Fractured Fibula, Healing But Pain Won't Go Away

by Sharon
(Massachusetts)


On 7/28 I fractured my fibula.

On 7/30 I was put in an air cast by a nurse practioner and the orthopedist office.

I kept the cast on except for showering for 6 weeks. On 9/10 the cast was removed, the x rays showed healing and I told the nurse practitioner that I was having considerable pain in my ankle.

I went to physical therapy for 3 weeks. The physical therapist said that I was making excellent progress. I was still having increased pain especially at the end of the day.

I saw the nurse practitioner at the orthopedist on 10/6. By now I couldn't sleep at night because of the pain in my ankle.

The nurse practitioner after consulting the doctor gave me a very painful cortisone shot and some pain medication and said it should be resolved in 2 or 3 days.

I found your website and started icing 4 or 5 times and day and ice water dipping 20-40 times a day for the past 5 days. My ankle is marginally better but at days end sore and interrupting sleep.

What now?



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Joshua Answers:

Hi Sharon. Thanks for asking. I like 'tough' scenario's to help figure out.

So....what the nurse practitioner really meant to say was that she 'hoped' that it would be resolved in 2-3 days.

Corticosteroid Injections don't fix anything. At best, they get rid of the pain for a while.


So I have some questions:

1. How exactly did you break the fibula?

2. How bad was the fracture?

3. How active are you on your feet historically?

4. Any history of pain/problem in the ankles, like Tendonitis?

5. Is the pain in your ankle now, at the site of the fracture or somewhere else?

6. Please describe the pain in as great detail as possible. How, when, where, what helps, what makes worse, etc.




Some thoughts I will expand on or not after I get your answers:

1. If you are Vit D and Magnesium deficient (very very likely) then the bone may not be healing as well as it looks like it is. Low magnesium levels equal less calcium utilization, for instance.

2. Depending on the impact and where your pain is, you may have jammed and stuck your joint and an expert chiropractor or osteopath can make it right.

3. KEEP ICING! There is a HUGE and stubborn Process of Inflammation that kicks in with fractures and breaks.


I'm curious to see how you answer the above questions.





Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Oct 12, 2009
Fractured Fibula, Peroneal Tendonitis, Healing But Pain Won't Go Away
by: Sharon

Thanks for your interest.

I fractured my fibula on the golf course walking from cart path to grass on uneven terrain, turned the outside of my ankle.

Before the fracture I played golf 4 times a week, walking not riding. I took power yoga classes twice week.

I went to the gym and used the elliptical trainer and do weight training 3 times a week. I'm 62, walk a lot and am fit. My bone density tests are good.

The fracture was distal and non displaced. It was not considered a problem break.

When I went back to the nurse practitioner at the orthopedist after consulting with the doctor he thought my increased pain was because I had peroneal tendonitis.

That's when I got the cortisone shot. I have flat feet and they tend to overpronate. I wear orthotics but have never had problems with tendonitis before.

My physical therapist suggested that when I fractured the fibula I also sprained my ankle and this tendonitis is the result.

I've been in pain from the time of the fracture.

The pain is strong right around my ankle bone and the cavity above the bone not the site of the fracture. It is an aching pain. There is also a pulling sensation that goes up my calf. It is not too bad just stiff in the morning and gets worse as the day wears on and wakes me up at night.

I've been icing 4-5 times a day and ice dipping 20-40 times a day. I've been keeping my leg up and elevated most of the day. It does seem better after icing or dipping. I take calcium, magnesium and vitamin D. Should I get an MRI?




Oct 13, 2009
PART 3 - Fractured Fibula, Peroneal Tendonitis, Healing But Pain Won't Go Away
by: The Tendonitis Expert

Joshua Comments:

Hi Sharon.

I don't know whether to be more impressed that you're that active at 62 (compared to other 60 year olds, not that 62 is 'old') or that you ice dip 40 times.

Rock on!

So.

1. Should you get an MRI? Only if it's paid for and you're curious about what it shows. Functionally, it's unlikely to give you any information that is going to make a difference.

That probably doesn't get across what I want it to, but...what you are going to do to get better isn't likely to change with whatever you happen to see on the MRI.

Having said that, they're interesting. It's all about learning more about your body. So go for it if you want to.


2. Am I correct that the fracture itself doesn't hurt, it's more up the leg and overall ache?

How much do you think that overall ache is from the fracture, as opposed to the tendon strain.


3. Out of curiousity, how much magnesium and Vit D do you take? (ever had your Vit D levels tested?)

If you're taking mag, that makes your calcium more uptakeable, so I'm not worried about the fracture healing.


4. If you feel pulling up your calf, that's a good indication that something like the Peroneus is involved. Maybe there's Tendonitis, maybe the muscle is just still overprotective and too tight from the ankle turn.


5. I bet you did sprain or strain your tendon.

Sprain is ligament, strain is tendon and/or muscle.

And, possibly you pulled a little bit of tendon connection away from the bone. That wouldn't show up on xray, unless it pulled up a chunk of bone too, which happens. Ouch.


Suggestions:

My first and main suggestion is to fine tune your icing by getting an ice cube, for instance, and massaging anything that hurts. This includes tracing that pulling up the calf, finding that specific muscle, digging the belly with ice, and follow it down to the tendon and attachment.

Ice dipping, keep that going. The more blood to the area and waste product and pain enhancing chemical out, the faster everything can heal.


