did i break my foot?

[powdork]

so i did this on tues


it hurt, but seemed like just a flesh wound. worked tuesday and it hurt, but still, like a flesh wound. wednesday i could barely walk, but still didn't feel like i had hurt my ankle or foot. thursday it felt much better, so i went hiking/climbing. it swelled up that night and hurt, but felt good again friday morning so more hiking/climbing

looking at it today, i noticed i can't bend/curl my outer toes. any idea what i did?

[systemoverblow'd]

Maybe, maybe not. But coming from someone that let a broken foot heal incorrectly when I was young, it still comes back to bite me in the ass several times a year. Get some x-rays.

[cat in january]

That and from those grainy photos I would have concern about infection.

[davieboot]

Oh man, could be a lot of things. In any scenario, you gotta get swelling down. RICE. I think you'd know an ankle break (they usually swell up like crazy, and instantly). And not being able to move your toes doesn't sound like the foot break I had. But a broken bone might not be the biggest concern.

Also, I'm no doctor and don't know what the hell I'm talking about.

[powdork]

i don't 'think' it's infected. i have been putting neosporin on the bandage since about 4 hours after the injury, which was when the first pic was taken. additionally the swelling improves dramatically overnight when the foot is raised.
half the time, it feels like a bad ankle sprain. the other half the pain is on either side of the gash. what scares me most is that it appears to be getting worse despite the fact that i took it easy today up until work. when it was time to go in (right when i started the thread) it was nearly impossible to get my shoe on. i work on my feet as a waiter so that takes a toll. i had a misstep tonight going up some stairs (basically my toe didn't clear the top of the stairs so it bumped slightly). That caused enough pain i had to go home.
seeing a doctor is not an option, nor is taking time off work.

[powdork]

i'll look into it some more obviously, but given the location of the gash and the feeling I have that it went to the bone and my inability to curl my toes, it seems there may be an issue with the Extensor Digitorum Longus Muscle, the Extensor Hallusis Longus Muscle, and the tendons by the same names.
So, if that is the case, does it get better on it's own? Does it require surgery to reattach the tendons? i suspect the answer lies in whether it was a complete tear of the tendons and or muscle. How do I determine this (again, without seeing a doctor)?
And who's up for a little slice and dice??

[justr]

Well... make seeing a doctor work. If it is infected, and it looks pretty bad, you risk the foot/leg or worse. Pics make it look red and swollen... bad.

Neosporin won't do shit for a real infection. It won't prevent infection... it is just there to make you feel good about healing and maybe help speed up the surface process by a day or two. But if you got bacteria IN there and it is growing... game over buddy.

Not getting better after a few days? Can't fit your foot in a shoe?

Um... time to see a doctor.

[Patches]

Is your calf as red and swollen as it looks? If so I would go to the ER now.

[powdork]

it is Not as red as it looks although it is as swollen, but when i wake up in the morning the swelling will be gone. There is some redness around the wound but it is almost an exact match for where the sticky part of the band aids were.
As far as it not getting better, i haven't been a great patient. Steep hikes and difficult climbing on thursday and friday surely exacerbated the situation, especially friday where i felt a sprain like pain at one point moving around during a belay. plus i was running late for work so basically had to run back down the 2 miles to the car, much of which was steep talus (and then spend 7 hours on my feet humping heavy trays around). Today was worrisome though as I took it easy and cleaned around the house and even let the girls walk the dogs. I knew work would make it worse but was surprised my shoe wouldn't go on. Wasn't so much the size as the inability to articulate the ankle, or should i say cankle at this point?

[systemoverblow'd]

You're doing brilliantly. Keep up the solid work!

[powdork]

Thanks!! That means alot...
Good news is that if it is what I think it is, surgery is generally not indicated. Bad news is that it requires rest rest rest and next week at work is the American Century Celebrity Golf Tournament. Sort of a can't miss situation in terms of money and keeping in good graces at work.

[powdork]

it is this red.

[sierraskier]

Post on 5 different internet forums and get a consensus for what people are saying, but ultimately just go with your gut. In the mean time climb hard, run long distances, and in general do as many high impact activities as possible. Add some some swimming, kayaking or wet wading to your routine as well.

[powdork]

tell me more about this wet wading. would it be in cloudy water where i can't see rocks on the bottom? if so, sign me up.

[sierraskier]

tell me more about this wet wading. would it be in cloudy water where i can't see rocks on the bottom? if so, sign me up.

Yes cloudy, warm, stagnant water. The dirtier the better. You're on the right track. Whatever you do, don't go see a doctor.

[powdork]

i don't like croctors. Not that it is all their fault, but in todays medicine their hands often seem tied in terms of treatment rather than giving the patient what he wants. didn't see one for this little mishap, and everything is peachy.
doggy never saw another vet for this one, and everything is peachy.

[neckdeep]

[QUOTE=powdork;4022574] in todays medicine their hands often seem tied in terms of treatment rather than giving the patient what he wants. QUOTE]

Ummmm.....so you are saying getting a scrip for $25 worth of antibiotics isn't in your health plan? Germ theory and prevention of sepsis isn't experimental therapy. Just sayin, I tried to tough out a herniated disc last month and now my right leg is partially paralyzed, maybe permanently. Oh yeah and I still had to go to the doctor and drop major coin to get fixed so the extra waiting time turned out to be a huge mistake. Just sayin...you could spend a little or wait and see if it will turn into major, expensive damage, your call. I'm not sayin it is infection, that sort of post trauma edema could be leaky blood and lymph vessels or it could be blocked lymph vessels. But, a guy who makes his livin on his feet might want to protect his livelyhood.

