This post is brought to you courtesy of one of my all-time favourite FMCs, who breaks her wrist and deftly braids her hair the next morning. I cringe every time I read that part of the story.

Sure, blocking some pain can be attributed to adrenaline, but that stuff wears off, and then the ache sets in with a vengeance. Most people can barely touch their fingers together the morning after they broke their wrists, let alone grip something tightly enough to pick it up, making a braid almost impossible.

And I know, because my kid broke her wrist at the beginning of January, highlighting how absurd bookish and film injuries often are.

Hence, this miniseries on writing injuries.

As always, I write these posts to help myself and other authors craft more believable stories. The best books allow readers to lose themselves in our worlds while also remaining relatable—and that without minimising anyone’s real-life experiences.

I am not a medical professional, just a writer trying to craft believable stories. Please seek medical help if you need to, and don’t base your medical decisions on what I’ve written in this post.

TRIGGER WARNING. During this miniseries, we will discuss various injuries and recovery time in detail, so if that makes you uncomfortable, turn away now.

In Today’s Post:

We’ll cover sprains, but we’ll talk about fractures, dislocations, head injuries, and hand injuries in upcoming posts. We’ll also chat about pain threshold and adrenaline in today’s post.

The miniseries will include a breakdown of each injury, classification, and a description of how it feels.

Where applicable, I’ll share personal experiences with in-the-moment pain levels, symptoms, and recovery times. I interviewed friends and family members for some of the injuries we’ll discuss, and also scoured the internet (aka Reddit is my friend) for other people’s experiences.

So, let’s get to it!

Pain Threshold and Adrenaline

For reference, I have a high pain threshold (even medical professionals have commented on it), but to keep these posts well-rounded, I also spoke to some folks who have a low pain tolerance, so you’ll be able to find the middle ground in your writing.

It’s important to keep in mind that members of the military or other highly-trained professions might be able to barrel through the pain with more ease than folks with a softer lifestyle, but it’s difficult to predict how anyone might act under the influence of adrenaline.

• Adrenaline typically lasts around 20-30 minutes.
• In extreme cases, adrenaline can last for up to an hour.
• On average, a person needs about an hour to recover from the effects of adrenaline.
• An adrenaline rush feels like:
  • Rapid pulse and breathing.
  • Higher concentration and quicker response times.
  • Higher pain threshold, and the affected person might not even realise the gravity of their injuries.
  • The heightened pulse means greater blood circulation to all the major muscle groups, which means the person might experience greater strength.
  • Additionally, fat stores are burned for extra energy.
  • The person might feel lightheaded or on edge, with shaky hands.
  • Hands and feet might also feel cold.
  • Memory might be spotty once the effects of adrenaline wear off.
  • The affected person won’t realise this, but their pupils will dilate, and they might seem pale or flushed, so keep this in mind if you’re describing them from another character’s perspective.
• However, once the adrenaline wears off, the pain sets back in, and some people report that it feels more severe than it would have in a less stressful situation.

That said, a librarian with chronic pain might have a higher pain threshold than the most badass marine, just because she’s so used to dealing with it.

Higher testosterone levels indicate higher pain tolerance in men, but women show higher pain sensitivity, especially during certain phases of the menstrual cycle. However, some studies state that men might not report pain as openly as women because of societal norms—they have to be tough and stoic—and that is why more women are diagnosed with chronic pain.

The bottom line? No two people are the same, and our characters should be just as varied and unique. It’s okay to have one or two characters grin and bear it, but the story loses believability when every character shoves aside their pain to get the job done. Not everyone handles injuries in the same manner.

With that out of the way, let’s get to it.

Sprains

Sprains are typically categorised in grades, Grade 1 being the mildest and Grade 3 the most severe.

A Grade 1 sprain causes some swelling, tenderness, and joint stiffness, but the pain usually fades within a day or two and recovers within a few weeks. The ligament remains intact.

A Grade 2 sprain means the ligament has partially torn, causing moderate pain, swelling, and bruising. Moving the affected limb is painful, so walking with a sprained knee/ankle can be difficult. Recovery might require a brace and can take up to 6 weeks.

A Grade 3 sprain means the ligament is torn. This kind of sprain causes severe pain, swelling, bruising, and joint instability, and might require surgery and/or physical therapy to heal. The joint will be immobilised for longer, and full recovery can take months.

Ankles

The most common ankle sprain is called a lateral or inversion sprain, and happens when the foot rolls inward so that the outer ankle is hurt (on the pinkie toe side). These sprains can occur while walking on uneven or slippery surfaces, running, jumping, or, for some of us, just going about our regular business.

Eversion or medial sprains occur when the foot rolls outward, and the inner ankle is hurt (on the big toe side). These sprains typically occur when someone lands awkwardly or suddenly changes direction.