That was mostly stream of consciousness there.

If it didn't answer your question(s) specifically....More questions, more answers.



Oct 14, 2009
Fractured Fibula, Healing But Pain Won't Go Away
by: Sharon

I take 400 mg of Magnesium and 1000 of Vitamin D daily.

The pain is definitely right around the outer (fibula) bone. My primary care doc had blood tests done 3 months ago. I was found to be low in Vitamin D.

My physical therapist has been doing electronic stimulation. He says it brings blood to the area.

I'm feeling very discouraged and sort of depressed at not being able to exercise. The physical therapist gave me some exercises to do.

So I've been doing those, icing and ice dipping. I know that everyone heals at a different rate but how long before this pain goes away. It is at the same level and intensity for the past week.

Sharon


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Joshua Comments:

Hey Sharon.

An infants dose of Vit D is 800 iu's. If 1k/day is all you've been doing, I guarantee your levels are still low.

This can have something to do with your pain, actually.

Keep with the Mag, that's good.

Stim is ok/good, exercise is good. Keep it moving.

I don't remember if you said where you live, but it may be worth it to find a really good massage therapist that knows what they're doing.

If you can relax the muscles and cuah of the lower leg, expecially that one that you feel the pull up your calf, that can go a LONG way.

You can massage yourself too. While watching tv, just feel around, explore, stretch, push, dig, pester, etc. The more tender a structure is, the more love it needs. Love being a technical term for attention and touch and work.


It sucks the pain is lingering, I know. Some things really do take time. But they take LESS time if you treat them right, with icing, and massage, and the right nutrition.



Nov 10, 2012
i got fracture the fibula in the joint of ankle but pain is still there even after 45 days
by: sanjeev gaur

I got fracture in fibula bone at lower front joint portion on 28 sep and applied the splint for 8 days and after that removed the splint and start bandaged the ankle and back to normal routine but i was not putting proper weight on my foot because there was not such pain in the ankle but now when i start putting weight on my leg for last one week the pain is not going and could not walk properly.

One can easily feel the fractured piece of joint bone of ankle by touching it. Doctor said that the bone is properly fixed.

I am taking one calcium tablet per day and one vitamin D in a week.


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Joshua Comments:

How much Vitamin D are you taking?

Might also want to consider adding magnesium, as Vitamin D and Magnesium are required for uptake of Calcium (and thus better bone healing).



Sep 13, 2013
You are not alone
by: Anonymous

I am so glad to know that I am not alone when it comes to how my fibula was broken. I too, broke my ankle on the golf course. I broke it bad and went through surgery a few days ago. It happened so fast that it is hard to explain how it happened.

But I am worried that it may take more time to heal than what the doctor is telling me. After doing my own research it will take 9 weeks at best to be up and running again. But, that is only if there was no damage to the ligaments - which I think there were.



Mar 11, 2014
I GOT THAT FRACTURE PLUSS BLOOD CLOT BEHIND KNEE OF INJURED LEG
by: KAY

I HAVE THE FRACTURED FIBULA AND IN A AIR CAST AND CRUTCHES.IT'S BEEN 6 WEEKS AND STILL CAN'T WALK WITHOUT CRUTCHES.

I ALSO CAME DOWN WITH A BLOOD CLOT BEHIND THE KNEE OF THE INJURED LEG. I'M BEING TREATED BY THE ANTICOAGULATION CLINIC AT OUR HOSPITAL AS AN OUT PAIENT. WITH TAKING INJECTIONS TINZAPARIN [INNOHEP] 9ML. AND WARFARIN 2.5 MG.. I INJECTED MYSELF EVERY MORNING AT 11AM AND TOOK BLOOD WARFFIN AT SUPER[ 2.5 ,3 OR 4 TABS ] DEPENDING ON MY BLOOD WORK . MOBILE LAB CAME THREE TIME A WEEKIN MORNING.

AFTER 9 DAYS ON TINAPARIN INJECTIONS I WAS TOLD I DON'T NEED TO INJECT ANYMORE BECAUSE MY LNR WAS 2.5. [ THE GOAL LNR IS 2.5-3.0] I WAS TO BE ON BLOOD THINNERS FOR THREE MONTHS AS AN OUT PATIENT. I'M HOPING IT'S GOING ALOT SOONER. NOW THE ISSUE IS I CANNOT GET PHYSIO THERPY BECAUSE OF THE BLOOD CLOT. SO ALSO I HAVE ISSUES WITH PAIN AND BEING UNCOMFORTABLE.

I TAKE A VIT D PERSCRIPTION ONCE A WEEK VIT.D. I NEED TO SOMETHING TO STRENTHIN MY RANGE OF MOTION WITHOUT BOTHERING MY BLOOD CLOT. CAN I ICE MY FOOT TOO. THANKS KAY


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Joshua Comments:

Hi Kay.

1. Please don't type in ALL CAPS

2. You may want to reconsider taking 'prescription Vitamin D', as it's almost always Vit D2, and you want Vit D3. D2 brings up levels but confers no benefits. Vit D3 confers benefits and raises levels.

What is your Vit D level?

3. Icing should be fine, but if you have a blood clot, you definitely need to ask your doctor.

4. Keep your foot ankle moving, even just a tiny bit inside the cast. MOvement is a good thing. Immobilization is not so great. But if you can activate the muscles and get even a little bit of length and shortness, that's a good thing in the long run.



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