#718 Broken toes with an ankle sprain? - DOC

#718 Broken toes with an ankle sprain?

Is it possible to break your toes at the same time you get an ankle sprain? Well, that’s what we’re talking about today on the Doc On The Run Podcast.



Let’s say you’re out on a trail run, you roll your ankle and sprained it. So what do you do you? You limp home, you get back to the car, you ice it, you take some pressure off of it, you elevate it, you do all the right stuff, but then it’s really painful and swollen the next few days. And then maybe a day later, maybe two days later, it really looks terrible kind of Frankenstein like.

It’s black, it’s blue, it’s swollen, but even worse, you look down and you’re kind of dismayed because your toes are swollen like sausages, and they’re completely black and blue. And believe it or not, I’ve had a number of athletes, a number of runners, a number of just even normal people who’ve sprained their ankles, and then they’ve come in not because they sprained their ankle, but because they’re actually worried they broke their foot or broke their toes.

I even had one guy that said, “I don’t know I’m pretty sure I broke my toes because they’re really really bruised, but it’s weird because they don’t hurt when I move them, and they don’t hurt when I squeeze them.” So this is a great question.

A lot of runners knowing about metatarsal stress fractures and how common they are. They’re actually worried that when they rolled the foot, they actually broke one of the metatarsals and although you can do that, it’s relatively rare. If you check some certain places on your foot, I’ve got other videos that show you how to do this. But if you push on certain things, it’s unlikely you have a fracture.

But in this case, what happens is, I thought it was worth talking about why did you get so much bruising in the toes when you sprained your ankle because they’re pretty far away. But what happens is really simple. You roll the ankle and you actually rip the joint capsule in the ligaments that actually stabilize the ankle. That causes a lot of swelling, causes a lot of bleeding under the skin, but because those tissues are all pretty deep, you don’t really see immediate bruising around the ankle.

Sometimes if you’re standing a lot, the bruising will drift from the ankle down to around the bottom of the heel. And then you get a whole bunch of bruising around the edge of the heel close to the ground. But also, if you think about how you stand, you know, normally your foot’s flat on the ground, but when you sprained your ankle, you may stand with your heel up in the air with your foot kind of elevated when you’re cooking, doing the dishes standing at your desk, standing in line at the grocery store, whatever kind of just keeping pressure off of it.

When you do that, the toes are pointing down and the blood from the ankle sprain actually seeps down through all the tissue planes in the foot and winds up all around the toes and the toes can be really ugly. They really look like they’re injured, but they’re not injured at all.

So the bruising and the toes., if you don’t have any pain there, it’s unlikely to be associated with any real injury. It’s also very unlikely you had a metatarsal stress fracture if you don’t have any pain in those areas either. Of course, you can check this out with X rays if you’re in California, Florida or Texas and you want me to order x rays to look at that I can certainly do that for you. Look at them with you and do a remote consultation. We’ll review it, but if you go in to see the doctor, they’re probably going to do X rays in the office too, if that’s what you’ve already done

The ankle sprains are very common, and they can cause a lot of a lot of swelling, a lot of pain and a lot of trouble. You just have to treat it appropriately right away. But you don’t have to worry so much in general about the bruising and the toes.

If you like this episode, please share it with a runner who needs to hear it and I’ll see you in the next training.



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