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Or, this really should have a wittier title, but I can’t think of one.
I have broken my foot five times, and both my elbows, and one of my wrists, and my nose twice. So I consider myself something of an expert on how broken bones feel. And I have a few things to say about the things that most writers get wrong.
Unless a break is really really bad, and something’s visibly crooked, or you have an x-ray machine, you usually can’t tell a bone is broken right away. Those little bone cracks feel just like a sprain or even a pulled muscle at first. My mom walked a mile home on a freshly broken ankle (which I don’t recommend, as this led to multiple surgeries). I paced around my neighbor’s living room for several hours on a freshly broken foot, and when I was four, I broke my heel and ran from the back of the yard into the house. And my heel was a particularly bad break that permanently deformed said heel, and is the reason for three of the other four times I broke my foot. I’m no wimp, and my mom is no wimp, but that’s not the reason we did what we did. New, relatively minor breaks just don’t hurt that much. Give it a few hours, or overnight, and suddenly your foot hurts when you breathe. This is because of swelling. Most of what hurts about a broken bone is the swelling, which takes time. The injury itself usually hurts at first because of the soft tissue damage you sustained at the same time you broke it, in other words, sprains and pulled muscles, which is why they feel the same. In fact, depending on the severity of the soft tissue damage sustained at the time of the break, a break may hurt less at first, than a sprain or pulled muscle.
The only way you can tell without an x-ray is time. The next morning, if it hurts worse, it’s not a pulled muscle. After a few days of ice and elevation, if it still doesn’t feel better, it’s probably a break or a severely stretched or torn muscle.
So, in short, pain, mobility, and ability to walk on it minutes afterwards is not a good way for a character to know if it is or isn’t broken.
As a side note, a pulled muscle can be much much worse than a break. If you pull it so badly that it tears, you may need surgery and intense physical therapy to repair, and you will almost certainly be much more likely to tear it the same way again in the future because it has been weakened. Writers, and non-medical people more generally, like to talk about breaks like they are the worst thing that can happen to an arm or a leg short of amputation, bullet holes, and stab wounds, but this isn’t so.
As for broken noses, they don’t hurt that much at first either, but mine at least bled way, way more than they usually do in fiction. The first time I broke my nose, I ran across my math class to the door, and by the time I got there, I had a full mouthful of blood, which had run down from my nose, down the back of my throat and into my mouth, to spit out. There’s still a stain on the sidewalk there, and I’m told teachers tell new students that stain is what becomes of students who forget their math homework. Actually, it’s what happens to students who face plant on concrete floors while wearing forty pound backpacks, but oh well. The point is, broken noses bleed a lot, and a lot of that blood comes out of your mouth instead of your nostrils. But it didn’t really hurt at first, and it never put me in agony. It kind of felt hot and numb until the next day when it just felt very bruised. The second broken nose went much the same way, except I managed to get to a sink before I started spitting out blood, so there’s no cool stain with an absolutely untrue story attached.
So severity of injury has little to do with immediate pain, and broken noses make you bleed profusely from your mouth. Any questions?
I have broken my foot five times, and both my elbows, and one of my wrists, and my nose twice. So I consider myself something of an expert on how broken bones feel. And I have a few things to say about the things that most writers get wrong.
Unless a break is really really bad, and something’s visibly crooked, or you have an x-ray machine, you usually can’t tell a bone is broken right away. Those little bone cracks feel just like a sprain or even a pulled muscle at first. My mom walked a mile home on a freshly broken ankle (which I don’t recommend, as this led to multiple surgeries). I paced around my neighbor’s living room for several hours on a freshly broken foot, and when I was four, I broke my heel and ran from the back of the yard into the house. And my heel was a particularly bad break that permanently deformed said heel, and is the reason for three of the other four times I broke my foot. I’m no wimp, and my mom is no wimp, but that’s not the reason we did what we did. New, relatively minor breaks just don’t hurt that much. Give it a few hours, or overnight, and suddenly your foot hurts when you breathe. This is because of swelling. Most of what hurts about a broken bone is the swelling, which takes time. The injury itself usually hurts at first because of the soft tissue damage you sustained at the same time you broke it, in other words, sprains and pulled muscles, which is why they feel the same. In fact, depending on the severity of the soft tissue damage sustained at the time of the break, a break may hurt less at first, than a sprain or pulled muscle.
The only way you can tell without an x-ray is time. The next morning, if it hurts worse, it’s not a pulled muscle. After a few days of ice and elevation, if it still doesn’t feel better, it’s probably a break or a severely stretched or torn muscle.
So, in short, pain, mobility, and ability to walk on it minutes afterwards is not a good way for a character to know if it is or isn’t broken.
As a side note, a pulled muscle can be much much worse than a break. If you pull it so badly that it tears, you may need surgery and intense physical therapy to repair, and you will almost certainly be much more likely to tear it the same way again in the future because it has been weakened. Writers, and non-medical people more generally, like to talk about breaks like they are the worst thing that can happen to an arm or a leg short of amputation, bullet holes, and stab wounds, but this isn’t so.
As for broken noses, they don’t hurt that much at first either, but mine at least bled way, way more than they usually do in fiction. The first time I broke my nose, I ran across my math class to the door, and by the time I got there, I had a full mouthful of blood, which had run down from my nose, down the back of my throat and into my mouth, to spit out. There’s still a stain on the sidewalk there, and I’m told teachers tell new students that stain is what becomes of students who forget their math homework. Actually, it’s what happens to students who face plant on concrete floors while wearing forty pound backpacks, but oh well. The point is, broken noses bleed a lot, and a lot of that blood comes out of your mouth instead of your nostrils. But it didn’t really hurt at first, and it never put me in agony. It kind of felt hot and numb until the next day when it just felt very bruised. The second broken nose went much the same way, except I managed to get to a sink before I started spitting out blood, so there’s no cool stain with an absolutely untrue story attached.
So severity of injury has little to do with immediate pain, and broken noses make you bleed profusely from your mouth. Any questions?
