Dear oracle.

I'm coming to you for advice as you know everything.

On Friday afternoon, during our usual end-of-working-week game of five-a-side, I damaged my ankle. I'm not sure whether I heard something tear or just felt it. What I do know is that it is the most excruciating amount of pain I have ever experienced (even more than sneezing with two broken ribs). The lads put me into a car and drove me through to A&E in Grantham.

I had an x-ray and the doc said, as far as he could see, it's not broken but badly bruised – although he didn't sound too convinced and even said that he'd revisit the x-rays on monday. As it's only badly bruised, I should be on my feet in a day or two, but that it'll still be sore.

My question is this… I "think" I heard a rip/tear noise (one of the other lads said he heard something too), how would the A&E doc know if there had been any ligament/tendon damage? It wouldn't show on the x-ray, would it?

After two days, it's still as sore and the co-codamol 30/500 is barely touching the pain. Do I go and get a second opinion or just MTFU?

Sounds like tendons to me I did they same in a very similar way, it will repair itself around week to 2 weeks if I recall correctly. Although after a day it was only painful to put weight on not resting.

I can't put any weight on it at all, In the above pic, I'm holding the foot just off the floor. It absolutely knacks.

However, two week repair doesn't sound too bad, if possible. Thanks.

thats quite an oedematous foot/lower limb you have there…
i would be visiting again for a 2nd opinion just to be on the safe side.
in the meanwhile follow the p.r.i.c.e procedure as much is as reasonably possible.
tendons healing in 2 weeks! you lucky thing if they did!
i would also look at some physio for it too, it'll help you gain full rom and quicker full recovery.
best of luck to you.
edit. just seen yr reply, if you cannot weight bear then deffo go back for 2nd x ray

Cheers Phillips (although I had to google oedematous 😳 ). Back to the same A&E, QMC in Nottingham (17 miles) or the village GP tomorrow?

Edit: I'll head over to QMC tomorrow morning then. Ta.

a lot of swelling and pain for a sprain but they can be like that. Diagnosis between broken and sprained ankles is often hard to do bu that needs another look at it. gp if you can an appointment easily has he should be able to refer you to the hospital for x rays missing out the queue in A&E.

Definitely needs someone to have another look at it tho. today or Monday

Thanks TJ. The triage nurse mentioned, while chatting, that 'you just know' when there's something wrong. I'm inclined to agree.

The hosptal was great though. No complaints about speed of treatment.

As it's only badly bruised

Sprains can be worse than breaks in some instances. I was told that my ankle would have healed better if I'd broken it rather than torn ligaments. It took me nearly 3 months to walk normally on it and that took twice weekly physio.

Bear in mind i have very skinny feet and ankles normally, at an outpatient appointment 8 weeks on the consultant mentioned that there was no swelling left which was a good thing and I had to point out that he might want to compare it with my good ankle/foot before judging that!

I only got an x-ray 3 weeks after the initial injury after being referred by my gp, he told me that 80% of the people he refers, who already visited A&E once, with ankle injuries end up having a broken ankle. I wasn't one of them though, mine turned out to be tears in the syndesmotic ligaments which hold the tibia and fibia together. Unfortunately as I'd been told to keep trying to walk on it since it's only a sprain, the bones have healed slightly farther apart than they used to be.

As mentioned there's a huge amount of swelling there that needs looked at, ankles aren't that hard to diagnose of broken not and using X-rays for ankles is not really necessary unless you fail the Ottawa test. If you struggling to walk on it then it's a strong suggestion that's it's broken. Back to A+E for you as they now have records to compare against to see how it has progressed.

I've had a 3 ankle sprains playing badminton – the ones where you hear a dodgy tearing / clicking noise, followed by a ton of pain 🙂

You will be lucky if its better in two weeks – you could be looking at at months depending on how bad it is. You really have to be careful in the future with your ankle now as it's probably weakened, which makes it more likely to happen again causing further damage and sadness 🙂

Perhaps worth getting a second opinion. I had mine xray'd and one thought they could see a slight break, but she was basically overruled by someone more senior. It's still not 'right', and I did the last one about a year ago.

my two weeks memory is a bit hazy, but i was a teenager at the time, and i don't remember hobbling around for long.

OK, sprained ankles in several easy steps…..

Everyone always hears something snap or tear and it's therefore a rubbish indicator of how much damage you have done. We ignore it.

