Should I see a different doctor?

[Phoe]

Go pick up your X-rays and pay a minimal fee for an office visit for a second opinion.

 

It's worth another assessment especially since you're off and can schedule a visit in the next day or so.

 

I have them on a CD

 

 

I doubt they need to be looked at again. It's the ligaments I'm worried about not the bones.

 

 

I'm back to work Friday anyway.

[Phoe]

Well I'm off to make dinner before he gets home. Poor guy, getting his foot run over.

 

I'll be back tomorrow, hopefully my foot will show signs of improvement then.

[CrystalCastles]

I also think you should go to the ER. Your foot is worth more than 100$. I know it means letting go of that money, but unforseeable things happen and you just gotta roll with it.

[RonaldS]

I have them on a CD

 

 

I doubt they need to be looked at again. It's the ligaments I'm worried about not the bones.

 

 

I'm back to work Friday anyway.

I don't care about this ER visit nonsense, or why you were kung fuming with your boyfriend. None of that matters at this point. I'm just trying to determine where exactly the injury occurred.

 

You are sort of saying the foot was injured, and I'm just trying to figure out if the 'pop' and the initial trauma was in the foot, or the ankle. Those are two different regions.

 

It sounds to me, from your description, that your foot was top-down on the floor, and your body was moved in such a way that the ankle joint twisted while the foot remained planted. Correct? So, it sounds like the ankle, not the foot, was injured, correct? It's an important distinction to make.

 

A 'pop' in the foot is generally going to involve a fracture, whereas a 'pop' in the ankle is typically a sprain. It's important to figure out the direction the foot moved, because if it goes forward, there's a chance that your talus can rotate abnormally upward and fracture the end of your tibia.

 

If it was a sideways roll, that's probably your standard garden variety ankle sprain. If you've never sprained one, the swelling and pain and immobilization of the joint can be awful. I'm assuming your foot is bruised badly. How about your ankle? Is it bruised, and what side is it bruised most heavily on?

 

Swelling is always going to come back after you begin to put weight on it, or after you've gone the full day w/o elevating it. Keep elevating it, keep icing it. I know icing sucks, but it does accelerate the reduction of swelling.

 

The ligaments are surely ruptured, but don't worry. They'll heal themselves. The important thing is getting mobility back as those ligaments are healing. Keep doing the rotations and ABCs. As your mobility comes back, you'll notice that it hurts to do those things, but immediately after you stop , the pain subsides quickly. The next thing to work on is getting weight on it and trying to get your foot perpendicular to your leg as much as possible. The easiest way to do this is to not put full weight on it, but still start to be able to straighten it all back out. Best way is to sit on the side of your bed, place the bottom of your foot flat on the floor, at whatever angle that happens to be from. Then, SLOWLY push your partial weight forward and try to get your lower leg as close to straight up and down (and ultimately even move your lower leg forward to an acute angle w/ your foot) with your foot flat on the floor as you can. Just go slow, and don't push it too far (which is hard to do because it's going to hurt).

 

I'm not going to lie....this stuff hurts, and hurts bad. But if it's a sprain, and I'm betting it is if they didn't put you in a cast or give you crutches, there is only one way to heal it and that's to start putting weight on it and working on mobility. That pain is just something that's going to be there, but you'll notice that the more flexibility you gain, the less it's going to hurt overall.

 

Sprains are a bitch. Way worse than fractures, in my opinion. Keep us posted.

Edited May 29, 2014 by RonaldS

[sweetjasmine]

The $100 ER fee won't seem so bad if you end up needing complicated expensive medical care to take care of an injury that worsened because of your delay. But, hey, it's your body and your money, so good luck.

[Phoe]

I don't care about this ER visit nonsense, or why you were kung fuming with your boyfriend. None of that matters at this point. I'm just trying to determine where exactly the injury occurred.

 

You are sort of saying the foot was injured, and I'm just trying to figure out if the 'pop' and the initial trauma was in the foot, or the ankle. Those are two different regions.

 

Swelling is always going to come back after you begin to put weight on it, or after you've gone the full day w/o elevating it. Keep elevating it, keep icing it. I know icing sucks, but it does accelerate the reduction of swelling.

 

The next thing to work on is getting weight on it and trying to get your foot perpendicular to your leg as much as possible.

 

I'm not going to lie....this stuff hurts, and hurts bad. But if it's a sprain, and I'm betting it is if they didn't put you in a cast or give you crutches

 

It's hard to describe what happened without showing you. It wasn't a sideways roll, it was a straight forward over extension. After feeling the pop I twisted sideways to pull my foot out from being pinned.