[systemoverblow'd]

in todays medicine their hands often seem tied in terms of treatment rather than giving the patient what he wants.

Ummmm.....so you are saying getting a scrip for $25 worth of antibiotics isn't in your health plan? Germ theory and prevention of sepsis isn't experimental therapy. Just sayin, I tried to tough out a herniated disc last month and now my right leg is partially paralyzed, maybe permanently. Oh yeah and I still had to go to the doctor and drop major coin to get fixed so the extra waiting time turned out to be a huge mistake. Just sayin...you could spend a little or wait and see if it will turn into major, expensive damage, your call.

Please, he's hardcore as fuck and doctors are for pussies!

[powdork]

yeah, what advres said.
last night was much better at work. partly because the other rooms had no banquets so i was able to set up a spot to RICE it during my shift, and partially cause it's doing better. The only ibuprofen I took was right before work and the pain was almost non-existent, although I can't walk anywhere near normal. I did wake up at 4:30 and have to take some though to be able to sleep. I am able to slightly raise and lower the outer three toes now so that seems to be getting better too. Now it's off to ruin all the progress with a day of climbing, or at least belaying.

[powdork]

also, doesn't the fact that I don't have a fever combined with the fact that the swelling responds to ice and elevation indicate that it is not an infection?

[systemoverblow'd]

You're looking less core with every post man. Just rub some dirt on it and wrap it with electrical tape. You're good to go based on my internet wound diagnosis.

[powdork]

good thinking, that will protect against rogue lightning strikes as well.

[old goat]

The lower shin has about the worst blood supply in the body. Even without the foot swelling and trouble moving your toes a dirty wound in that area can turn into a real mess, with a large, nonhealing ulcer. Lack of fever is a good sign, but the amount of redness and the trouble with the toes, as well as the foot swelling are worrisome. (Were the foot and ankle injured when the shin was injured?) Hard to tell from internet pics but it very well may need antibiotics. See a doctor. Please. If it doesn't need antibiotics, great. And abusing it may make it take longer to get better but isn't going to prevent it from getting better or cause further damage. And if you do need antibiotics you would still be able to abuse it, unless you're on IV's. BTW how up to date is your tetanus shot?

Re: doctors--there are times when there are choices in treatment and the patient should be able to choose. And there are times when there aren't choices and what the patient wants isn't going to work. The way I see it, in order for a treatment occur--in my case that usually means surgery--both the patient and the doctor have to feel it's a reasonable way to go, not necessarily the best way, but reasonable. If I patient wants an operation that I feel would be non-beneficial or harmful, I don't do it. If a patient truly needs an operation and refuses, they have that right, but it's best if they see another doctor. Of course the patient is entitled to a full explanation of why there is no choice, as well as a second opinion if there's time. And I say all that as someone who has been a recommended surgeon for Jehovah's Witnesses--who refuse blood transfusions--and Hmong patients, who REALLY don't trust doctors.

[powdork]

regarding treatment choices I was mostly referring to the link to my broken hand a year ago. i just wanted someone to set it and splint it, knowing full well that it wasn't best standard of care available. i couldn't afford the best standard so instead i got nothing and moved on. on the bright side i didn't miss a single ski day in what was one of the best cycles we had in 2012.
regarding my foot, it's doing much better. I gave it my own form of RICE today with Rock, Ice, and Climbing at Elevation. There were times it hurt, especially on the approach, and cracks I couldn't twist it into, forcing me into an uncomfortable lieback on a slippery wall. But at the end of the day the swelling was much less than it has been since thursday and I could move my outer toes much better than previous days (and even see the tenting from the tendons). I think part of that had to do with climbing shoes which kept the swelling from going below my ankle.

Regarding your question, I didn't feel there was an injury to my foot or ankle at the time of injury, although it may have been masked by the pain from the injury. Generally, after nights at work, the area from the injury down to my toes would be hella swollen and the pain would be in my ankle/foot area when walking. When i woke in the morning and the swelling was gone my first steps out of bed felt like the bone was broken at the point of injury/gash.

[old goat]

regarding treatment choices I was mostly referring to the link to my broken hand a year ago. i just wanted someone to set it and splint it, knowing full well that it wasn't best standard of care available. i couldn't afford the best standard so instead i got nothing and moved on. on the bright side i didn't miss a single ski day in what was one of the best cycles we had in 2012.
regarding my foot, it's doing much better. I gave it my own form of RICE today with Rock, Ice, and Climbing at Elevation. There were times it hurt, especially on the approach, and cracks I couldn't twist it into, forcing me into an uncomfortable lieback on a slippery wall. But at the end of the day the swelling was much less than it has been since thursday and I could move my outer toes much better than previous days (and even see the tenting from the tendons). I think part of that had to do with climbing shoes which kept the swelling from going below my ankle.

Regarding your question, I didn't feel there was an injury to my foot or ankle at the time of injury, although it may have been masked by the pain from the injury. Generally, after nights at work, the area from the injury down to my toes would be hella swollen and the pain would be in my ankle/foot area when walking. When i woke in the morning and the swelling was gone my first steps out of bed felt like the bone was broken at the point of injury/gash.

That's a tough situation, when someone simply can't afford what they need. In that situation I agree a doc should do the best they can for you that you can afford.
My wife broke her hand (and the other wrist) last season. Could have had surgery, could have just had a cast. She had casts, did ok. Sometimes there are options they don't even tell you about.
Very glad to hear you're doing better. Still, that's a scary looking injury. If the sore starts to enlarge, or anything else starts going south, take my advice and see a doc. Otherwise, carry on.
BTW where are you finding ice to climb around here, or are you not at Tahoe any more?