I came across this sentence:

Knowing that I hurt you is breaking my heart.

but I couldn't understand whether the word hurt is present form or past because all its three tenses are spelt same. How do I distinguish them?

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    You use context. Otherwise, it's not possible if the writer doesn't include a time adverb. – Random Dude Apr 6 '16 at 15:53
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    Most 'meaning' in any utterance is understood in terms of the discourse context. What are the two people involved talking about? --a past injury done by the speaker, or injuries the speaker constantly does? – StoneyB on hiatus Apr 6 '16 at 15:53
  • I came across only this sentence, so I couldn't distinguish them but a person said It seems to be past form because if it is present form, the writer wrote that "I am hurting you". Is it right? – Yuuichi Tam Apr 6 '16 at 16:00
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    No, there is no reason why you couldn't use present simple form. "I am hurting you" could also be used instead of "I hurt you", they just have different meanings, but neither are incorrect(in this sentence). @YuuichiTam – Random Dude Apr 6 '16 at 16:05
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    Technically, no one can without context.... so there's no way for anyone to know what the "correct" interpretation is. That being said, it would be pretty unlikely that they are currently hurting someone... I would argue that this would generally be phrased "Knowing that I am hurting you is..." So I would say that this is a past hurt. – Catija Apr 6 '16 at 16:05

This sentence is ambiguous. The only way to tell the tense here is by context, namely some kind of indication as to whether the hurtful action is finished or continuing.

If you wanted to disambiguate this sentence, you could say either "Knowing that I hurt you in the past…" or "Knowing that I am hurting you…".

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First, given your example:

Knowing that I hurt you is breaking my heart.

Does it really matter? Generally in situations where the spelling is the same, precisely determining whether it is past or present may not matter. Verbs like this include hurt, put, cut, and set and probably one or two more.

When it does matter though - if you want express that one of these verbs happened in the past, but isn't happening now, the past perfect comes to the rescue:

Knowing that I had hurt you is breaking my heart (this impiles you are not currently hurting anyone)

I believe did would also convey the same to most English speakers even though do X doesn't have any of the time relation meanings that have X does.

Knowing that I did hurt you is breaking my heart.

If you want to do the opposite, i.e. express that it is in fact happening now, you can use a continuous tense. Which is generally used in English anyway instead of simple present tense to express things that are happening right now. So that's another reason why there usually is no confusion about these verbs.

I am cutting this paper on the machine.

I cut this paper on the machine (Most would assume past tense here unless context clearly shows you are logging/narrating someone's actions).

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