ASK A PHYSIO
ANKLE & FOOT
I have a severe high ankle sprain with pulled lateral ligaments. I was diagnosed wrong when I first did it July 15. I was trying to walk on it etc. On July 23 I went back to emerge and was told I have severe high ankle sprain etc. I have been in a regular air cast since and not walking on it. I was referred to bone specialist and thought I would get MRI by now but my appointment isn’t until the 25! Can I start walking on it next week? Start physio?? They said it wasn’t broken and my bones look good!
I’m sorry about your injury. Both bone and soft tissue injuries generally take 6-8 weeks to heal. However, it is a great idea to start rehabbing as soon as possible. There are exercises you can do to make sure you maintain range of motion at the ankle and keep strength in the areas above your injury.
You might be able to start partial weight bearing as well as long as you do it correctly and pain free. As for exercises, when your ankle is out of the air cast in the evening and morning you could start simply flexing your ankle up (toes towards nose) and down (point toes) slowly and controlled within your limits of pain. If this is pain free you could progress to ankle circles, spelling the alphabet with your toes working towards some light strength work with therabands.
A physiotherapist could definitely help you get your ankle moving again while you wait for your MRI.
Yesterday I went skydiving and at the moment of the landing, something went wrong so I had a big impact on my ankles. It didn’t hurt right afterward and now it’s been a few hours and it still doesn’t really hurt, but even though I’m not in pain, I was wondering if I might have injure myself because, like I said, the impact was quite big. What should I do?
If there is no redness, swelling, or bruising and no pain it is unlikely that you have injured yourself. It is amazing how resilient our bodies are!!
If you are concerned and want to take a precaution you can ice your ankles for 10 min – always put a thin towel between the ice pack and skin to prevent damaging your skin with the ice. Icing can be helpful in the first 48 hours after an injury, and won’t cause any harm if you are not injured.
Enjoy your adventures and take care of yourself!
11 yr boy with avulsion fracture (small) of medial malleollus. Fracture discovered today but appears to have first occurred 10 days ago. Should a moon boot be worn? What treatment & precautions are required?
Yes, without further information or assessment, I would recommend an air cast. The bone with the fracture (the tibia) is the major weight bearing bone in the lower leg and it is difficult to limit the amount an 11 year old uses his leg without a cast to help protect it! It takes 6-8 weeks for bone to heal and it is especially important in a child that bones are given the time and protection to heal well.
I would recommend avoiding any activities that involve running or jumping during this time. The cast can be taken off in the evening to allow the child to point and flex his foot (as long as this is not painful). If he finds this movement easy he can practice spelling the alphabet with his foot through motion at the ankle (https://www.youtube.com/watch?v=7iueNeAkAFo). If he finds actively moving his ankle painful, you could try gently moving it for him, again as long as this does not cause pain.
It should be emphasized that although moving his ankle during these exercises may feel stiff and awkward, he should not experience pain at all (during or after) or an increase in swelling or bruising. If he experiences any increase in swelling, bruising or pain or a reduction in the amount he can move his ankle during or after the exercise or the following day he should ice his ankle for 10 min at a time and come in for an assessment prior to resuming any exercises
I have recently followed a bodybuilding program the routine include the exercises Squats, OHP, Romanian Deadlift, Front Squats and Bench Press. Due to these exercises I have felt nerve pain in my left foot just from sitting, and I can’t point out what the reason can be. I have met a physiotherapist and he checked me out, but he said that I have to stretch my nerves but I think I could have a piriformis syndrome, why I believe so is because the nerve pain occurs when sitting and not walking. What should I do, and what exercises should I cut out of my routine?
For the time being I would recommend you cut out any exercise that makes your pain worse. You could try the same exercises with only body weight, doing them very slowing and watching your form carefully. If any of them continue to cause pain, stop doing them for the time being until you have addressed the issue. Nerve pain in your foot could be caused by the nerve being under pressure in your foot, or any where further up your leg into you gluts, or even from your back.
You could try stretching well prior to exercise, and if you have reason to believe it is piriformis syndrome you could try self massage of the glut region. To do this you could sit on a tennis ball and roll it around the muscles around your sit bone until you find an area that is especially tight. Generally it is not recommended to stretch nerves, as they are not designed to be stretched and do not need to be stretched because they do not contract and get short. I recommend you ask your physiotherapist questions regarding you diagnosis and if they think you have piriformis syndrome.
I would also ask your physiotherapist or general practitioner to make sure you do not have a problem with a disc in your low back, or problem with your sacroiliac joints. Both of these things are also common causes of symptoms such as yours, but do depend on many things such as your age and flexibility