High ankle or ‘tib-fib’ sprains affect the upper ligaments of the ankle (tibia and fibula) and are the least common kind of sprain. They are also typically more serious and usually occur due to a blow to the joint (while practising sports) or when the joint is twisted.

Wrists

Radial wrist sprains are the most common and usually occur when a person falls with an outstretched wrist. The scapholunate and/or radioscapholunate ligaments are affected (the ligaments connecting the scaphoid and lunate bones).

Ulnar wrist sprains affect the ligaments of the triangular fibrocartilaginous complex or the luno-triquetrum complex. These sprains occur during the same kinds of events as radial sprains, radial loading, or repetitive motions.

Elbows

Elbow sprains are common among athletes and people who use repetitive motions, such as heavy lifting, in their workplace. These injuries usually occur due to impact during sports practise or accidents, or repetitive motions such as tennis, golf, etc.

Knees

Knee sprains are caused by any hard impact, such as in sports or accidents, sudden changes in direction, landing awkwardly after a jump or fall, twisting the knee, or putting too much pressure on the joint.

Fingers and Thumbs

These sprains occur when the joints are bent too far in the wrong direction, such as during falls or sudden impact in sports, etc. Repetitive movements, such as gamer’s thumb, can also lead to sprains.

What a Sprain Feels Like

• A sharp, sometimes fiery jab in the affected joint.
• This may be accompanied by a popping or tearing sound.
• The joint might burn or tingle.
• The joint won’t bend or move.
• With more severe sprains, waves of nausea, dizziness, or both might follow.
• In addition to the above point, many people report flickering vision, black spots along the edges of their vision, or their vision fading to white.
• Saliva might pool in the person’s mouth, and they might also experience a rush of sweat.
• Some people might cry or have tears prick their eyes.
• If it’s a sprained knee or ankle, the injured limb won’t hold weight, and walking will be impaired.
• Sprained fingers won’t grip, and elbows or wrists won’t bend.
• The initial sharp pain will dull to an insistent throb that will persist in more severe sprains. The first night after injury usually comes with a good dose of throbbing ache.
• Joint stiffness and swelling will set in soon after the injury and can take days to normalise. This means moving the affected joint will remain difficult for a while, so walking etc will be affected, too.

Personal Experience

I’m neurodiverse, so spatial awareness is a challenge, and I’m constantly bumping into things or falling over my own feet.

One of my worst falls occurred around 8 years ago, when I slipped on loose river sand on a wooden walkway and sprained my ankle. I partially tore the ligament, classifying it as a Grade 2 sprain.

It Felt Like:

• White-hot fire running up my ankle to my knee, and the pain worsened every time I tried to step on the injured foot.
• I was instantly dizzy, and my vision pulsed in time with the ankle.
• Waves of hot and cold alternated over me, but the nausea only hit as we walked towards the car.
• I couldn’t get there on my own and had to lean heavily on my husband.

It Looked Like:

• The swelling set in almost instantly, leaving my foot almost twice the size of the other one.
• A line of solid blackish-purple formed along the outer edge of my sole, and the bruising crept upward over my ankle and toward my calf.
• The swelling remained for a good week, even though the worst of it went down within two or so days.
• The bruising remained longer, especially the line along my sole.

Recovery Time:

• I could start putting light weight on the ankle after about four days, but that sharp, burning pain shot upward whenever I overdid it.
• The throbbing persisted for the first few days, too.
• I hobbled for a good week.
• After that, I could walk as long as I did it slowly and carefully. Again, that sharp pain and throbbing returned if I overdid it.
• The joint moved normally after about 4/5 weeks, but was noticeably weaker than the other side for months. Because I’m stubborn and don’t see doctors when I’m supposed to, I didn’t rehab the joint, which would’ve significantly decreased the recovery time. I later learned that I probably should’ve worn a brace.
• That ankle still rolls or sprains more easily than the other, and tends to get achy in cold weather.

The majority of athletes on Reddit report being able to run again after about a week, depending on the level of the sprain, but there are reports of re-injury due to shortened healing times, too. Some athletes of Reddit also reported being fine, then realising something was wrong 6 months after the injury, and ending up in surgery anyway. Bodies are different and react differently to healing procedures, so it’s important to write that into our stories, too.

And that’s it for today’s post. Since these posts require a lot of research, I won’t offer another next week, but look out for the rest of this miniseries. Meanwhile, if you have any injury stories to share or requests for topics in this series, feel free to contact me. I love hearing from you.

If you’re looking for more posts like this one, but with an emotional focus, check out the Writing Emotions series. I also have many other resources for writers in my Let’s Write posts.

Until next time.

Yolandie.