a joint in a teen who is still growing, is worth having checked rather than trained through. Risk factors NIAMS lists include overtraining, increasing intensity too quickly and playing the same sport year-round.

Head injuries

A concussion is a type of traumatic brain injury. The CDC's HEADS UP programme is its resource on concussion for young athletes, parents and coaches, covering the signs to watch for and the steps for returning to activity. Any suspected concussion, during training, sport or anywhere else, should be checked by a health care provider, and a teen should not return to training or sport until a provider says it is safe. Signs that get worse, such as repeated vomiting, growing confusion or unusual drowsiness, need emergency care.

Coming back after an injury

MedlinePlus advises recovering completely from an injury before starting a sport again, protecting the injured area if possible, and starting slowly on return. NIAMS notes that a rehabilitation programme, often including exercise and other therapy, is usually recommended before going back to the activity that caused the injury. A health care provider or physical therapist can say when and how to return; a coach or training partner is not the right person to make that call.

Sleep, eating and mood

Not every reason to see a doctor is an injury.

• Sleep. The CDC advises talking to a health care provider about regular problems sleeping, such as trouble falling asleep, waking often during the night, or feeling tired even after enough hours.
• Eating and exercise. MedlinePlus describes eating disorders as serious but treatable medical conditions that frequently appear in the teen years, and lists excessive exercise and fasting among their symptoms. The National Institute of Mental Health says that becoming fixated on weight, body shape or controlling food may be a sign, and that early treatment is important. Exercise that feels compulsory, or that continues despite injury or illness, is worth raising with a doctor.
• Supplements and other substances. Anyone who has taken a supplement, steroid or other product and feels unwell should get medical advice. The guide on supplements and steroids covers this.
• Mood. Feeling persistently low, anxious or not like yourself is a health matter like any other. If someone has thoughts of harming themselves, contact local emergency services or a crisis line straight away.

Getting the most from an appointment

A few simple steps help a provider help:

• Note when a problem started, what makes it better or worse, and what training or sport was going on.
• List any medicines, supplements or other products being taken, including anything bought online. MedlinePlus and the FDA both advise telling a provider about all supplements.
• Mention any plans: a new sport, a strength programme, a competition.
• Bring questions. It is reasonable to ask when it is safe to train again and what to avoid in the meantime.

Teens often find it easier to raise these things with a parent or carer there, and sometimes easier alone. Either is fine. The guide for parents has more on how adults can help.

That is the last guide. Read the guide for parents