Fractured Fibula, Healing But Pain Won't Go Away

by Sharon

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?


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?

See: What Is 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.

Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.

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

Subscribe to The Tendonitis Expert Newsletter Today!

For TIPS, TRICKS, and up-to-date Tendonitis information you need!




Don't worry -- your e-mail address is totally secure.

I promise to use it only to send you The Tendonitis Expert Newsletter.

Reversing Achilles Tendonitis ebook cover

Plantar fasciitis Treatment That Works dvd cover

Reversing Shin Splints ebook cover

Comments for Fractured Fibula, Healing But Pain Won't Go Away

Average Rating starstarstarstarstar

Click here to add your own comments

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!


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.


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.



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.


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
by: KAY






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.

May 12, 2015
Spiral Fracture of the Fibula now swelling and uncomfortable
by: Angela

One week ago I fell whilst hiking and broke my fibula. I have a minimally displaced spiral fracture. I am due to see the ortho surgeon tomorrow. At the moment I just have a backslab on.

Initially I had no pain and really didn't think it was broken till the xray was taken.

My foot and ankle is now swelling and aching and uncomfortable. Elevation helps a little.

Can you describe the icing and dipping procedure. I would like to know any other techniques to help repair and elevate the aching.

thanks Angela


Joshua Comments:

Hi Angela.

See: How To Reduce Inflammation

What did the doctor say?

Did you get a cast on?

Jun 01, 2015
broken fibula, 13 weeks still painful
by: Paulunderhill

I'm 45 and fell over and broke the fibula about an inch above the ankle, plaster cast for a week then airboot for 6 weeks.

Doing my own physio at home, stretching etc but walking is painful after about 15-20 minutes, progress seems slow hindering me from golf, hiking and my job as a postman.

Orthopedist was happy after 6 weeks that bone had healed so why 7 weeks later is there 4 hours of discomfort after about 50 minutes walking?



Joshua Comments:

Hi Paul

Aside from any residual of the actual broken bone, discomfort etc exists because if the chronic inflammation, but moreso the connective tissue shrinkwrapping that happens when immobilized in a cast etc for weeks.

Muscle gets constricted by connective tissue. Connective tissue shapes itself to the smaller shape. Muscle is constricted, and doesn't work very well in that scenario.s

Sure you took it out of the air cast some, but the dynamic remains.

Jun 03, 2015
Am I worrying over nothing?
by: Paulunderhill

Is it worth going back to check at hospital if bone residue is present or does this problem resolve itself over time as will the inflammation and I just need to be more patient?

Thankyou for your time


Joshua Comments:

What do you mean, 'bone residue'?

Personally, I would never be patient in the hopes that pain problems will fix themselves.

You might realize one day that it's been 2 years and still hurts. Humans are funny like that...we have this innate expectation that we'll just eventually heal back to normal.

With my ruptured disc thing, I had learned to manage it, but one day I realized that I'd had significant pain in my back for 3 years. 3 years! And I noticed I had this daily conversation in my mind that 'it would get better soon'.

So I wouldn't be patient.

I'd be ice dipping as per the How To Decrease Inflammation link you'll find in this thread.

I'd be hitting up important nutrition to give your body everything it needs. Bones need access to calcium, and you need adequate Vit D and Magnesium for your body to utilize its calcium.

I'd be lengthening the too tight connective tissue that is now compressing everything in/around the area.

Jun 03, 2015
by: Paulunderhill

I was referring to your quote of "residual bone" that I interpreted as there may be bits of bone from the fracture present?

But surely if this was the case it would hurt from my first steps in the morning whereas I have NO pain until I've been walking for about 10 mins.

The doctor told me to walk and play golf but it's difficult as its so painful after about half an hour. Do you think this is normal or I get checked out again?

I'm an active person so being immobile drives me nuts! But I don't want to do more harm by doing too much if there is such a thing?

After all the bone had healed as I saw the x Ray image so do I plod on through the pain or get checked out again?

Really appreciate your input, thankyou


Joshua Comments:

Oh, I see.

Sorry, I meant residual downsides of a broken bone, specifically bone/calcium build up, pain at the specific site of the break, pain from the periosteum (the connective tissue layer that shrinkwraps bone) swelling etc.

If you have a floating shard of bone that's likely problematic, but not what I was referring to. It's unlikely short of a couple specific (and bad) kinds of breaks, where bone shatters or splinters in to multiple pieces.

Yes, it's probably normal. You're ONLY 7 weeks out from a break and immobilization.

The bone healing is only one of multiple factors at play.

* Chronic inflammation process and pain enhancing chemical in the area
* Connective tissue layers shrink wrapping/constricting
* Too tight muscle
* Muscle tone set too tight by the nervous system trying to 'guard and protect'
* Various other smaller but possibly significant factors

Have you ice dipped as I suggested (after going for a walk and upping the pain levels)?

