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ankle injury

17 replies

shouldwestayorshouldwego · 03/06/2017 09:25

Dd (age 10) landed awkwardly on her ankle a week ago. It swelled up somewhat and she was not weightbearing immediately afterwards. She was in pain but not substantially - 5/10 according to her. We were fairly remote and took a watch and see approach. By Mon it was looking more swollen so went to minor injuries and had x ray on Tuesday. No apparent fracture. Tenderness is only over the bone (sticking out bump on outside of ankle I believe is the technical term 😁), as noted by the nurse practitioner not the ligaments. They were happy to discharge without further treatment.

It is still swollen, weightbearing but still hobbling as much as when first injured a week ago. Just wondering if/ when we should go back to GP.

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RedBugMug · 03/06/2017 09:30

I would go back.
even a soft tissue injury should be much better by now.
some breaks only appear on fine scans (mri or ct) or when the bone starts to heal.

shouldwestayorshouldwego · 03/06/2017 09:34

That is my concern RedBugMug wondering if need to go to OOH or wait until can see GP next week.

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Penfold007 · 03/06/2017 09:38

I'd go back to Minor Injuries unit as it may need another X-ray.

RedBugMug · 03/06/2017 09:41

stupid question:
has she rested the foot well?
cold compresse?
will the swelling go down if she puts the foot up and only walks to the loo and the table to eat?

nearlyfinishednearlystarted · 03/06/2017 09:55

It may need another x ray - depending on pain & swelling - it may be better to go today? Is the swelling getting worse? Does it feel very tight to her? If so then go today.

Put her foot up on a few cushions and ice it for 20 minutes on then 20 minutes off.

Does pain medicine help ?

shouldwestayorshouldwego · 03/06/2017 10:07

Have had cold compress and ibuprofen - though not full dose - mainly at night to sleep. Still very tender to touch. She has had it up most days - have been in car and she had it up on chair in front. She had one day of unavoidable moving around due to funeral but she still rested it quite a bit. I have been letting her judge how much to walk as they said to treat it as a sprain and keep mobile. Maybe I should enforce more rest, ice and elevation over the weekend. Will be a different hospital to the first one.

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nearlyfinishednearlystarted · 03/06/2017 13:32

I would go back in. It should be on the mend not just the same.

shouldwestayorshouldwego · 07/06/2017 06:42

We went back to see GP (as outside 48hrs need GP referral). Said thought probably a torn ligament because immediately after accident she did bear some weight on it - she hasn't ever walked normally since the accident though. We have been given some exercises and told can tubigrip it for walking. It could be 6-8 weeks or more to heal.

She is refusing to weightbear at all now - will not put it on the ground (was like this when saw GP). She screams when put tubigrip on but says it feels better with tubigrip once on but still won't put weight on it. She is getting good at hoping everywhere but she is still on half term. I don't know that I can send her back to school like this. Would they be likely to give her crutches so that she can be controlled in her movements? She hops as if she has a skipping rope - using her arms for balance (or leans heavily on me for support). I can't see this as being practical when she is in a busy school. She relies on me to help her in and out of cabin bed and up and down stairs. Her classroom is up three flights of stairs. She is resting as much as possible and doesn't need reminding to put her foot up. Still somewhat swollen and can't be touched although sometimes she says it is numb and tingling. Just wanting to know timeframe to ring dr again about crutches.

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shouldwestayorshouldwego · 07/06/2017 06:59

Looking at a picture it would be in the site of the Calcaneofibular ligament.

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LIZS · 07/06/2017 06:59

They don't recommend crutches etc now as the best treatment is to keep flexing the joint otherwise it can stiffen up and trigger more issues and a longer recovery period. She needs to follow the advice to exercise it, write letters and shapes in the air with her toes for example and weight bear. I suspect she may be better when she goes back to school as she'll be distracted and while it may take longer to move around, perhaps you could ask that she can do so before the bell goes to avoid risk of knocks. You could try a physiotherapist for an assessment and treatment, such as through the local sports centre. It can take anything from 6 -12 weeks to get normal movement back with less swelling ime.

Toffeelatteplease · 07/06/2017 08:16

Speaking as a family who are prone to sprains and strains (hypermobile joints). Torn ligaments can be agonising for weeks. DD was still on ibrupofen/paracetamol round the clock and applying ice packs at this stage.

Those microwaveable wheat bags put in the freezer are better than cool packs. They mould to the body better and don't get too cold but hold the cold for a long time. 10 mins max

If you can keep walking without crutches that's better but otherwise yes definitely to crutches. Explain it is to help her weight bear, not so she can swing her ankle through. SHE MUST WEIGHT BEAR this is so important but there are some (very very rare but just so happens I have had) complications that can be avoided by continuing to weight bear and it reduces muscles loss (which is important for holding ligaments and tendons in place). It is easier with crutches as you start with just putting the foot to the floor as you walk but taking most of the weight through your crutches.on a particular bad injury at a two weeks I was still reminding DD of the need to do this and not swing the leg through as she found it very painful. Only at four weeks I had removed the crutches from her since she didn't need them but was nervous to do without. But it took this long for her to full weight bear. Healing sprains is slow and isn't easy, but the more you can keep it moving (on land or water) the better.

