Mid foot sprain or more serious?

by Connie
(Victoria, TX, USA)

4 days ago I tripped over a garden hose and fell forward landing on my hands and knees, when I fell I felt 2 pops in my left foot. It didn't hurt at first but 2 hours later my shoe felt tight and when I removed it I felt the pain. Since then my foot has been swollen & I can't bear weight or flex my front part of foot. I can move toes without pain but can't walk on it. I have a lump that comes & goes on top of mid foot. I don't have pain when I'm sitting only if I try to walk. I can put weight on heel

I was told it was sprained but I'm worried about possible fracture. No x-Rays taken
I have been keeping foot elevated and Ice packs on for 4 days.
Last 24 hrs started felling tingling numbness and a heavy feeling as if something were laying across top of foot
Never had much bruising just slightly right below my 2nd & 3rd toe. Does this sound like a simple sprain or something more? How long should it take for me to be able to walk, if it is just a sprain?

RESPONSE

Hi Connie,

The only way you can make a diagnosis of sprain is to first rule out a fracture. This is especially true in cases of trauma.

You tripped over the garden hose four days ago and it appears your symptoms are worsening. In simple sprains, in most cases, your symptoms would have begun to improve. That does not sound like what you are experiencing.

The places you marked on your foot do not help me determine the extent of the injury other than telling me your fall was severe enough to cause pain in three places.

In your narrative it sounds like you sought medical attention but they did not take x-rays. Am I reading that correctly?

Any time there is trauma a precautionary x-ray should be taken particularly if the pain was bad enough to bring you to the doctor's office.

So, since it has been four days since the trauma and since your symptoms seems to be worsening, I would suggest you have an x-ray taken. At the very least it will give you peace of mind it there is no fracture on x-ray.

If it turns out that there is no fracture, then yes, you just have a sprain. If that is the case, your doctor needs to give you some advice on how to move this process forward so that your foot starts to feel better.

The problem with foot injuries is that because we have to walk on our feet, the simple act of walking delays healing because with every step you take, you are essentially re-injuring an already injured area.

Icing is fine for the first 24 hours or so, which essentially helps with the swelling, which reduces pain, but ice has no rehabilitative capabilities. Modalities that produce heat generally help an injured area get better faster because heat increases blood flow to the injured area and blood contains nutrients which allow us to heal. Even with just a bad sprain, immobilization may be necessary simply to get the stress off the foot, so that it can heal.

These things along with perhaps some anti-inflammatory medication (if you can tolerate them) are the things you need to discuss with your doctor.

Marc Mitnick DPM
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