Question
Hello,

Thank you for your time and generosity in answering questions!

Three days ago I injured my foot when I was out shopping. I kind of fell of the front of my (platform) shoe and I heard a cracking sound which disturbed me. I couldn't walk at all not even to the car. Because of circumstances, I had to hobble around a bit an hour or so after. It was painful though.

I figured that was not wise and once home put ice on it and have kept it elevated as much as possible and at night too, (have been following R.I.C.E.) I read it is bad to limp so try to walk normal but still on day three I can't put my full weight on my foot. After a few minutes of standing or even sitting normally my foot hurts and I need to elevate it again but I can walk / hobble slowly around the house.

Last night I was up and down on my feet for a few hours as we had guests but by the end of the night I had a bad headache and was feeling nauseous and my bandage felt tight. When I looked my foot had ballooned worse than when I first injured it. I did the ice and elevation again and was relieved that this morning it was down.

The swelling is around both sides of the ankle (like a tennis ball over my ankle) especially the outside of the ankle.

I am wondering how much swelling is normal for a sprain and when to be concerned? The bruising is coming out and is right on the inside ankle bone, along the side of the foot and above the instep.

I did tear the tissue in this very same foot about 10 years ago and was on crutches for a few weeks and could only think maybe that weakened my foot.

My question is, when should I be concerned about the swelling? Can a bad sprain have swelling for several days? Is there some checks for whether it could be a fracture rather than a sprain, (for e.g. would I expect pain to the touch?) or could it rather be torn tissue again?

I do not have access to medical treatment right now as I am living in a foreign country and I am just hoping with anti inflammatory tablets, and RICE it will come right in the next days or so on it's own...at what point would you expect improvement / or if it doesn't improve recommend getting medical treatment.

Sorry if this was long winded and thank you very much for your help!

Thank you!

Answer
HI Jennifer,

It would be difficult to know if you have a fracture in addition to soft tissue injury.  Swelling can last weeks, however, if you did fracture or dislocate a bone you would want to have that treated sooner rather than later.  I would do my best to get an x-ray.  I would certainly continue your protocol and try to get some crutches.  It would be in your best interest to see a dr as soon as possible to avoid future problems.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com

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