 

 

The majority of the swelling is around the outer area of my foot under my ankle spreading down towards my 2 smallest toes. Blood pooled around that side. There's also very slight bruising and mild pain directly under my shin and on the inner side of my ankle

 

 

My foot is stuck at a 90 degree perpendicular angle right now. When I lay flat my toes point straight towards the ceiling and can't be moved to point in any other direction. If I let my leg hang off the bed I can get some slight extension, but laying my foot on the floor and trying to get flexion is excruciating. I feel shooting and stabbing pains when I try.

 

 

When I flex my other leg, I can feel a large tendon coming down off my shin into my foot. When i relax the foot, that tendon also relaxes. On the injured leg, that tendon is perpetually tensed and quite hard to the touch. I can't get it to straighten out or loosen. Then there's the tendons and ligaments right in front of my ankle that are very painful. It's the bones directly in front of my outer ankle (I believe they would be tarsal bones?)that feel like they're clicking and popping when I put weight on that foot. The swelling has made my outer ankle bone disappear. My foot is also perpetually slightly tingly.

 

 

I was explicitly told by the first doctor who saw me, to not walk without crutches under any circumstances, and to keep off of it. I have been using crutches everyday, today I used just one because my armpits are killing me

[ASG]

 

I was explicitly told by the first doctor who saw me, to not walk without crutches under any circumstances, and to keep off of it. I have been using crutches everyday, today I used just one because my armpits are killing me

 

Lets forget the ER for a moment... can you not go back to that doctor?? You said he was off when you went back with the results... but surely he'll be working other days and you could get a consult??

 

You clearly didn't trust the other doctor (and I wouldn't either), so you'll keep second guessing his diagnosis until you get another answer (which might be the same, but given by someone you trust). So can you not go back to your emergency care doctor and have him look at it???

[RonaldS]

Interesting. You're talking about the tendon going from your shin to the top of your foot? I think that's the extensor something or other tendon. That's a pretty unusual injury. It doesn't sound like that tendon is completely ruptured if it's still rigid. If it were a complete rupture, it wouldn't be rigid, and more importantly, there would be nothing connecting your foot to your leg in the front, so you wouldn't be able to hold your foot at a 90deg from your leg.

 

I'm really curious, because that's not a common part of the foot to injure, and it sounds like the trauma resulted from torquing the lower leg forward over the top of the foot. Fortunately, while there was weight on the foot, your body weight was not coming down on it simultaneously, which would result in probably more ligament and tendon rupturing and probably tibial fracture.

 

Honestly, since this is a pretty non-traditional injury, I would try to find a way to have a specialist look at it. Forget the ER. They're not going to be able to give you a specific care plan nor recommendations on reconstructive procedures if any are necessary. Since your boyfriend jacked your wheel up, have him help pay for it.

 

I would still put my money on a sprain, albeit an unusual location. And if there is a tendon tear, it is probably only a partial. But typically rupturing a tendon doesn't have a tremendous amount of pain associated with it. It just snaps, and the pain comes more from the muscle not being attached to anything. Intense, acute pain and swelling are typically textbook sprain symptoms.

 

I don't know. I would have a specialist look at it.

[RonaldS]

Ok, wait....I just cruised a little research. I might have been wrong with the initial conclusion that it was a traditional ankle sprain.

 

The tendon you describe is the extensor digitorim longus tendon. Most of the stuff I could find on it related to hand/finger injuries and were typically associated with trauma with a finger being in one state of flexion with the wrist in another flexion state. Did not find much on this injury in the foot. The one article I found stated it was a very rare injury, but the speculation of the direction and force of the trauma sort of matched your description.

 

Look, I hate to say it, but you're going to have to see a specialist for this one. Most of what I saw on post-care management of the injury when associated with the hand was non-surgical but specific support was required to allow it to heal properly. I'm assuming the same would be true in the foot.

 

Plus, you don't really know the severity. Is there a just a partial tear? Is there a fracture associated with it?

 

Yeah....unfortunately this doesn't sound like a standard run of the mill sprain, so the standard operating procedure for post-trauma care probably doesn't apply here. Weird one. Find a way to have an ortho-specialist take a look at it, such as a Bone and Joint clinic. Don't waste time with an ER or any GP...they're not going to have any clue about what you should do.

[Phoe]

 

You clearly didn't trust the other doctor (and I wouldn't either), so you'll keep second guessing his diagnosis until you get another answer (which might be the same, but given by someone you trust). So can you not go back to your emergency care doctor and have him look at it???

 

That's been on my mind, but I don't remember his name, and I don't know when he will be there.

 

 

There's 3 doctors who work there. A white man, a black man, and an asian man. The white one is the one who seemed interested in actually finding out what was up with it.