There are a set of rules for which ankles get x-rays and which don't (called the Ottowa ankle rules as they were invented by a bunch of Canadians in Ottowa). These have been validated to pick up over 99% of significant ankle fractures.

If you got an x-ray it's coz you met the Ottowa ankle rules criteria and needed one, this doesn't necessarily mean it's broken just that it needs an x-ray to rule it out.

All A&E departments have a back up of x-ray reviews to make sure no-one misses anything. Most A&E docs should be able to pick up significant fractures but every now and again we miss something tiny (our current miss rate is less than 0.5%). Your x-rays will be reviewed by a consultant x-ray doc in the next few days. If A&E have dropped a clanger they will ring or write to you depending on how quickly they need to see you.

If it's not broken it's the ligaments not the tendons. (Tendons attach muscle to bone and move things, ligaments hold stuff together and stop things falling off.)

As stated above some sprains can take longer to fix than broken things, I tend to give 4-6 weeks as my usual guesstimate.

Best advice is to stay off it completely for 48hrs and then slowly get using it again; building things up slowly. Took me four weeks to even get back on my bike last time I did it.

The last thing to fix is proprioception (joint position sense) and is the most important bit for balance (and therefore not going over on it again). This can take months to fully repair. Wii balance board games are good for helping this fix although something simple and easy is trying to balance on one foot for a couple of minutes (this will be surprisingly difficult at first).

Physio may help if it's not settling.

Hope this helps….

Any questions fell free to ask!

Oh, and if the co-codamol are not helping you can take ibuprofen as well as long as you don't have any problems with it.

If we are having foot pics, here's mine.
7 pins and a heel plate in there.
1 year off work!

Hope you get it sorted freddy and don't end up like me!!! 🙂

Wow. Thanks Dr_Death ( 😯 ) et al.

I feel a bit better, especially as you've just confirmed that what the A&E doc did was standard practice. Me and MrsG are now suitably re-assured.

BTW – I am also taking ibuprofen as well as the co-codamol…… any advice for the constipation? 😆 (haven't 'been' since friday – maybe the jolt has rendered my digestive system so efficient that all I'm going to 'pass' from now on is gas!)

Bloody hell Soops!!! 😯

Are you okay now?

Fell 25ft, so happy to be here!
Suffer every day with it, lost 50% of movement.
Did it 7 years ago so have got used to how and when it is going to play up from doing too much on it. Usually every day!!!!
Take it easy with it, i am sure you will be ok. 🙂

Smashed calcaneum then…… a.k.a. Burglars fracture!

(FreddyG – Senna, fruit and ghost stories)

Cheers Dr_Death. I've been on a veggy diet since I started on the co-codamol. Hence the gas…. Years ago a coffee and cigarette would have sorted me. I don't smoke anymore so I'll go seek some senna. Thanks.

Ha try taking Dihydrocoedine then you know what it's like to be bunged up, now on it regualarish for repeating kidney stones.

The funny thing is, I don't feel bunged up/ready to burst – Friday lunchtime was the last time I went, and I just don't feel like going! Odd.

Having just got back from A&E with a sprained ankle I now feel I can contribute to the thread!

Had the x-rays and the tests and nothing broken, so given some painkillers and anti-inflammatorys and sent home.

Been told to take it easy and no sports for a few weeks then to see how it goes.

Best bit was when she said no sports my Dad jokingly asked 'Does that include watching?'. The nurses reply 'Well he can stand at the sink' took me by surprise. Oh well, it's late so I'll give her that one.

I heard that dr_death, but i fell whilst climbing because of some twunt not concentrating on the other end of the rope!!! 👿

Exactlty how felt the other day freddy but then started with pains but they lasted only an hour or so, well wasn't pain more a discomfort. Drank loads of fresh orange and that worked after a good while.

"If A&E have dropped a clanger they will ring or write to you depending on how quickly they need to see you."

I fell over on black ice going to rescue my 2 year old son who had done the same (having been told 'don't go over there, it's slippy') and thought I'd wrist.

My wife thought I was overreacting but reluctantly let me go to a&e where an x-ray was taken and a 'sprained wrist' diagnosis was made. Queue much 'I told you so' type noises plus a moan to her best freind.

the following day we received a call at home (I was out) from a Dr 'from x-ray dept' sayign they had reviewed the x-ray and thought it was possible I had broken my scaphoid after all and could I keep an eye on it.

