FOOT AND ANKLE INJURY

Injury Definition

  • Injuries to a bone, muscle, joint or ligament of the ankle and foot

Types of Injuries

  • Fractures (broken bones)
  • Dislocations (bone out of joint)
  • Sprains - Stretches and tears of ligaments
  • Strains - Stretches and tears of muscles (pulled muscle)
  • Contusion  (bruise) - A direct blow or crushing injury
  • Achilles Tendon Rupture - Pain in the Achilles tendon (area above heel and behind ankle), with weakness or inability to extend the foot (e.g. can't stand on tiptoes).

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WHEN TO CALL YOUR DOCTOR FOR FOOT AND ANKLE INJURY

Call 911 Now (you may need an ambulance) If:

  • Major bleeding (actively bleeding or spurting) that can't be stopped. FIRST AID: Apply direct pressure to the entire wound with a clean cloth.
  • Limb has been partially or completely amputated
  • Injury looks like a dislocated joint (crooked or deformed)
  • Bone sticking through skin

Call Your Doctor Now (night or day) If:

  • You think you have a serious injury

  • Severe pain
  • You can't stand (bear weight) or walk
  • You are over age 54, have osteoporosis, or use steroid medications routinely

Call Your Doctor Within 24 Hours (between 9am and 4pm) If:

  • You think you need to be seen
  • There is a large swelling or bruise (wider than 2 inches) at the site of the injury
  • You are limping

Call Your Doctor During Weekday Office Hours If:

  • You have other questions or concerns
  • Injury interferes with work or school
  • Injury and pain have not improved after 3 days
  • Injury is still painful and swollen after 2 weeks

Self Care at Home If:

  • Minor bruise
  • Minor strained (pulled) muscle or sprained (stretched) ligament

HOME CARE ADVICE FOR MINOR BRUISE, SPRAIN OR STRAIN

  1. Treatment of Minor Bruise (e.g. direct blow to ankle or foot):
    • Apply a cold pack or an ice bag (wrapped in a towel) for 20 minutes each hour for 4 consecutive hours.  (20 minutes of cooling followed by 40 minutes of rest for 4 hours in a row).
    • 48 hours after the injury, use local heat for 10 minutes 3 times each day to help reabsorb the blood.
    • Rest the injured part as much as possible for 48 hours.
  2. Treatment of Minor Sprains and Strains of Foot and Ankle:
    • FIRST AID - Wrap with a snug elastic bandage. Apply an ice pack  (crushed ice in a plastic bag covered with a towel) to reduce bleeding, swelling, and pain.
    • Treat with R.I.C.E.  (rest, ice, compression, and elevation) for the first 24 to 48 hours.
    • REST the injured leg for 24 hours. You may return to normal activity after 24 hours of rest if the activity does not cause pain.
    • Continue to apply crushed ICE packs for 10-20 minutes every hour for the first 4 hours. Then apply ice for 10-20 minutes 4 times a day for the first two days.
    • Apply COMPRESSION by wrapping the injured part with a snug, elastic bandage for 48 hours. If you experience numbness, tingling, or increased pain in the injured part, the bandage may be too tight. Loosen the bandage wrap.
    • Keep injured ankle or foot ELEVATED and at rest for 24 hours. Keep your foot up on a pillow and stay off your feet as much as possible.
  3. Pain Medication: For pain relief, take acetaminophen every 4-6 hours (e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours (e.g. Advil, Motrin; adult dosage 400 mg).
    • Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
    • Do not take acetaminophen if you have liver disease.
    • Read the package instructions thoroughly on all medications that you take.
  4. Expected Course: Pain and swelling usually begin to improve 2 or 3 days after an injury. Swelling is usually gone in 7 days. Pain may take 2 weeks to completely resolve.
  5. Call Your Doctor If:
    • Pain becomes severe
    • Pain does not improve after 3 days
    • Pain or swelling lasts more than 2 weeks
    • You become worse or develop any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Adult HouseCalls Online. Copyright © 2000-2004 David Thompson, M.D. FACEP

Reviewed 8/2004

Revised 8/2004

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