Making Injuries Hurt

Yeah yeah, I know, we discussed this - or something similar to it - not all that long ago with the discussion on how Hit Points work and what you thought they meant. Today I want to talk about something else. It's something that almost every system that turns health into a number, be in a table top RPG or a computer game, has issues with. Namely, how do we make injuries hurt and make the player feel like their character is hurt?

Before I begin I feel I should clarify. This isn't something that should be done in every game. However, when you want your game to be a bit more gritty, a bit more dark, than having injuries hurt can be a huge deal. For more adventure based games you probably won't want this. For down, dirty, and perhaps even more 'black' type games, then you probably do.

The Problem With 1 HP
The problem, when you want this sort of thing, with a lot of games is that someone is just as effective at fighting at 1 HP as they are at full HP. Now, no matter how you describe what an HP is this character should be exhausted, beaten down, and on their last leg because, well, they are. Instead though, the person is able to jump around and do everything they could at full HP, just if they get flicked in the nose they're down for the count. It is something that can break the tension and mood in a scene and one of the places where mechanics can regularly get in the way of story. So what do we do?

Wound Penalties
A lot of games have gone with wound penalties to make injuries hurt. As you get more hurt you become worse at just about everything. You can't hit as well, you're easier to hit (sometimes), you lack power, you can't do skills, you essentially become nigh on useless as you get injured. This isn't without its own problems but it definitely gets the point across that injuries hurt and you may not want it. However, it is still pure mechanics and can still take someone out of the game. Also, it can make combats feel impossible once everyone has a big negative modifier and no one can do anything anymore, and that can be a problem in and of itself.

Complications
This is one of the methods that the Fate games use and is also seen in Cortex Plus. Essentially, along with whatever damage you take, the character gets a Complication. The complication is an Aspect that anyone can tag against the character for a bonus and can just in general be used against them. These come into play for helping by adding description which then flavors how its used. I.E. someone who is shot in the leg is 'dodging' differently than someone who is 'pinned to a wall' and so on. These do work, but it does it mechanically in an interesting way. The character isn't performing less well, but things working against them are given an advantage. So a character who is likely to roll a 12 on his skill check is still likely to roll a 12. The thing he is rolling against just gets another die/bonus to throw against them.

Description
This is the opposite end of wound penalties. No mechanics, all fluff. You describe how bad things are, the player plays in, and while mechanically there may be no impact you can feel it at the table. This works great for people who are more concerned about the narrative, but can leave people wanting mechanics feeling a bit underwhelmed. Also, it does leave things open to some players being a bit too dramatic or having clashing ideas on what is appropriate (and trust me, you will understand that more when you have one person trying to play the game like it is a gritty samurai drama game and the other viewing it like their favorite battle anime with less energy blasts.)

Which Is Best?
Like with so many of these the cop out answer applies. It depends on your game. It also depends on how much you want someone being heavily wounded to matter. Do you not want the added drama, tension, and vulnerability of being heavily wounded to impact things? That's perfectly fine. D&D has been doing it for years and people like it. If you don't want being injured to be seriously hindering than don't have them be. On the other hand, if you want every blow to hurt and be felt, than you are going to want something. Depending on your play group - or desired type of play group - you may want to stray more towards mechanics or more towards description. There is a happy middle to be found, but that is also going to vary from group to group and play style to play style.

However, with some of the options laid out, I'm curious: how much do you want injuries to be felt in your game, and what do you do to make that feeling come out?