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Do I go back for another x-ray?

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  • #21
    Best case scenario is that you waste some people’s time and learn that your foot is fine and just needs time. You are worth the time and trouble! Foot pain blows chunks...if it was my foot, I’d go back to the ER if that was the most expedient way to a diagnosis.
    I’m not a doc, nor do I play one on TV...based on where the studs hit on the top of your foot, there could be a break...your symptoms sound like some sort of nerve impingement.
    I recently had big toe surgery for a giant bone spur and the opposite of a bunion...big toe was trying to be a thumb. The surgery and swelling afterward, brought to light a Morton’s Neuroma that I didn’t know I had. What I’ve learned is that nerve pain is like no other! Like there were tears involved! And any sort of pressure or wrap around my foot brings the feeling of fire and hot pokers...or tingling and numbness.
    Go and get your hoof checked out!!! Fingers, toes, eyes and legs crossed for a good result!!!

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    • Original Poster

      #22
      Originally posted by Barn Mom View Post
      Best case scenario is that you waste some people’s time and learn that your foot is fine and just needs time. You are worth the time and trouble! Foot pain blows chunks...if it was my foot, I’d go back to the ER if that was the most expedient way to a diagnosis.
      I’m not a doc, nor do I play one on TV...based on where the studs hit on the top of your foot, there could be a break...your symptoms sound like some sort of nerve impingement.
      I recently had big toe surgery for a giant bone spur and the opposite of a bunion...big toe was trying to be a thumb. The surgery and swelling afterward, brought to light a Morton’s Neuroma that I didn’t know I had. What I’ve learned is that nerve pain is like no other! Like there were tears involved! And any sort of pressure or wrap around my foot brings the feeling of fire and hot pokers...or tingling and numbness.
      Go and get your hoof checked out!!! Fingers, toes, eyes and legs crossed for a good result!!!
      That’s exactly what it’s like! The tingling / electric shocks if I move the foot and the hot poker if my bed sheets brush against it or it touched the inside of my boot. But I can poke and prod at it without getting the same pain
      Last edited by BigMama1; Dec. 30, 2019, 10:09 PM.

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      • #23
        Or you might have a Lisfranc injury which isn't always evident on x-ray imaging. Orthopedist, podiatrist, sports med doc should be able to identify what's going on.

        Comment


        • #24
          Originally posted by BigMama1 View Post

          That’s my worry - that I’d be wasting everyone’s time for nothing. And though I definitely have some foot pain and lots of tingling in the foot, the sharp pain is pretty much entirely in the toe. I can bear full weight on the foot if I’m in bare feet, which makes me think the foot is not fractured? But then again when I had the literal tibial plateau fracture I could bear weight too.

          If it is nerve and / or soft tissue damage does anyone know if there is treatment? Or is it just a matter of time? I guess what I’m wondering is if I am delaying healing or causing damage by attempting to carry out normal activities to the best of my ability? Or should I be staying off it completely? I had assumed not since the ER doc recommended against a boot and didn’t suggest crutches. I used a cane for the first few days to help with my balance but don’t need that now, as long as I walk slowly without bending or pushing off the foot.
          without proper diagnosis you cannot prognose or treat. No honest PT would touch this foot without proper documentation of the actual damage.

          I partially tore my arm deep flexors 13 months ago. Amazing pain, amazing bruising no deformity. No surgery required. This was an adverse event for a medication I took. It was not deeply painful unless I weight loaded the fingers. PT was focused on proper and gentle stretching and gradual weight loading of the fingers ( thus the flexors) with an exercise gadget. I am a competitive archer so as I progressed out of PT I had to slowly build back my ability with my bow.

          Put yourself first and go back to the ER if that what it takes in your system to get proper work up. Focus on the pain and the continued compromise of the injury. Tingling is usually nerve damage and can take a long recovery time.

          The diagnosis was "Not a fracture" but they have not ruled out partial soft tissue tears. It could be that you simply need more time but what you really need is MORE KNOWLEDGE AND INFORMATION to make wise and safe choices.

          If this was your horse you would be on the phone to the vet , you betcha

          Take care of you as a priority
          Last edited by hoopoe; Jan. 4, 2020, 11:19 PM.
          _\\]
          -- * > hoopoe
          Procrastinate NOW
          Introverted Since 1957

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          • #25
            In the meantime, get yourself some Back on Track socks. It will help a lot with the swelling and pain.
            Boss Mare Eventing Blog

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            • #26
              How many views did they take initially? I think I'd go back for more at this point and maybe go to a sports medicine/ortho/podiatrist type if you can.

              Even if it's not broken, maybe with less swelling they can better evaluate the soft tissue. At least maybe you walk out with a different protocol--PT prescription, maybe now it's time to put you in a boot, etc.

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              • #27
                I'm not a doctor but did spend 10+ years in the Medical Professional Liability business. You learn a lot of Medicine in that world.

