Yeah, Noofy is right here: always begin and end with the fiction, it says that in the book, right? Well that means we're not dealing Hp damage without a cause in the fiction. And if there's something causing damage in the fiction, we describe it and react to it as usual.
So bottom line: yeah, my players definitely get more than just damage out of their attack. One of the things that drew me into DW was that this is a game where "I swing at his knee" MEANS something- if you succeed there, you busted his knee. The flipside of this (and the payoff for the gm) is that I get to say, like, "well, you're swinging at his knee, right? Your gaze is down, here's what you didn't see coming..."
That was all implied by the rules, to me. If they can damage something out of combat, why would that suddenly change? I mean, this is how my table does it and that only makes it official for us, but it's fun as hell, so...