 

 

I don't exactly wanna walk in the lobby, ask if the white doctor is in, and then walk out if he's not there. That looks horrible.

[Phoe]

Interesting. You're talking about the tendon going from your shin to the top of your foot? I think that's the extensor something or other tendon. That's a pretty unusual injury. It doesn't sound like that tendon is completely ruptured if it's still rigid. If it were a complete rupture, it wouldn't be rigid, and more importantly, there would be nothing connecting your foot to your leg in the front, so you wouldn't be able to hold your foot at a 90deg from your leg.

 

Yeah, that's the tendon. It's really big and hard to miss.

 

 

I tried to find a photo describing what my foot did but I can't find one.

 

 

My foot got bent straight forward so that the extensor tendon connected to my shin got pulled hard. My heel started moving towards my calf and my Achilles' tendon got crunched up.

 

 

As I felt the tug on that tendon I think I twisted as an automatic reaction, to try to get my foot out, and that injured one of the tendons down in front of my ankle.

 

 

http://www.podiatrychannel.com/pod/Images/ft_sdvw.gif

 

 

The long white tendon along the shin is what got pulled at first, then when I twisted, the inferior extensor is what I think got damaged as well.

 

 

The extensor along my shin is now tensed up and tender, and can only be stretched out if I force it with my hand, while the inferior extensor around my ankle feels very loose and basically useless. Both areas have swelling and bruising. Even my achilles is a little tender and bruised from getting smashed into itself.

 

 

I feel like my desperate twist to get out of my position managed to damage even more areas of the foot and ankle.

 

 

 

It's no better and no worse today. Still the same.

 

 

 

edit to add: the talofibular ligament also looks to be in about the right spot too.

Edited May 29, 2014 by Phoe

[RonaldS]

The reason you're going to want to see a specialist is because if there was a complete rupture of that inferior tendon, it will need to be repaired, and if not repaired, you could risk losing a degree of flexion in your ankle.

 

If you say the EDL is tight but tender, that's probably 'good' news, as that seems like the more important tendon countering your Achilles. But you don't want to go through the rest of your life without full functional flexion in your ankle.

 

I'll stress again...go to a bone and joint clinic. A GP will be clueless about what to do with this .

 

The good news is the damage is done, so it's not like you've hot to rush right in to get it fixed. I know people that ruptured ligaments in their knees and once the swelling went down, they were able to walk OK, and then they would sometimes wait 6 months or more to have surgery.

 

But if you go into a B & J, they can at least accurately assess the injury and give you some options on what do next.

[RonaldS]

Can you move your foot from side to side?

[GemmaUK]

Aw! Phoe!

 

A. Ouch!

B. Your bf had his foot run over too? Oh boy!

C. That isn't ligament.

 

It has to be tendon or bone.

Swelling makes me thing bone..and admittedly I know not a lot about tendon injuries.

 

I had a ligament foot injury that stopped me from walking for 5 months.

Bruising nor swelling ever happened.

 

Can you get to see a physio in the States cheaper than ER?

My physio helped me with my foot way more than ER (ER was free - I am in the UK). A Phsy might help you decipher what is wrong.

 

Please get it looked at...we need out feet.

 

Can you wriggle your toes without pain?

If you can broken bone is unlikely. If you can't..you need help now.

[Phoe]

Can you move your foot from side to side?

 

Nope. I can't move it in any direction. The only way I can get any movement on it, is if I let it hang off the edge of the bed and try to point my toes to get a little extension. Gravity is helping out there.

 

Otherwise it's completely stuck

 

Aw! Phoe!

 

A. Ouch!

B. Your bf had his foot run over too? Oh boy!

 

Can you wriggle your toes without pain?

If you can broken bone is unlikely. If you can't..you need help now.

 

 

His foot ended up being okay. It's sore, but his steel-toe boot saved him from any injury. Sadly the boot was ruined.

 

 

I can wiggle my big toe just fine, my 2 bottom toes I have to struggle to get a small amount of movement out of them, and doing so sends pain up my foot.

 

 

 

 

I have my xrays on a CD, so I will hold on to those, but I feel like I need an MRI to make sure I didn't destroy any soft tissue.

 

 

I'm giving my foot until Sunday to show signs of improvement.

[Chocolat]

I don't think I was rude, just pointing out a discrepancy between your ostensible reason for posting (2 days ago) and your response to the advice you've received.

Edited May 30, 2014 by Chocolat

[William]

It doesn't matter what you think, only what our guidelines provide for. Hence, postings chastising the thread starter for 'not taking advice' are deemed off topic and rude and will be sanctioned as such. Onward!

