Severely sprained ankle, 2 weeks ago

by Brenda
(Cortland, Ohio)

Hi, I stepped down on edge of step and twisted my r ankle, went down so hard, thought I broke it. Well I called my dr to get an x-ray, as I have no ins. (Hubby lost job in sept when plant closed, presently looking for one) well I am glad to say, not broken, but it has been 2 weeks , and I can not put any weight on it. When I try, it is like electric shocks in toes and foot and heel.The swelling has gone down, and my foot is not as colorful, and I keep it up most of the time, and it still swells some. I can move my toes, an the range of motion is not as good as other foot, but I am moving it.I have been wearing a type of Velcro brace, and a type of air cast if I go anywhere, and using crutches.I did not go to the dr. Office, as unemployment does not go far, so I have been treating at home. I have also been soaking it and doing some exercise, like moving foot up and down etc.I am a very active person, and this is getting old, so I wanted to know if it is normal to take this long.I am a runner, and I have twisted it before, but usually walk with no problem. I think I have covered everything, thank you, Brenda

RESPONSE

Hi Brenda,

The question of "how long" is asked of me all the time and it is not an answer I can give with any accuracy.
There are a number of factors to consider, the most important of which is the degree of trauma the ankle suffered. Based on your narrative it sounds like it was a very severe sprain.
Assuming there was no break and I say that because sometimes small fractures will not show up initially, we do know that there was no overt break in the ankle or foot bones as a first year medical student would be able to identify that.
One caveat, in ankle sprains such as your where the foot inverts inward (inversion sprain), non-foot specialists will look to the ankle for a fracture, BUT, it is important someone takes a look at the fifth metatarsal bone as well. This is the bone on the outside of the foot, just behind the little toe.
The nature of your injury is such that in many instances the fifth metatarsal bone will sustain the brunt of the trauma and will fracture.
So, assuming you got lucky and did not break anything then we can assume you have a severe sprain, if not possible tear, of the lateral ankle ligaments which are the ligaments that attach the lateral (outside) part of ankle to the foot.
The issue then becomes how are you going to treat this since you do not have medical insurance.
The current thinking these days is to start re-habbing the injury as soon as possible, except, in those instances where the patient cannot bear weight on the foot, which seems to be your case.
It almost sounds like you are doing pretty much all you can on your own.
My only suggestions would be to start soaking the foot in warm water or use the hot part of a hot/cold pack on your foot and ankle as much as you can. You can apply the pack to the lateral side of the ankle and wrap it with an ace bandage so it stays put. Heat, opens up blood vessels which increases blood flow to the injury and it is blood that bring nutrients to the area to heal the injury.
Additionally, if you can tolerate them, I would start on a regimen of Advil, Motrin, or Aleve and take them on a regular basis as suggested in the package insert. Regular dosing helps bring downinflammation which should make the foot less painful. One word of caution: I would not take any of these medications for longer than 2 weeks as they all have side effects.
Lastly, if it hurts too much to walk on it, then wrap the foot ankle with an ace bandage and use your crutches to stay non-weightbearing.
Its been two weeks already, I would recommend that if you do not start to see significant improvement over the next 5-7 days, you may have to bite the bullet and seem additional medical attention.

see related article....ankle sprain

Marc Mitnick DPM
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