Hello and thank you for listening.
In September I broke the middle three metatarsals on one of my feet. I was seen in the ER and followed up with an orthopedic doctor for several months. Due to the location on the fracture the only treatment was for me to wear a protective boot for about three months. My doctor then said that all the bones were healed. I did not go for PT due to insurance reasons but I have looked up some exercise techniques and I have been trying to work on it myself at home.
The pain however, has never gone away. It is awful for the first few steps after rest then becomes somewhat better. It is also better when I wear a high quality tennis shoe. The pain is at the site of the break as well as the muscle on the side of my foot, which may be due to my gait. When I am resting it is a burning pain (nerve?) and when I am using it I feel more of a throbbing pain.
Recently, it has become worse and a couple of days ago I noticed a bruise on the inside of my ankle area. I am wondering if this could be caused by muscle or nerve problems? I had the orthopedist look at my x-rays twice before I left his office last time because of how badly it still hurt and he assured me that the bones were totally healed and I could use my foot in a normal manner.
I am wondering if you have a clue why this is still happening and if so what I can do to try to heal it. I have taken so much tylenol that I am afraid my liver is going to get up and walk away.
DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
************************************************** *********
I would have no way of knowing or assessing your actual status, the efficacy of the healing of your fracture or how appropriate the type of treatment for your injury was, and especially what your doctor meant by telling you that there was some special consideration regarding the location of the fractures which excluded other treatment approaches. But I can, with complete comfort, tell you that fractures do not occur in a vacuum and there is always collateral soft-tissue damage which often creates a far more long-term problem than the actual break in the bone(s). This damage can be to ligaments, nerves and tendons, and even complete healing in those tissues can often leave behind debilitating fibrous scar. The need for appropriate dedicated, physical therapy in a timely fashion after any injury cannot be minimized, and your avoidance of this for financial reasons may not be as cost-effective as you might have thought, both in terms of finances and terms of your future health and function. The ship may or may not have sailed on that issue, but certainly, it must be considered as a possible reason for delayed or less than complete rehabilitation and return to function. I cannot say whether the ankle bruise you've experience has anything to do with your previous injury or its care, but the typical appearance of bruises or contusions are the result of blood element leakage into the skin from structures in the area or into areas dependent by gravity from areas of injury. Nerve injury would not be something which I would generally consider directly responsible for the appearance of a bruise. In terms of your request for help with healing, healing is not something that doctors directly do. Rather, they simply attempt to place the body in the optimum mood and capability of self-healing. The adverse effects of excess use of acetaminophen on the liver is not to be taken lightly, but as to what is actually the cause of problem which you are experiencing and what might be done about it is not only beyond the scope of any forum or, for that matter, anyone who cannot examine you, but taking such advice as might be given without appropriate knowledge of your specific situation might compound your difficulties.
__________________ Foot Doc
Last edited by Admin; 16th March 2009 at 09:15 AM.
Reason: fixed typo
Thank you so much for your reply. I feel better just having some direction. I will try to get into PT this week, I hope it is not too late. I wish that my Dr. had explained that not getting in right away could have long term consequences. I thank you for doing so. He also never explained that there was more to heal than just the bones and seemed to think I was crazy or something for still having pain.
I can't tell you how much I appreciate your advice and explaining the urgency of getting in for some PT. I also appreciate your explaining how the tendons and ligaments can be involved.
One last thing, if the PT does not work, what kind of Dr. should I seek out to evaluate me? A poditrist? A GP or an ortho?
DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
************************************************** *********
A couple of further points which I think might be of essence, as I did not intend that you conclude that physical therapy was necessarily the answer to your problems . .
1. Physical therapy is not a substitute for inadequately assessed, addressed or treated problems.
2. Physical therapy is not going to correct conditions which are beyond the intended scope of such treatment.
I would therefore recommend that any comprehensive determination as to what should be done now might best first be effected through an independent evaluation of or multiple evaluations of your present status and a critique of the already provided care by a well-vetted second opinion consultant(s) . . certainly, unlikely a GP, but a doctor who is trained in providing such care.
Thanks for clarifying. I'll call my family Dr. tomorrow and see who he suggest I see for a 2nd opinion in addition to making an appt. with PT. I appreciate your pointing me in the right direction and your kindness.
I'm only in my 30's, I would hate to have this limp my whole life!
Three broken metatarsals, pain months later
Linear Mode