[Phoe]

thanks to those who gave advice.

 

i will have it checked out again on Sunday, as I have most of the day off then.

[bubbaganoosh]

 

I am so frustrated and in pain. I don't know whether I should seek a second opinion or just wait to see if it gets any better through the week. I don't even know where else I would go... it takes 3 weeks to a month to get into my primary care, and the ER visit costs $100 so I don't want to go there unless absolutely necessary.

 

Phoe. Got news for you. It is absolutely necessary. get your butt to the ER and get help. Fat lot of good your doing yourself with a possible broken foot or worse.

 

Please tell me you foot is worth $100.00. Mine is not to mention if you think it's going to heal itself with a ice bag and a few Motrin, well it isn't. Don't play games with you health.

[RonaldS]

Phoe. Got news for you. It is absolutely necessary. get your butt to the ER and get help. Fat lot of good your doing yourself with a possible broken foot or worse.

 

Please tell me you foot is worth $100.00. Mine is not to mention if you think it's going to heal itself with a ice bag and a few Motrin, well it isn't. Don't play games with you health.

 

What good is going to the ER going to do her? Spending $100 to find out what she already knows? And then get no worthwhile after-care recommendations? No procedural recommendations?

 

The 'E' in ER is for emergency. This is hardly an emergency. The damage is done, initial x-rays apparently did not reveal a fracture.

 

A specialist such as a bone and joint or foot and ankle clinic is the only thing that will do her any good at this point.

[whichwayisup]

In the meantime please buy yourself a tensor bandage for your ankle. Wrap it up and see if you can borrow crutches. Ask around and see if any co workers or friends/family can lend them to you.

 

Please go back to the DR and don't leave until they give you the attention your ankle needs, or go to the hospital. 100 bucks isn't that much money, if you can't afford it then ask your boyfriend to help out or ask your parents, or a trusted friend.

 

Ice your ankle, do everything you can NOT to put pressure on it. Read up on how to tend to a very badly sprained ankle. I hope it isn't broken, didn't like reading about grinding and moving bones, that actually sounds serious and something you need to tell the Dr.

[Phoe]

In the meantime please buy yourself a tensor bandage for your ankle. Wrap it up and see if you can borrow crutches. Ask around and see if any co workers or friends/family can lend them to you.

 

Please go back to the DR and don't leave until they give you the attention your ankle needs, or go to the hospital. 100 bucks isn't that much money, if you can't afford it then ask your boyfriend to help out or ask your parents, or a trusted friend.

 

Ice your ankle, do everything you can NOT to put pressure on it. Read up on how to tend to a very badly sprained ankle. I hope it isn't broken, didn't like reading about grinding and moving bones, that actually sounds serious and something you need to tell the Dr.

 

It's been wrapped since day one.

 

 

I thought I mentioned it earlier but I might not have. I've been using crutches all along as well.

 

 

I definitely won't be asking people for money, but I don't think the ER is the right choice for me. Like some others mentioned, there's probably not much they would do for me. I need a specialist, which means I will need a referral, which I will get taken care of over the weekend.

[GemmaUK]

I agree with your course of action Phoe.

 

I damaged my ligament on holiday and had been on crutches already for 2 weeks before I was home and could do anything 'real' about it.

 

I went to emergency and they x-rayed, found no breaks and all they did was tell me to keep weight off it and take painkillers. They couldn't even say if it was ligament or tendon damage.

 

I only got actual help when I saw a physio (luckily a very good one) who was able to tell what was wrong from my description of it and what I could and couldn't do.

Mind you, before that physio I visited another place and the person there wasn't very interested in my actual injury but was more concerned with the porition of my toes when relaxed (I have very high arches so y toes happily compensate and when relaxed are not flat flat.

I said it was no problem, never caused me any pain and that that wasn't why I was there but before I could stop her she gothold of my toes and cracked them down on both feet. It was agony!

I actually couldn't walk out of the building and booked a cab directly to the other physio..who initially treated the new ligament damage around my toes caused by the first physio I saw.

 

Get yourself a good specialist. I wasted a few weeks by visiting that first one who had no clue about feet.

[whichwayisup]

It's been wrapped since day one.

 

 

I thought I mentioned it earlier but I might not have. I've been using crutches all along as well.

 

 

I definitely won't be asking people for money, but I don't think the ER is the right choice for me. Like some others mentioned, there's probably not much they would do for me. I need a specialist, which means I will need a referral, which I will get taken care of over the weekend.

 

Sorry I may have misread or not seen that part of your reply.

 

Keep it wrapped during the day and unwrapped at night in bed.

 

Hope all went well with a referral.

[hotgurl]

So how did your appointment go on Sunday?