Should I go to the ER?

August 31, 2022 6:20 PM

YANMD. I just sprained my ankle, or did I break it? What should I be thinking about as I decide whether or not to escalate this to ER/urgent care?
posted by BlahLaLa to Health & Fitness (15 answers total)

Best answer: Well some urgent care places have xray machines....many don't
posted by aetg at 6:23 PM on August 31, 2022

Check out the Ottawa Ankle Rules. If you can independently walk 4 steps, you can probably skip the ER.
posted by shock muppet at 6:31 PM on August 31, 2022 [11 favorites]

Best answer: Oh I am sorry! For me the big thing was that after some solid RICE time with my ankle I still couldn't even walk/hobble on it, I decided to go to the ER. They basically took some x-rays, wrapped it up in a serious wrap and gave me crutches and an appointment with the orthopedist the next day who declared that I'd chipped my ankle bone and gave me a boot and advice on how to manage it. Agree with aetg, if you go to Urgent Care, try to go to one with an x-ray.
posted by jessamyn at 6:31 PM on August 31, 2022 [3 favorites]

If you can, look for a clinic that specializes in sports injuries and sprains. They may have walk-in or same day appointments.

The walk in clinic did an x ray on mine and said it would be fine in 2 weeks. 6 weeks later the sports clinic did an ultrasound and confirmed I had damage to 2 ligaments and gave me proper PT and a game plan. Sprains really need good evaluation and PT (which you can do at home). I didn’t, so my ankle is still pretty screwy 2 years later and took months to settle down.

See someone who knows what they are taking about and can get you in quick.
posted by Crystalinne at 6:47 PM on August 31, 2022 [1 favorite]

If you have insurance, you might have an advice nurse you can call to help you make this decision.
posted by aniola at 7:15 PM on August 31, 2022 [5 favorites]

Is the swelling general or very very local? Local more likely to indicate break.
posted by supermedusa at 7:24 PM on August 31, 2022

Depending on your location you might have a dedicated orthopedic urgent care near you / that will take your insurance, etc. We have one in our relatively small city and I get the impression that they're becoming more of a thing. It's great for things like this, where it's maybe not ER worthy but your average regular urgent care might not be able to do the diagnosis you need.
posted by macfly at 7:47 PM on August 31, 2022

I would RICE until tomorrow morning and if it is not showing any signs of improvement then I would go to urgent care with an x-ray machine. Even if it is broken or fractured or chipped, 12 hours of rest will not harm it. If the swelling goes down, the x-ray may be clearer.
posted by JohnnyGunn at 8:16 PM on August 31, 2022 [1 favorite]

It is possible to sprain your ankle so hard that it breaks your foot. I speak from experience - it's called a Jones Fracture, and a lot of times the people who have one think that they just had a bad sprain and put off going to the doctor and try to walk around on it - and the break heals improperly and they have to get surgery. ....By contrast, when I had one, they said that because I hadn't been walking around on it I would only need a boot cast for 2 months and I'd be fine. I bounced back way faster that Jones Fracture patients usually do.

I'd follow Johnny Gunn's advice - that's pretty much what I did; I stayed home and RICEd for 2 days (it was a weekend) and went to the doctor when it still wasn't better, and that's when they found it. If it is just a sprain, then at least you'll know for certain.
posted by EmpressCallipygos at 8:19 PM on August 31, 2022

I was a pretty active athlete in college and sprained my ankles rather badly about 10 times and each time, even when they were "better", the pain would come back for months, especially if I wore shoes with a certain heel height.

Then one time I sprained it excruciatingly badly and the first diagnosis was a bone chip. I got crutches and did zero weight bearing. After a few weeks, on a check up x-ray, they said it might never have been chipped after all. I decided I trusted the first diagnosis better and continued zero weight bearing for a month. I also soaked it in ice water every day (apparently the vascular constrict / dilate cycle helps speed healing). It finally healed, better than it had ever been, and the painful shoe-heel height that I couldn't tolerate for over a year has been fine ever since.

All this to say, people tend to brush off ankle sprains, but resting it aggressively (can you aggressively rest something? I sure tried) can really help.
posted by nouvelle-personne at 9:05 PM on August 31, 2022 [4 favorites]

I would try to go to an Urgent Care with an X-Ray tomorrow. If they think it is more serious than what they can handle, they will refer you to the ER. That also may help in terms of your insurance paying for it.
posted by spinifex23 at 9:18 PM on August 31, 2022 [1 favorite]

Response by poster: Okay so I went to an urgent care that does x-rays...and it's broken. Now I have a splint and I have to follow up with an ortho. Thanks for the assistance.
posted by BlahLaLa at 9:51 PM on August 31, 2022 [22 favorites]

I sprained my ankle badly in lockdown - definitely a sprain not a break - but wasn't able to get any help from the NHS due to it not being an emergency. As a result, relying only on elasticated support rather than a stabilising boot, it didn't heal properly and still gives me some trouble today, 18 months on. I have to do a lot of exercises every day, rotating it, manipulating my toes, etc. which helps but it would have been much better at the time if I'd been able to get a boot for it. So I would say get it checked out and make sure you get the correct support for it.
posted by essexjan at 1:24 AM on September 1, 2022

Also, sprains are actually worse to recover from than breaks according to my orthopedist. The orthopedist who also told me I too had sprained my ankle so bad that it broke my foot. Womp womp. Two weeks in a walking boot and a full year to feel back to normal. Foot still tender sometimes.

Wishing you a speedy recovery!
posted by lydhre at 12:38 PM on September 1, 2022

Response by poster: Got to see an ortho today -- a weird stroke of luck, with my GP pushing the referral thru + the ortho having a single slot open before the 3-day weekend -- and it turns out it's not a terrible break, so I have a boot and a 4-6 week recovery. That feels like the best of all possible outcomes and I'm thrilled that I got to take a shower.
posted by BlahLaLa at 6:42 PM on September 2, 2022 [4 favorites]