Realistic Injuries

Something that often bothers me in books is unrealistic injuries. Authors can tend to overplay the effect of the injury, or underplay it. Both are equally annoying, coming from someone who’s broken three bones. Let’s remember the difference between what is possible, and what is realistic. 

You don’t have to fall very far, or hard, to break something, and there are plenty of instances in books where characters jump from a third story window, roll, and get back up running. I’m sure this is possible, but a fall from that high can break bones. Is it possible to keep running with a broken arm? Yes (I broke both bones in my arm and ran several blocks back to the house. It’s totally possible.), but remember, as soon as that adrenaline wears out, not only are you tired, but your senses are somewhat down. You react to things slower than normal. 

Your character might not have an adrenaline rush at all. People vary, so you’ve got some room to work with. When I broke my collar bone, it hurt like heck. I honestly don’t remember very much about it except the pain. There certainly wasn’t any adrenaline rush to numb the pain there. What’s the psychological damage of it all? A broken arm or leg can look pretty strange, and/or gruesome. Maybe your character doesn’t handle blood well. 

It is entirely possible to not realize you’re hurt until after things have calmed down. For instance, if the character broke a bone in their hand, they might not realize until after everything’s happened, but don’t downplay the broken hand once it’s been recognized. That’s going to hurt, and they’re going to need to be treated. 

Consider how long it takes them to get treated. If a bone is left broken for too long, it has to be re broken so it can be set properly. Also, don’t forget other, smaller injuries. Let’s go back to the window example. Even if all the character has broken is an arm, they are going to be pretty banged up otherwise. When I broke my arm, I didn’t even notice the huge gash in my knee until I get to the hospital and the doctors pointed it out. I didn’t feel it at all, because I was so focused on my irregularly shaped arm. 

Head injuries get downplayed a lot. They’re serious, and shouldn’t be taken lightly. Head injuries can be fatal. If someone is knocked out for more than a few seconds, something serious is going on. 

Even bruises can hurt for a while. Don’t forget that you don’t have to get in a fight to hurt – practicing sports can leave aches and pains as you use normally unused muscles. Often in books someone gets in a fight, and the author describes the vast bruises and aches they have, then promptly forgets about them in the next few days.This always really bothers me. If several large events happen one after another, this is going to affect the character’s physical and mental strength. 

Different fractures heal and are treated differently. Is it going to be a full length cast or just a half one? Even after a cast gets taken off, many people wear a brace. Collar bones are different. There isn’t much you can do but wait, or wear a sling. (I hate slings – I think they’re really constricting.) Broken bones can take up to ten weeks to heal, and the younger you are, most likely the faster that will happen. When I broke my arm, I went through two different casts and a brace, and my arm was still really weak for a while afterwards. If your character breaks their leg, they’re likely going to have a limp. 

Make sure you don’t downplay all of this, but don’t overplay it either. After a week or two, it will likely stop hurting, and you can get up and do things, though not to the extent you could before. A broken arm is not going to leave a person bedridden for a week. 

Other unrealistic injuries that bother me a lot are sword/arrow injuries. An arrow to your arm is going to hurt, but unless it’s poisoned, one arrow probably isn’t enough to kill you. What will kill you is loss of blood. The more you move, the more blood you are going to lose. Removing the arrow can be a bad idea, since it might have been staunching the blood flow. Simple nicks from swords can cause  a lot of blood loss too. Character’s can pass out seeing the blood, or feeling faint from loss of blood. You don’t have to cut off someone’s hand. 

Lastly, consider the reason your character got hurt. Maybe they got caught up in something and it couldn’t be help. Maybe they got seriously hurt and needed a break from the action in the story. Attitudes affect You can learn a lot about someone by how they react when injured, or how they react to help injured friends/enemies. 

-Aivee

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21 thoughts on “Realistic Injuries

  1. Wow. I’m so glad I found this. I’m writing a scene following up a duel where the character broke his collarbone. I was trying to figure out how to handle it. Now I know. =) Thank you!

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    • I’m glad this helped. In my opinion, broken collar bones are more painful and annoying in the long run. The most you can do is wear a brace so it sets properly, but the brace goes under your shirt, so someone just looking at you doesn’t have any indication that you’re hurt. For the first two-ish weeks, you can’t move your arm very well.

