Sprain or broken foot

Patient

Q: I tripped on a curb last night and immediately started having pain on the top of my foot kind of in the middle area of my foot. I immediately started R.I.C.E. I have stayed off of it since this happened. There is no swelling, bruises or discoloration. I can walk on it if I put more pressure on my heel than the ball of my foot. It has reactionary pain when I turn it a certain way, but does not hurt too touch, massage or just sit or lay down. No constant throbbing, just a sharp pain at certain points of stress. I do not have insurance and I am personal trainer, so I am in good physical health, generally, until I met this stupid curb. Just wondering if I sprained a tendon or ligament or I could still have a fracture. I can wiggle my toes and move my foot around without a lot of pain, but when I try to turn it while standing or put too much pressure on the ball of my foot, like I am standing on my tip toes, then it sends a sharp pain that immediately ceases once I stop that action.But it the pain is right in the middle of the top of my foot. I would appreciate any advice. I thought I would stay off of it for the next couple of days and see if the pain subsides at all. I have been taking Advil, Aleve and an anti-inflammatory medication as well!

Doctor

A:    From all the ankle injuries, the sprains are the most common. Ankle sprains are classified in 3 grades as follows: : mild degree of swelling and stretch has occurred to the ligaments. Weight bearing is possible. : moderate swelling and an incomplete tearing of ligaments, also mild instability may be present and also pain with weight bearing. : severe swelling and pain , complete rupture of at least 1 ligament, there is remarkable instability. If you are experiencing limitation to walking, severe pain and swelling and/or deformity, I strongly recommend you to go to the emergency department and get a doctor’s evaluation and x-rays to rule out a fracture. If it is an Ankle sprain without fracture the treatment strategy is as follows: First thing to do is applying ice and lift the affected limb for the first 24 hours, to control the pain and swelling. Physical therapy is recommended for sprains grade II and III with protected ambulation, and exercises to get back the normal range of motion and strengthening of the ankle muscles and ligaments. Treatment during this acute phase is aimed to minimize swelling and pain, allowing you to begin walking asap. The acute phase of treatment should last for 1-3 days after the injury, the 4 to 6 weeks after that you should have a combination of protection, relative rest, ice, compression, elevation, and support. Also you can continue taking the anti inflammatory medication (as “motrin”, “aleve”) those help in reducing swelling and pain. The healing time is different for each patient, and also depends on the severity of the initial injury

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