Trying to get on the good foot but this sprain isn't helping

April 5, 2012 9:02 AM

An old foot injury is kicking up. Your advice and experiences wanted.

Two years ago, I sprained my left ankle and twisted my left foot, both of which swelled and hurt like a son-of-a-gun. Like a big dummy who couldn't take time off work, I hobbled around on it for a day before fetching up in the urgent care, where I got a split and crutches. I still couldn't take much time off work, so only had one day actually off the foot.

It never healed correctly. My ankle still hurts sometimes, especially when I go down stairs. My foot is permanently wider. But the worst part is the pain from the foot injury, not the ankle. The pain runs in a line from the fourth toe to the ankle - sort of a long pain that seems to run between the metatarsals. It's sometimes markedly uncomfortable now, but I am more worried about the future, when I'm properly old instead of in my thirties.

Before I bother going to the doctor, here's what I want to know:

1. Is this common after sprains? Do they often fail to heal completely? Or do they just take a really long time to heal? What has been your experience?

2. Is there anything you'd recommend now as a home treatment, given that it's so long after the injury?

3. Although YANAD, do you have any thoughts about what might be wrong?

4. Is this worth seeing a doctor for? It's painful, yeah, but in your experience is this type of thing fixable?

posted by Frowner to health & fitness (5 answers total)

The usual RICE (rest, ice, compression, elevation). Add some NSAID type pain pill.

Generally, the injury needs time to heal. Then some rehab - think stretching and strengthening work to help prevent it from happening again.

It's possible to tear the ligaments such that you need surgery.

(I used to wonder how folks who sprained their ankle were hurting so bad, until I severely sprained mine. Doc said once you've done a major sprain once, you are more likely to do it again, and may need surgery to fix the tear.)
posted by k5.user at 9:10 AM on April 5, 2012

Your symptoms sound very familiar. I sprained my ankle badly once and it swelled up and was a mess of pain. When I went back to the doc after a few days because I was still in agony I asked if they had x-rayed my foot and it turned out that they had not. They did that and it turned out that one of the bones in my foot was broken. I wore a cast for a month and it's never bothered me since. It sounds like you might have had a similar break that the doctors missed.
posted by mareli at 10:40 AM on April 5, 2012

That sounds to me like it could be a hairline fracture that isn't healing properly. They hurt like a bitch, and they heal much more slowly than an actual break, and because of that there's a greater risk of re-injury before it fully heals.

I'm not a physician, but I've had more than 70 hairline fractures — several years ago I had a bone disease that caused them to occur all over my skeleton. Two things you said in your question made my ears go straight up: your mention of pain when going downstairs, and the part where you describe the metatarsal pain. Bone pain is surprisingly difficult to pinpoint.

I'd get a few x-rays of your foot and ankle to rule it out.

Also, just on a tangential note: if your doc gives you pain meds for this, think carefully and logically about how comfortable you are with the idea of blocking pain signals. I found that I would constantly re-injure myself, especially my feet, when I wasn't keenly aware of the pain. Pain is your (super annoying) friend, unfortunately.
posted by heyho at 1:03 PM on April 5, 2012 [1 favorite]

yes, once you've sprained it it's very easy to re-injure even years later if it's not completely healed (which takes forever and ever), and it might hurt sometimes too, especially if you're stressing it with exercise etc. The pain you describe sounds worse than normal though, especially since the sprain was so long ago, and it'd be worth checking out to see if you've torn a ligament or something else that you might be able to fix with surgery. It sounds like you might have done more than sprain it.

There are some ankle exercises you can do to regain strength and flexibility which might help prevent future injuries - these can be found online or taught by a physiotherapist. I'd get the pain checked out first, though - you might make it worse if it's something more than a slowly recovering sprain.
posted by randomnity at 1:06 PM on April 5, 2012

It could also be a ligament issue (I think it is ligament, not tendon.) I have the same type of pain on the top of my right foot, my podiatrist gently manipulates the ligament back into place and the pain goes away for a few days. Eventually I am going to have to have surgery on it, but for now, I deal with it with rest and going back when the pain gets too bad.

If you can take NSAIDs, they will often prescribe those for it. (I cannot) They should definitely do x-rays as well, as a hairline fracture (as many have suggested) is a possibility and it will not heal on its own.

Good luck with the foot!
posted by SuzySmith at 11:57 PM on April 5, 2012