(Chelsea Update would like to thank Dr. Barry Nemon , ER director the Chelsea Community Hospital for the information in this column.)
Midsummer. Time is flying by.
And although they can happen at any time of the year, let’s talk about ankle sprains. It’s very hard to be your own doctor so the ER is always happy to evaluate you at any time. But I know that sometimes you’re traveling , it’s a weekend or it’s late at night. Is there a way to know if you need to get an x-ray for an ankle injury?
Perhaps these guidelines might be helpful.
The Canadians did a study several years ago and published the “Ottawa Ankle Rules”. The study stated that if you used these “rules” as guidelines, you could tell if an ankle x-ray would be helpful. And although these rules are not 100-percent accurate, they are close. (Keep in mind, there are no absolutes in medicine … just probabilities.)
If you do not have tenderness at the ankle behind the 2 knob-like bones that form it (the fibula and the tibia) and if you can walk four steps and bear weight without much discomfort, then an x-ray would probably not be helpful. In other words, it’s unlikely that you have a bad fracture that needs a rigid splint or manipulation.
To try this, feel your ankle now, when it’s not hurt. Push on the back of both sides of your ankle for practice. But keep in mind that just because you don’t have tenderness at the back of both sides of your injured ankle and you can bear weight for 4 steps without much pain, it does not mean you did not injure yourself.
There are ligaments and tendons that can also be injured, which might benefit from some type of splinting. But, you can take some time and take it easy to see if the injury improves, and if it doesn’t follow up with your primary care doctor.
These guidelines are for ankle injuries, only. In all cases, common sense trumps “rules.” If you think something is very wrong, seek immediate medical attention.
So what about pain in your foot, not your ankle?
There are “rules” for foot injuries as well, but I do not think I can describe them well enough for you without drawing some pictures. So perhaps a simple rule for a foot injury is: if can’t easily bear weight for 4 steps or if you have a lot of pain in the foot, it’s probably best that you see a doctor and possibly get x-rays.
Sometimes patients come to the ER and we don’t find a serious injury, then they apologize for wasting our time. Our job in the ER is to be there and help you decide what is a serious injury. And, I can’t think of any reason for a patient to apologize for seeking a medical opinion.
In two weeks, we’ll talk about poison ivy.
Very interesting article Lisa thank you for sharing. As someone who had both ankles rebuilt last year because of lack of treatment this really hits home. Yes sprains can sometimes feel like breaks but there is also a risk of damage to tendons and ligaments which can lead to more damage down the road. I wish I would have read this article about 15 years ago!!