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Injured Foot

Hi. I have a relatively weak ankle and have injured my ankle in the past while doing sports. Last night I was texting and walking in the room and my ankle gave way and I hurt the side of my foot. I iced it immediately, however, when I woke up, it was swelling quite badly and I could not put any weight on that foot. I was wondering how long I should wait and continue to ice the injury and monitor before I should go get an x-ray. I would prefer to not go to a hospital during this time if possible. I have uploaded the photo of the injured foot and my normal foot for comparison. Thank you for your help!! 

(IMAGES MIGHT BE POTENTIALLY DISTURBING, CLICK TO REMOVE BLUR)

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Dr. Hamid R
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Doctor
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Dear @Iamking ,

I am so sorry for the delayed response and to hear about your injured ankle. It does sound like a low energy mechanism and judging from your history, it sounds like an acute-on-chronic ankle sprain. How is the swelling and pain now? And have you seen a doctor and gotten an X-ray done as correctly advised by Dr. Dinesh G ? For general management of the swelling, please elevate your ankle with 1-2 pillows whenever you are lying or sitting down. Icing does help as well. Do not apply directly to skin and not for more than 20 minutes each time. Do let us know how you are getting on and will be happy to provide further advice.
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Dr. Dinesh G
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Hi @Iamking oh dear Im sorry to hear this! I am afraid there is quite a bit of swelling in the image, you may have a fracture and your condition requires a physical examination with a doctor for them to make that determination and create a management plan tailored to your needs accordingly. Given the severity of the pain and your being unable to bear weight on the foot, depending on the doctor’s findings on examination he may need to arrange an X-Ray for you to check if there is a fracture. 

Some may go to an emergency department for a condition like this, however I would not recommend that as the waiting time may be considerable. There are a few GP clinics that have X-Ray capabilities which you can consider to save time in case you end up needing a scan, these include the Raffles Medical Clinic at level 2 in Raffles Medical Hospital (RMH). In the mean time, try to avoid bearing weight on your foot and if the pain is severe, get help or use crutches/wheelchair (if you have any) as you make your way to the clinic. Hope this helps!
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@Iamking
Hi Dr. Hamid Razak and Dr. Dinesh Guna . Thank you so much for your advices. I really appreciate them!! I followed your advices and used crutches for a week, kept it elevated when I sleep, and ice it if I walk/put too much weight on it. After that, I use an ankle guard, especially if I am going to be on my feet or walking around.

I no longer have any pain when I am walking around, although I have not tried running. When I do exercises that involve jumping or putting my body weight on my left feet, it hurts slightly after - it is a very bearable pain. I normally try to avoid these exercises or I ice the foot immediately after. However, since it has been more than a month, I am wondering if this is normal.

I did not go and get an x-ray, mainly because it started to feel better after one week so I thought it would just go away. I am also wondering if it would be advisable for me to start running again to see how it feels. 

Would love to hear your advice! Thank you!!
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Dr. Dinesh Guna
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Hi @Iamking sorry to hear that this is still bothering you! Pain is a signal from the body of injury or generally that something is wrong. Pushing through with body weight exercise with pain from a known injury may lead to progression to a more permanent injury.

I would suggest to give your body more time to rest, and would definitely advice not to start running yet. Perhaps consider some non-body weight exercises for the time being. Its good that you have followed Dr. Hamid Razak 's excellent advice to rest, ice and elevate the leg, and it would be beneficial to continue this . That said, the fact that the pain still persists is an indication to have it evaluated with a GP. Not forgetting also that with the COVID-19 lockdown, movement is restricted and you already are not moving around as much as you normally would. 

If the pain is mild and it does not affect your daily activities, then seeking a review or even a scan at this point is not recommended especially given the ongoing lockdown, since it is unlikely to change management. However if the pain is progressing, especially if it is essential for your career/lifestyle that you return to running as soon as possible, then this may be a consideration. Either way, I will be working at the lvl 2 clinic in RMH tomorrow, happy to help with an evaluation if needed. Take care and stay safe!