pain across outer ankle, top of foot over to arch

by Sherrie
(Orlando, FL)

About a month ago I was walking with my family and tripped on a curb, landing hard on my right foot and going down on my left knee. I didn't have any pain at the time of the fall, but the next day I started having pain high across the top of my foot near my ankle. I did not go to the doctor because I felt the pain would go away over time. Over the next month the pain has not gone away but has become worse extending from the outer ankle clear across the top of the foot all the way to the arch. My foot over the past week has started to feel very fatigued after any amount of time in a shoe. Do bone breaks in the foot typically cause pain like this? It feels to me, more like muscle/tendon pain. I'm a teacher and need to constantly be on my feet,but school will be out in a week and I will be able to rest it more.(I'm hoping that will help the pain go away.)

RESPONSE

Hi Sherrie,

Any time there is trauma to a portion of the body there is no way of knowing the type or severity of the damage that you did to yourself without an examination by a doctor. In your instance you did two things to your foot; you jammed it into the curb and then you landed on it. Both these actions probably did some degree of damage.

Here is my concern, You state the problem has become worse. That is never a good sign. I Have have stated many times on this site, injuries to the foot and ankle are a little bit more unique than injuries elsewhere for the simple reason we all need to keep walking. Very few of us have the luxury to sit home and rest the injured foot. So typically by walking on an injured foot or ankle we essentially are extending the healing process because every time you walk on the injury you are basically re-injuring the injured area.

If you had fallen and injured your hand and wrist, you could have limited the use of your hand, perhaps put it in a sling for a couple of weeks and it would have healed more quickly than a foot that is constantly being "walked" on.

That is problem number one. Problem number two is that without a medical examination which will probably include x-rays and perhaps even an MRI at this point, we have no idea how much damage you sustained to the foot and ankle and without knowing the amount and type of damage, there is no way to know how long it is going to take for your foot and ankle to heal.

I cannot tell you if you broke a bone or if your pain is more tendon or ligament in nature. Certainly by tripping and then falling on the foot there is always the possibility that you broke a bone. Keep in mind, there are varying degrees of broken bones ranging from a complete break in the bone all the way down to just a small "crack" in the bone.

Your ability to walk on the foot regardless of how uncomfortable it may be is not an indication of whether any thing is broken or not. Only an x-ray can determine that.

Speaking in broad terms, most simple sprains and strains of the foot and ankle at one month post trauma will feel somewhat better, perhaps not one hundred percent better but certainly a lot better than it felt say three weeks ago. I realize you are a teacher and are on your feet more than most and I am also assuming you are in good health, reasonably young and not overweight.

In your narrative if you said to me that you are perhaps at least fifty percent better than four weeks ago, I might have leaned somewhat to the notion that once school is over and you rest your foot and ankle, things would dramatically improve, but since your particular pain has actually worsened I feel it is imperative that you see a doctor and get a handle on exactly what kind of damage you did to yourself and by knowing the exact damage, steps may be taken to deal with your particular problem and that will certainly speed up the healing process.

I would also like to point out that some acute injuries, if not properly treated, can end up becoming chronic sources of pain which will then bother you to varying degrees for years to come. Examples would include a partial ligament tear that is not properly allowed to heal may become a chronic pain source. Should you have suffered a fracture that goes undiagnosed and if it does not properly close, that too may become a source of constant pain. Lastly, there is a possibility that you may have done some damage to your ankle joint and without proper treatment, you may end up with some degree of arthritis in the joint.

So in closing I think you probably get my message: see a doctor.

Marc Mitnick DPM
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