                It's not uncommon to have non-displaced fractures. These will NOT show up on an x-ray done close to the injury time. After a period of time the bone will will de-mineralize at the fracture site and then the fracture will show up on an x-ray. I'm not sure about the time frame but it's not overly long (I want to say in the 7-10 day range).

                Soft tissue injuries take a LONG time to heal. And can be painful and debilitating as they do.

                First, get another x-ray and ensure you don't have any fractures.

                If you don't have any then have your doc set you up with whatever modalities they recommend for treatment of soft tissue injuries (medication, PT, massage, compression sock, whatever). Follow the recommendations.

                I'm sorry to hear of your mishap. These things just take Tincture of Time by the tun. Sometimes a little red wine can help out!

                G.
                Mangalarga Marchador: Uma Raa, Uma Paixo

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                • Original Poster

                  #28
                  I’ve been putting it off because I keep convincing myself it is getting a bit better every day. And it is better than it it was 3 weeks ago, but far from good.

                  Promised my kids if it still hurt Friday night and / or I still could t wiggle my toe, I would go back Saturday morning. Well, it’s Friday night and I’m the most uncomfortable I’ve been all week.

                  Thought things were good because I can put my Uggs on with almost no pain, and can walk in them without much discomfort, as long as I take very small steps and don’t push off the foot.

                  Went to the barn fully believing today would be the day I would put on my riding boots and experiment with putting my foot in the stirrups. By the time I walked all the way down to my horse’s field and brought her into the barn, toe was throbbing.

                  Didn’t even get foot halfway down into tall boot before realizing the top of my foot (where winter studs landed) is actually still very painful when squished up against hard leather and not soft sheepskin boots. Thought I was going to throw up and didn’t even get to the point where I would have had to squish my toe into the boot. Aborted the mission.

                  Guess I’m going for an X-ray tomorrow...fully expecting them to say nothing they can see or do, but at least I will have tried. And then next week I will make an appointment with my physio, although the thought of letting anyone touch it makes me break out into a sweat.

                  Comment


                  • #29
                    I'm a retired podiatrist. It really sounds like you've got a fracture at one of the metatarsal necks, right behind the head. Many times the micro crack isn't visible on x-ray till 10-14 days later. It tends to be behind the 2nd toe. The nerve pain can be a nerve irritated between the metatarsals. Fractures take a good 6-8 weeks to heal. Many will say if its not displaced, you can have walking boot. My advice after 30 years is stay totally off weight bearing and you'll heal MUCH faster and with less problems, ALWAYS get a 2nd and 3rd opinion and run from anyone trying to book surgery on the first visit. I loved doing surgery, but ethical, and required surgery.

                    Comment

                    • Original Poster

                      #30
                      Thanks for everyone pushing me to go back. Dr was quite dismissive at first, saying he was certain it was just soft tissue but would xray just for my peace of mind and “since I was there anyway.”

                      Turns out the top joint of the little toe is fractured after all. Confirmed when he squeezed it hard and I responded by screaming and swearing. Loudly. His reply? “Oh! You aren’t making it up!” Wish I had kicked him l

                      It looks the same on the original xray as this one but was likely missed because it isn’t a clear line or break. It’s more like a mushy misshapen blob, and the space that is supposed to be there between the top and middle joint isn’t visible at all.

                      Managed to talk him down from zero weight bearing on crutches, to buddy taping and a walking boot for 2 weeks, as long as I promise to stay off it as much as possible. No dog walking, no barn and (my interpretation here) no housework. It’s only 2 weeks and at least I now know I wasn’t just losing my mind or turning into a giant wimp!

                      I am bummed about missing another 2 weeks of riding after already missing 3, especially when we’re having such a mild and pleasant January. In other years I would have been delighted to stay warm at home instead of freezing my a$$ off at the barn. Luckily I have a great part boarder and my horse is in full training, because at her age she really needs to be ridden consistently 5 days a week.
                      Last edited by BigMama1; Jan. 4, 2020, 07:23 PM.

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                      • #31
                        Thank goodness you went back!!! Now put yourself on some real stall rest!!! You need it to heal!!!

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                        • #32
                          And when the boot comes off don't except to go and resume life. You still have to take it easy and let it heal. Wear shoes that offer support. You make be a while yet to get into your tall boots. I wore lace up boots with room for my larger than normal toes. I had someone riding my horse for some time before I eventually got back in the saddle.. Good luck!

                          Comment


                          • #33
                            I had to spend 8 weeks in the boot for a 5th metatarsal fracture. It still hurts. Mine also had the mushy blob as opposed to a clean fracture. Foot doc says it will take up to 2 years to completely heal. I also still did everything but ride or go to the gym while I was in the boot
                            "You can't really debate with someone who has a prescient invisible friend"
                            carolprudm

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                            • Original Poster

                              #34
                              Originally posted by mroades View Post
                              I had to spend 8 weeks in the boot for a 5th metatarsal fracture. It still hurts. Mine also had the mushy blob as opposed to a clean fracture. Foot doc says it will take up to 2 years to completely heal. I also still did everything but ride or go to the gym while I was in the boot
                              Poor you! 8weeks is not going to happen. I’ve already lost 3 hobbling around and now 2 in the boot. From what the dr on my second ER visit said I gather the boot is as much for the soft tissue to heal as it is for the toe fracture. He wanted zero weight bearing but in all honesty that is just not compatible with having kids and a job. So I talked him into the boot with the promise that I would stay off it as much as humanly possible.