My wife assumed it was her freind on a wind up and refused to believe it was a genuine call. It all ended with the Dr saying in a tone of voice that clearly indicated she thought my wife was a bit touched to 'be sure to tell your husband I called'.

It was only when she did 1471 afterwards that my wife realised it had been a real doctor 🙂

My wrist did turn out not to be broken, just badly bruised etc.

You got feet like Frodo 😆

Some very unleasant looking injuries here!

I too would be heading out for a second opinion. Tendons healing in weeks, not likely, took about 2-3 years for mine to return to normal, but it was usable in weeks, just kept locking up randomly like someone had tied knots in them!

waynekerr – Member

You got feet like Frodo

😆 You were warned….

Leg doesn't look any better this morning, although a bowl of muesli and a gallon of grapefruit juice sorted the other problem. 😉

Similar here.
Football injury.
Some one told me to apply cold as long as yu can stand then hot as long as you can stand.
Brakes up the blood crystals and increases circulation ??
Sounded like hard work to me so just took it easy.
Maybe walking in a few weeks, but a few months before proper strong – although riding was fine.
Wii fit sounds good.
Or a wobble board – top shop will have a cheap version
http://www.return2fitness.co.uk/Rehabilitation/Wobble_Boards?gclid=CLPz09vE4p8CFRhp4wodDzRFHw
J.

Cheers J.

The wobble board looks a good idea – it'll be a while though, I still can't put any weight on it, although it's still only just over 2 days…

Going to sit tight for another 24hrs. If still no joy, I'll go to the GP tomorrow afternoon.

I went over on my ankle once playing cricket – chased a ball to the boundary, flicked it back and ran on into the longer grass where I stepped half down a rabbit hole. I think all on the field heard the tearing, followed by a ton of swearing.

That took weeks to heal and after i was continuously going over on it, until a proper sports physio told me how to tape it properly to provide that extra bit of support; then subsequently someone else recommended a semi-rigid lace up ankle brace which did the same job. Worth seeking out all you above that might benefit.

http://www.return2fitness.co.uk/Supports_And_Braces/Ankle_Supports/soccerank196

Update….

I decided to go back to A&E this afternoon as the swelling was a little worse today.

I am now in plaster from toes to knee for the next 4 to 6 weeks. I'm not overly thrilled at the prospect, but having my ankle immobilised feels loads better.

Public thank you to Grantham A&E; I was seen by a triage nurse, doctor, x-rayed, back to doctor and plaster on in just under 2 hours. Top stuff.

Torn tendons IMO.

I dislocated my foot and snapped my shin a year a go and had the exact same symptoms.

Post op for plate in shin and 6 weeks cast off…

Another question (I forgot to ask the doc yesterday)…..

As I've now got my foot in plaster and ankle immobilised, will I be okay to drive the car? I'm not into left-foot-braking, so will only use the gammy leg for clutch duties.

Ta.

Driving is something you'd have to check with your insurance company.

You need to check with your Dr and the DVLA/insurance but doubt you can drive with a cast on. I wasnt allowed to drive with an uncast break and 3rd degree sprain (severed ligament, apparently you shouldnt be able to walk on it but I managed ok…) until the DVLA & insurance had confirmation from my physio I was fit.

I walked around on that for 3 weeks after a french hospital missed the break. I was given a strap on plastic cast and sent home, it wasnt till I got in to see a physio privately he had it xrayed with bupa and the diagnosis confirmed. In the UK it would have been operated on and Id have been stuffed for at least 6 months. As it was kept moving but immobilised in the correct way, with the help of physio I was pretty much normal after around 4. But then Im bloody minded, see being able to walk on something with bruising worse than anything else I could find on the internet ;oP

I had an auto and my insurer said is technically legal but said if I had an accident the other party would target my injury as probable cause….not a leg to stand on so to speak 😉

Driving is something you'd have to check with your insurance company.

DVLA and Dr is your best bet.

Don't drive with a pot on. Your insurance company will look for any excuse not to cover you and that would be just what they needed…. and you'll break it.

Did they spot a break after re x-raying it or just a pot for ligament damage??

Hello again Dr_Death.

The second x-ray confirmed that there was no break; the second A&E Doctor was concerned with the amount of swelling and wanted to verify that the foot was okay too – the previous x-ray was of the ankle and lower fib/tib. They've potted it to immobilise it (only ligament damage) and to help control the pain.

I've got a visit to the soft tissue clinic in two weeks booked.

Many thanks.