Soft tissue injuries to the foot and ankle

First few days

In the first few days following an ankle and foot injury you can expect pain and swelling. If you follow the instructions below these symptoms can be reduced.

PRICE

• Protect
• Rest
• Ice
• Compress
• Elevate

Protect

Protect the foot or ankle from excessive use which may delay the healing process. This means you should not take part in activities such as running, jumping and dancing.

Rest

Limit your activity as much as possible but do not become inactive.

Using ice

See leaflet ‘GHPI0659 Ice and heat treatment at home’, available on the Gloucestershire Hospitals website (www.gloshospitals.nhs.uk) for more advice.

Applying ice to the injured area for 10 to 15 minutes every 2 hours will help to reduce any bruising and swelling. Ice treatment must be used carefully as it can burn your skin. The skin will become red and cold. Check the area every 5 minutes and follow the advice below.

• Dampen a towel or cloth and wrap around the ice before placing on your skin. Never apply ice straight on to the skin.
• Only use an ice pack on areas of normal skin and where you have sensation (able to feel hot and cold).
• When using an ice pack if your symptoms increase, remove and then reapply for 5 minutes every hour.
• If the skin becomes white, blue or blotchy remove the ice pack straight away and leave off for 2 hours.
• Never apply a dry ice pack straight onto the skin.

Compress

Compression bandages are not applied to soft tissue injuries as research currently shows they increase the likelihood of complications. We advise you not to purchase or apply this type of bandage.

Elevate

Elevating the leg will reduce swelling and help with healing. Support the injured leg in a raised position, this should be a little above your hip. Use a pillow to support the length of your leg with your heel resting in mid-air (to prevent pressure sores developing on your heel).

Exercises

It is important to get your ankle moving. This includes walking and slowly increasing the amount of time you are on your feet. You need to keep a good range of movement, so start the exercises straight away.

These exercises should be repeated 10 times, twice a day increasing to 20 times 4 times per day over the following week.

1. When sitting or lying, circle your ankle and foot in one direction and then the other.
2. When sitting or lying, move your foot up and down at the ankle. Try to move as far as you feel comfortable.
3. When sitting with your foot on the floor. Turn the soles of the feet in towards each other then turn them out away from each other.
4. Place a towel around the ball of your injured foot, and pull gently towards you until you feel a stretch in the calf. This should be held for 10 to 20 seconds (start with shorter times if needed).

Walking and walking aids

When walking with or without a walking aid always try to put your heel down first and push off through your toes. Incorrect walking, toe walking and limping will delay healing and may cause other injuries. If you have been issued with a walking aid, please refer to the advice leaflet. Walking aids should only be used as directed. It is important to walk as normally as possible.

Pain relief

It is important to take regular pain relief and not wait until the pain is unbearable - your local pharmacist will be able to advice you. Always follow the instructions on the packet. Ibuprofen should be avoided until the injury is 48 hours old as it will act against the body’s initial healing response.

Remember

With soft tissue injuries there is a risk of an undetected fracture. We will contact you should this be the case. If your symptoms are not improving after 7 days, please return to the Emergency Department or your local Minor Injuries Unit for reassessment.

Should the pain in your foot increase or your ankle continue to swell or it becomes hot to touch then you need to seek further advice. Please contact your GP, NHS 111 or return to the Emergency Department.

Further information

You can refer yourself to a physiotherapist for advice, please visit:

Website: www.gloshospitals.nhs.uk/our-services/services-we-offer/physiotherapy/how-can-i-see-physiotherapist/

Arthritis Research UK

Website: www.arthritisresearchuk.org

NHS 111

Tel: 111