Ankle injury - physio ?

[LIZS]

I twisted my foot before Chritmas coming down stairs and sprained the area just below the ankle bone. Did the RICE treatment immediately, it swelled a little and was very bruised for about 2 weeks but was able to drive and weight bear after the intial few days of rest. Rested it a lot and wore support bandage but a month on it is still restricted in movement (can't fully flex the foot)and I get various points where it becomes achy and sore if , for example, I crouch down to look in the oven and go onto ball of foot, but no persistent pain.

Does it sound as if I need physio ? If I go to gp now am I likely to be dismissed as the injury was so long ago. I possibly could go private but would still need a gp referral. Due to go skiing in 2 months but couldn't possibly get the boot on yet and can't exercise !

I would go to the GP and ask for a referral to an orthopedic surgeon, someone who specialises in sports injuries. I would not be fobbed off to physio. I think you need an e-ray / mri to at least rule out any structural damage (cartilage, ligamens, bones, etc).

And I'm sorry to say the ski trip doesn't sound very promising...

somewhere like this

Thanks , I hope it isn't that serious. Have sprained it unmpteen times before and it has recovered eventually but just seems more of a pita this time.

If it makes you feel any better, I twisted my ankle at Tower Hill tube station almost a year ago. Kept thinking oh it will get better -- ten months on it still hurts when I run. I think maybe i should get round to seeing someone. I just hate the NHS. I know they'll give me a band aid and tell me to go home and take two tylenol rather than trying to fix the problem.

I don't want a coping strategy. I want to go running... duh!

Sorry, I'm a tad anti NHS.

I know what you mean . When living in Switzerland I could have self referred and got it sorted out on Insurance but with small kids, school runs, commitments etc never got around to it. Now I have woman from Norwich Union insisting I must go via GP to begin with and then they'll see ! Got dental surgery scheduled for Friday so it aint going to happen yet anyway , can only handle one thing at a time.

You don't have to have a GP referral for physio if you don't mind paying privately. I self-referred last week with a calf injury that won't heal. I paid £30.

Just checked our local private hospital - initial consultation is £82

Don't want to sound full of doom Liz, but I think you should go for referral. Could be so many things and even if it is a bad spain you may need rehabilitation excercises in order to regain full strength and mobility.
Physios vary massively in my experience, its worth asking around for recommendations.
I was recently treated for a sprain and had 4 months of weekly physio on NHS! It is OK now, but I still wear special strapping for running and netball. Think you need to get is sorted asap if you want to go on your trip!

That's most likely because the private hospital will take a cut of the fee maybe? I found my physio by looking in yellow pages and then asking my colleagues in local running club which one they recommended.

It's a 3 partner business run from converted house in the town... not mega posh surroundings, but the physio himself seems very knowledgable and capable and well-equipped.

guess I'll be calling gp on Monday

Hi Lizs, I'm a physio and from your history I would definately recommend you see a physio....chronic ankle problems like yours are worth getting treatment for as they just tend to re-occur again and again without some rehab. As the previous posters have suggested I would probably recommend seeing a private physio asap as your skiing trip is not far away. You can at the same time get a referral to your local NHS physio via your GP...there's bound to be a long wait but some rehab programmes for ankle problems can take several months (which will end up v. expensive if you go private every time). Most NHS physio departments also have a gym area with lots of rehab equipment (some private physios wont have all this), in several of the hospitals I worked in we used to run a circuit/rehab class for people with just your sort of injuries.
You can find a private physio in your area using the Chartered Society of Physiotherapy's web site (just google CSP) there is a search engine on that called Physio2u , the specialities you want are musculoskeletal or sports physio. Hope that helps!

I injured my knee in the US last year and didn't have any treatment at the time. Two months on it was still swollen but not bruised so I saw the GP who said soft tissue damage 6months-1year to sort out. I asked about physio but he said the waiting list was so long it wouldn't be swollen by the time I got an appt. He said physio would help but if I were to go privately would be unlikely to need more than 2 sessions - one to show me exercises and one to check later - and if someone tried to encourage me to sign up for 10 sessions I should hotfoot it out of there!

I self-referred to a local group of physios, well-used round here, and had only one session in which I was well checked and shown exercises. Well worth £32.

Good luck.

Thank you . Will ring dr tomorrow, in case they can fit me in, if not see if there is any particular local practice they'd recommend and will have a look at the CSP site in the meantime.

gp appointment tomorrow pm - wish me luck

good luck

gp looked at it, comapred to the other foot, and was actually impressed by how much movement and relatively little pain I had ! Saw no need for referral as the stage it is at is consistent with the injury, I've apparently been doing the "right" things but has given me some exercises to follow gently to increase flexibility and reduce the soreness. Guess I can but try. I'll give it a week or two and see May ask around at school for recomemndations anyway in case (surprisingly noone local came up on that site).

Sorry, but it sounds like he gave you a coping strategy.

I agree Uwila . Spoke to a fellow mum who is a gp and she has told me where she suggests people go. If I can resolve it short term I can still ask for a referral to assess it generally, possibly via a private annual health check.

But, what about the ski trip?

She seemed to think it should be ok enough to ski on .

Do you think it's okay to ski on a foot you can't fully flex?

Boot does hold it rigid and supports the foot but hopefully flexibility should come back with the exercises she gave me plus anti inflammatories etc.

if you've sprained it a lot before, then a visit to a good sports physio for a biomechanical assessment is well worth your cash. They may recommend orthotics to slip into your shoes. I'd put a tenner on you overpronating.

Is that when you walk more on the inside of the foot and flatten the arch a bit ? If so , I'd agree. Will give these people a call I think.

I'm torn between her having basically reassured me that all will be well if I continue as is and frustration that it could use a proper looking at but that is time (and money) we can ill afford atm.

Hi LIZ Your Yellow Pages will also have a section in under Physiotherapists with Chartered physiotherapists listed. Word of mouth recommendation is great if you trust the recommender iyswim. I'm a physio who's had ankle problems and I'd say you probably need some specific treatment for any specially painful bits but before skiing some balance rehab work. I'm sure because of ski boots that knees are far more of a risk when skiing than ankles but still you don't want to chance it.