Dump the tubigrip (what doctor is still giving out tubigrips?!?! They do nothing literally) in favour of kinesology tape. It's what the athletes use and it's aim is to promote active healing. It helps hold the ligaments and tendons in the right position while they heal. Ime it is incrediable stuff and may provide the necessary support your DD needs to get foot to floor and walk on it. For ankle you need roughly forearm length straps wrapped under the foot crossed on the top of the ankle and run up the leg. Basically dping the job of a tendon. You can search kinesiology tape ankle injury on you tube but not one that mummifies the ankle, less is quite definitely more. ( If you actually get one) your NHS physio won't approve and will tell you off (they want you to full weight bear regardless), but a private physio will be doing it for you. If you can afford to get to a good private physio it is worth trying to do.

Watch out for repeat injury after. If at 2-3 months you find your DD is still failing over and twisting it on a semi regular basis, at that point she absolutely needs physio. NHS is fine but will take a while (3 months in our area). Private better because it is quicker. We have used both depending on finances.

Add another 6-8 weeks recovery time everything it twists again. You really want to avoid this so its worth thinking about shoes!!

On shoes it will be sensible shoes all the way for a while... She will find something like memory foam trainers easier at the start (they absorb some of the impact of the heelstrike reducing the pain of getting the foot down) but they don't really offer a fantastic level of support. At a barest minimum, something with a decent heel cup (think the footbed of a birkenstock) so the ankle and foot is held in the right position, and a way of securing it over the top. She may find long walks quite sore for quite some time after and that when it's tired it is more prone to twists and turns. You want to support the ankle well to prevent this. I found it a tug of war with DD over the demands of peer pressure etc, but if she is walking any distance she will wear dr martens all year round and (after a few shoves in the right direction by physio) will now wear kickers for school. DS wears kickers almost full time. I wear Dr Martens and ankle walking boots if I am walking anywhere with uneven ground. Mostly I can get away with decent sandles on the flat in summer.

Good luck and she has my sympathy. It's miserable.

Toffeelatteplease · 07/06/2017 08:51

They don't recommend crutches etc now as the best treatment

No but they will give them if the injury is substantial enough you are going to have trouble weight bearing without support. Sometimes they are the only way to retain natural movement whilst the tendons/ligaments heel enough to full weight bear.

DD has been given them twice. First time she used them for a month (she had bent her ankle entirely back) second time just 2 weeks. However both times I had to ask but they were more than happy to give them to her. But if i hadnt asked they would have just left her without any weight bearing capability whatsoever. Diabolical.

Toffeelatteplease · 07/06/2017 09:05

Sorry so much so say....

Yes it's needs resting but it also needs movement. The longer she doesn't have it moving for the more hurty it will be to get foot to the ground and move. So generally on a sprain getting it moving will be agonising after a nights rest, then it will feel OK, then it will tire easily and needs resting (with cold pack ibrupofen and occasionally flexing). It's it's hard after a nights rest you can imagine how hard it will be if she hasn't put it down for a while. She does need to understand this to understand that getting it back moving will be hard and will be painful (our instinct is to avoid pain) but it is still necessary.

As well as the stuff in my first post , Try the bath or swimming pool for getting it moving again and putting it down.

shouldwestayorshouldwego · 07/06/2017 09:42

Thank you both. We have managed to source a crutch and she is walking more normally rather than flailing wildly. I was concerned that she would injure something else in the process. She has done her exercises - she could stretch up and down a little, and twist slightly but couldn't circle it. Will try to do it throughout day.

It was after swimming that she couldn't put her foot down at all, so might wait a while before doing again. Baths have been good. Might try to find a private physio to show me how to strap it. It's not all the time but to make the pain bearable when we go out - e.g to piano lesson.

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Toffeelatteplease · 07/06/2017 10:01

One not two!!! One crutch is really hard to get right. Two you keep the body upright and symmetrical. Unless you really know what you're doing on one its really easy for the "good" side of the body to overcompensate causing further problems.

The kinesiology tape you can put on and leave. 20 odd years ago when I first had it the sticky was so strong you literally couldn't get it off!!

Yes to private physio if you can, especially given the trouble she has had getting it down. Mine only charged £90 for three half hour sessions to sort a (this time not ankle) injury for DD. She did it (kinesology tape + exercise) and in a fraction of the time of the NHS wait to start treatment.

LIZS · 07/06/2017 10:26

I found swimming made it worse so perhaps go easy on that for a while.

shouldwestayorshouldwego · 13/06/2017 22:56

Just a kind of update. Another x-ray still doesn't show a fracture. She has crutches from hospital now, still not weightbearing, still in considerable pain -taking ibuprofen and paracetamol. We have first physio appointment at the hospital tomorrow. She also seems very tired which is unlike her. She still complains of numbness. Still swollen although she has a little more mobility and although she screams still if she accidentally bears weight on it or someone touches it she will gently give resistance against my hand. I would say baby steps, but maybe not quite at that stage, hopefully physio will help.

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