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  2. One thing that you don’t mention – any displaced fracture near a major blood vessel can be lacerated by the broken ends of the bone itself. If that happens, you can bleed out easily and very quickly. The more you move it, the more likely it is to happen – which is one reason why we immobilize broken bones.

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    • This is a really great point that I hadn’t thought of. In addition to it being very painful to move a broken bone, there’s always the danger of internal bleeding. Thank you for sharing!

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    • I understand that rolling helps to prevent breaking bones – I suppose I was just questioning at what point you will be entirely unharmed simply because you rolled correctly.

      I definitely agree that there are ways to realistically lessen the injuries a character sustains. Thanks for explaining how rolling at impact can help.

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  3. I’ve cracked my wrists a few times—mildly enough that the doctor put me in a splint the first time, my parents ignored the second time (not that they would admit it), and after that I just recognized the sensation and ignored it, myself, since getting anything for it would have too many repercussions.

    One thing that’s good to keep in mind is that bones weaken when not put under stress, and they strengthen when put under stress.

    I’m writing an urban fantasy series that’s building to the narrator having an injury, probably a broken bone, that won’t be able to be healed with magic. This post was a nice rundown of timelines as one factor to consider when I get to that point in the series. 🙂 Thanks!

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    • Carradee, it’s not so simple as bones weaken when not under stress and strengthen under stress. Bones can be weakened for a variety of reasons, including because of stress. Usually, that’s when you get a stress fracture. I have experience because I’ve been dealing with a 5th metatarsal stress fracture for 2 months. The fracture was caused by my exercise routine and it will now take much longer for me to work back up to what I could do before.
      Now, using it and applying stress can help strengthen bones, but only to an extent. This is why many runners and other athletes suffer stress fractures and other bone injuries. The bones have weakened because of too much stress over time. It also leaves you more susceptible to repeat injuries which is important to note as well.

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      • True that it’s a simplification, that there are more factors that can affect things, but I was intending to refer specifically to the osteoblasts and osteoclasts, with proper all other factors being what they should be.

        Bones will also be weak and inclined to cracking if you’re kept underfed throughout your childhood—which can ultimately lead to ANY exercise making you extremely ill. That’s my own experience. But it’s not pertinent for most folks.

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  4. So I was writing a scene tonight where my protagonist breaks her ankle and gets a shallow dagger cut across the forehead. I finished and got onto Pinterest, and this article was the first thing that popped up. Just what I needed to check myself! It also drives me crazy when writers don’t do injuries correctly! I’ve never had any really painful injuries beyond surgery for a torn ligament, so I’m not good at describing them because I have no clue how it feels to even break a bone. Thanks! 🙂

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  5. I broke both bones in my left arm at the age of nine falling out of a tree, got up and got in the car and didn’t even know it was broken until my mom pointed it out. Though, last year, I fell off of my horse and broke both bones twice in my right arm. I didn’t realize it and tried to get up when I couldn’t feel my arm. Scary… I am a writer and when people underplay the injuries it gives me insane. I didn’t feel any pain until I got to the hopsital(45minute ambulance drive) because of the adrenaline. It hurt like nothing before after my rush ended and it didn’t help that I don’t tolerate morphine so it almost killed me when I went into surgery and it didn’t mute the pain. It’s not unbearable but it feels strange cause you can’t pinpoint the pain it just hurts. Thank you for this article though! Definitely an eyeopener for those who haven’t suffered an injury they are writing about.

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    • For me the struggle is how to portray my characters’ reactions to injury. Unless your character is trained to endure pain or used to injury, it would have a strong effect on the character. Most of my characters are normal kids getting launched into something too big and too dangerous – how do I make them react realistically without the book sounding like a sob story?

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      • This is a really good point. I think one thing you can always use, which Sarah mentioned, is that there’s often some sort of adrenaline rush that will last for a little bit (the timing will change depending on the injury and the person). Other than that, I think it depends on what your characters are enduring. There’s a point where some people can push pain aside to finish a job – just don’t forget to allow them to feel the full effect afterwards. On the other hand, someone might get hurt and not be able to continue. This can all play into your plot and character/relationship development. You just need to make sure its balanced. If your characters are just normal kids, readers shouldn’t judge them too harshly for faltering a few times, especially the first few. They just can’t freeze every time they get hurt (unless, of course, that plays into the plot).

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