                              Ive been doing pretty much everything except riding and walking the dogs since I got stepped on, without much healing, so am trying to be a responsible adult and give it a rest now. I’m dying to go to the barn to at least watch my trainer ride, but even that will inevitably lead to a lot of standing around and walking.

                              Comment


                              • #35
                                I was at wef when I got stepped on. I had to walk that infernal showgrounds for 3 weeks. Then I had to stay in an apt with 2 flights of stairs while doing a substitute teaching gig. I did everything but shower and sleep in the boot I was told a minimum of 4 weeks for the boot to work
                                "You can't really debate with someone who has a prescient invisible friend"
                                carolprudm

                                Comment


                                • #36
                                  Get a knee crutch. It will help you be mobile without dealing with one of those scooter things or full crutches and while you are still in the boot.

                                  A friend had ankle surgery and it was the only way she could get around uneven terrain at the barn to visit her horse.

                                  Comment


                                  • #37
                                    Originally posted by BigMama1 View Post

                                    Poor you! 8weeks is not going to happen. I’ve already lost 3 hobbling around and now 2 in the boot. From what the dr on my second ER visit said I gather the boot is as much for the soft tissue to heal as it is for the toe fracture. He wanted zero weight bearing but in all honesty that is just not compatible with having kids and a job. So I talked him into the boot with the promise that I would stay off it as much as humanly possible.

                                    Ive been doing pretty much everything except riding and walking the dogs since I got stepped on, without much healing, so am trying to be a responsible adult and give it a rest now. I’m dying to go to the barn to at least watch my trainer ride, but even that will inevitably lead to a lot of standing around and walking.
                                    I second the knee walker. When a Dr tells you no weight bearing it is, usually, for a reason. You can either choose to pay now or pay later. Generally the no weight bearing is to allow ligaments to heal. By putting weight on your foot you may suffer for years in a way that could have been prevented.

                                    Knee walkers, (in Ontario), can be rented for about $40.00 a month. They fold up for the car so you can take them with you.

                                    If you have a knee walker you can go to the barn and anywhere else you want to that has fairly level floors. I was non-weight bearing for 3 months. It can be done with a job and kids. YOU can do it if you make yourself a priority.

                                    Comment


                                    • #38
                                      My friend found something like this to be much better than the scooter type walker. She broke her ankle and had 2 surgeries.

                                      https://store.iwalk-free.com/iWALK-2...rutch_p_8.html

                                      Comment


                                      • #39
                                        I can't stand those walking boots. They are only nice if you can bare weight on the injury and lift the boot during walking. My foot is not having any of that. The boot does not prop up well for resting your leg. Why they didn't design it with a flat spot on the heel, i can't understand. As then you could prop your foot up with the boot on and rest your leg. Otherwise the weight of the boot tips your leg sideways.

                                        I'm thinking of ordering this:
                                        https://www.amazon.com/gp/aw/d/B00YZ...T7IPAAIU&psc=1

                                        In the meantime, I'm using a polo wrap and that seems the most comfortable. In tried a cotton bandage with vet wrap and that did not help. I tried elastic bandages but they were too stretchy and not supportive enough. The ankle boot is fine for resting weight on and sitting at the computer, but too heavy otherwise. The polo wrap is just perfect. Especially since I'm non weight bearing.

                                        ​​​​​

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                                        • Original Poster

                                          #40
                                          Update - I sat on my horse today!

                                          Started physiotherapy last week and ditched the walking boot this week. Comfortable barefoot and getting around pretty well in my Uggs, as long as I remember to take very small steps and don’t accidentally push off my foot. That still HURTS, as does wearing normal shoes / boots, as I discovered at the barn today.

                                          My tall boot are still a hard no, they out too much pressure on the top of my foot that has all the nerve pain now, and on the side of my broken toe. My paddock boots are better. Painful, but bearable.

                                          Was worried about mounting, since my left foot is the injuries one. Turns out it’s just fine if I shove my foot all the way into the stirrup so my toes have no weight on them. Having weight in the stirrups while trotting hurts. Not horribly, but enough. We just did 5 mins on the lunge line today after my trainer finished riding my horse. Had intended to do it without stirrups and that will be more comfortable. However there was way too much snow sliding off the arena roof to safely try that today. After 6 weeks of no riding my balance and core muscles feel like mush and the limited amount of stickability I used to have is long gone.

                                          So, small steps forward. Still lots of physio work on breaking down the scar tissue and trying to get normal sensation back into the foot. It will come. Looking forward to a couple more lunge lessons next week. Might as well make the most of this time and work on my position and seat.

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