Some Basics...

• There are many ways that people can injure their foot or ankle.
• There are also many types of foot and ankle injuries. There are bones, tendons, ligaments, cartilage, and muscles in the foot and ankle. These can all be injured.
• Treatment depends on the type of injury a person has. A doctor will know the right way to treat a foot or ankle injury.

Types of Injuries

• Abrasion: This is the medical term for scraped skin. This happens when an injury scrapes off the top layer of the skin. Examples are when people "scrape" their elbow or "skin" their shin or ankle. Pain is usually mild. This can usually be treated at home.
• Achilles Tendon Rupture: This is a tear of the tendon behind the ankle. This tendon joins the calf muscles and the heel bone. When the tear happens, there is usually a loud popping sound or feeling. Pain may be mild to moderate. The person cannot stand on the toes of that foot. This injury happens more often to athletes and older people. Surgery is almost always needed.
• Contusion: This is the medical term for bruise. It is caused by a direct blow to the skin and muscles. The skin is not broken, there is no cut. The bruised skin may first look red, then purple, and finally orange-yellow. These skin color changes are from blood that leaked from tiny torn blood vessels in the bruised area. The skin may also be swollen. Pain is usually mild to moderate. Bruises are tender to touch. Most often this can be treated at home.
• Cut - Superficial: Superficial cuts (scratches) only extend partially through the skin and rarely become infected. A scratch is an injury to the skin made by a sharp edge. For example, scratches can be caused by fingernails, a sharp nail, a piece of metal, or a branch of a tree or bush. A paper cut is a scratch from the edge of a piece of paper. This can usually be treated at home.
• Cut - Deep: Deep cuts (lacerations) go through the skin. Lacerations longer than 1/2 inch (12 mm), or 1/4 inch (6 mm) the face, usually need sutures. A laceration is caused by cutting the skin with the sharp edge of an object.
• Dislocation: This is when a bone comes out of the joint. The joint always looks crooked or deformed. The pain is severe. A person with this problem should go to the doctor right away. A doctor will treat this by putting the bone back into the joint socket.
• Fracture: This is the medical term for a broken bone. It means the same thing as a break or crack in the bone. The pain is severe and there is often marked swelling. The type of treatment needed depends on the type of fracture. Sometimes a person with a fracture just needs a splint or a cast. A person with a more severe fractures may need surgery.
• Sprain: A sprain is the medical term used when ligaments are torn or over-stretched. Ligaments are the bands of tissue that connect bones to each other. A "twisted ankle" means the same thing. Pain and swelling can range from mild to severe. Minor sprains heal themselves with time and rest. More severe sprains need a splint or a cast and take 4-6 weeks to heal. Surgery is rarely needed for a sprain. A person who hurts his or her ankle and cannot put any weight on it should see a doctor.
• Strain: A strain is the medical term used when muscles are torn or over-stretched. A more common term for this is a "pulled muscle". These are common injuries from falling, heavy lifting, and sports. Strains may heal themselves with time and rest. Surgery is rarely needed for a muscle strain.

Pain Scale

• None: No pain. Pain score is 0 on a scale of 0 to 10.
• Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
• Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
• Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

1. What You Should Know:
   • There are many ways that people can injure their foot or ankle.
   • There are also many types of foot and ankle injuries. There are bones, tendons, ligaments, cartilage, and muscles in the foot and ankle. These can all be injured.
   • You can treat a minor bruise, sprain, or strain at home.
   • Here is some care advice that should help.
2. Treatment of Minor Bruise (direct blow to ankle or foot):
   • Cold Pack: For pain or swelling, use a cold pack or ice wrapped in a wet cloth. Put it on the sore area for 20 minutes. Repeat 4 times on the first day, then as needed.
   • Heat Pack:
     • If pain lasts over 2 days, apply heat to the sore area. Use a heat pack, heating pad, or warm wet washcloth. Do this for 10 minutes, then as needed.
     • For widespread stiffness, take a hot bath or hot shower instead. Move the sore area under the warm water.
   • Rest the injured part as much as you can for 48 hours.
3. Treatment of Minor Sprains and Strains of Foot and Ankle:
   • FIRST AID: Wrap with a snug elastic bandage. Put an ice pack on it to reduce bleeding, swelling, and pain. Wrap the ice pack in a moist towel.
   • Treat with rest, ice, compression, and elevation (R.I.C.E.) for the first 24-48 hours.
     • REST the injured leg for 24 hours. You can then return to normal activity if it is not too painful.
     • Keep using crushed ICE packs for 10-20 minutes every hour for the first 4 hours. Then use ice for 10-20 minutes 4 times a day for the first 2 days.
     • Apply COMPRESSION by wrapping the injured part with a snug, elastic bandage for 48 hours. If you feel numbness, tingling, or more pain, the bandage may be too tight. Loosen the bandage wrap.
     • Keep injured ankle or foot ELEVATED and at rest for 24 hours. Keep your foot up on a pillow. Stay off your feet as much as you can.
4. Pain Medicines:
   • You can take one of the drugs listed below if you have pain.
   • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
   Acetaminophen (Tylenol):
   • Regular Strength Tylenol: Take 2 pills (650 mg) every 4-6 hours. Each pill has 325 mg of acetaminophen.
   • Extra Strength Tylenol: Take 2 pills (1,000 mg) every 8 hours. Each pill has 500 mg of acetaminophen.
   • Do not take more than (3,000 mg) of this drug per day.
   Ibuprofen (Motrin, Advil):
   • Motrin and Advil: Take 2 pills (400 mg) every 6 hours. Each pill has 200 mg of ibuprofen.
   • A second choice is to take 3 pills (600 mg) every 8 hours.
   Naproxen (Aleve):
   • Aleve: Take 1 pill (220 mg) every 8 hours. Each pill has 220 mg of naproxen.
   • A second choice is to take 2 pills (440 mg) every 12 hours.
   Extra Notes:
   • Use the lowest amount of a drug that makes your pain feel better.
   • Your doctor might tell you to take more than what is shown above. That is because your doctor knows you and your health problems.
   • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription drugs. It might be in more than one drug you are taking. Be careful how much you take. Too much of this drug can hurt the liver.
   • Caution- Acetaminophen: Do not take it if you have liver disease.
   • Caution- Ibuprofen and Naproxen:
     • Do not take ibuprofen or naproxen if you are pregnant.
     • Do not take these drugs if you have stomach problems or kidney disease.
     • Do not take these drugs for more than 7 days without checking with your doctor.
   • Read all package instructions.
5. What to Expect: Pain and swelling most often get better 2-3 days after an injury. Swelling is most often gone in 7 days. Pain may take 2 weeks to go away.
6. Call Your Doctor If:
   • Pain becomes severe
   • Pain is not better after 3 days
   • Pain or swelling lasts more than 2 weeks
   • You get worse