Oct 21, 2015
Fibula break and arch in back of ankle hurts in cast
by: Anonymous

Hi I have recently broke my fibula in a cast at the moment but having pain under the arch of my foot right around the back of my ankle is this normal? 4 days in a cast so far.


Joshua Comments:

Hi Anonymous.

I don't know if it's normal or not, but it's definitely within the range of unsurprising symptoms/side effects.

Is the cast pressing/rubbing on anything in a way that would cause this?

Dec 12, 2015
Looking fot Advise about broken fibula and 4 weeks of pain
by: Anonymous


I fell 4 weeks ago breaking the fibula at my ankle and mid way.

Both breaks were non displaced and I was placed in a plaster cast for 4 weeks.

I walked around with my leg broken for 2 weeks before i even knew it was broke because the doctors told me it was fine and would heal on its own.

Ive had the cast on for 2 weeks not not including the 2 weeks I had nothing and I noticed that my leg is still sore when i apply pressure when walking or move a certain way.

I have also chiped the bone at the top of my knee as well which my ortho surgeon stated she wanted to put my knee in a brace but couldnt because the cast came up so high and there would not be room.

At first i was not able to bend or fully extend my knee which i am able to do now but if im sitting or standing for long period of time my knee locks on me.

Is it normal that i should still have pain after 4 weeks of the injury and when i see my ortho surgeon in 2 more weeks time anything i should ask or tell her .

She stated as long as everything heals the way she thinks it will i will not require surgery but it bothers me my ankle and my mid fibula still hurt in the cast about the same as when i did it 4 weeks ago.

Any advise ?


Joshua Comments

Hi Anonymous.

You broke a big bone from a big impact, and walked around on it for two weeks.

It is not at all surprising that it hurts 4 weeks later.

Did you chip the bone at the knee from the same fall?

If so, that was a major impact, so yeah, 4 weeks is easily to be expected.

We'll just have to see what the knee does. Mobile joints don't like to be immobilized. If the chip is floating around in there.....

Dec 15, 2015
fractured fibula
by: Abdi

Hi Doctor, I broke my fibula and ankle 11/09/15 after a car ran over my leg got some screw in my fibula luckily didn't fracture my tibia.

I spent 3 nights in the hospital and then was sent home with antibiotics and pain killers.

I did some icing while I was in the hospital but since I came home I never iced it because swelling went away real fast within the first week after I had my cast off and I'm just on removable boot so just wanted to know is good to ice knowing that I have screws in my leg. I thought Introducing ice would not be a good idea I don't why i thought that honestly but it has been 5 weeks now and just wanted to know if icing now after 5 weeks into is ok?

Some swelling back after I had to some places and I have been on foot with crutches and hanging my other for so long caused me some and some swelling. Soon as I came home I started elavating and icing because of the swelling and pain even tho I was pain since my first after breaking leg.


Joshua Comments:

Yes icing/ice dipping after 5 weeks would be a good and smart thing to do.

Dec 16, 2015
Snapped displaced Fibula
by: K8

11 weeks ago I slipped down 2 stairs, my foot folded in half and I heard a snap. Immediate shock.

Teeth chattering, garbled speech and extreme nausea. Called Ambulance. Told it was a sprain and to put weight on it. Got up in night to go to bathroom. Felt sick and faceplanted after passing out. Shock symptons worsened, carpet burn on my face. 20 mins in and out of conciousness although only totally out max 60 sec at beginning. Crawled back to bed. Damaged arm shoulder and intercostal muscles.

Had to keep lifting half of foot back onto pillow . Iced etc. Sweated until drenched - clothes sheets.

3 days later went to Dr then Hospital. Snapped like a carrot they said and back slabbed it. Week later said it was displaced and manipulated it without painkillers to line up. Ouch! Saved having Titanium rods.

At 7 weeks they thought it would be time for weight bearing but xray showed not healing very well.Changed to Moonboot.

Due to go back at week 14. Painful if I dont have regular meds. Can move a little. Have a knee scooter- only way I can get around.

Why is it taking so long. Im an active female in my 50s feeling miserable , sore, swollen, housebound and unable to do very little.

And to top it off my husband broke his Scaphoid in 2 places right in the middle of his dominant hand.

Any advice please?


Joshua Comments:

Hi K8.

Why is it taking so long?

Because you snapped your foot, got terrible care from your doctors/hospitals, got no good rehab followup, and are certainly (becuase most everybody else is) nutritionally lacking in the sense that you'd heal better/faster with more/better nutritional intake.

Oct 18, 2016
Son had severe pain after fibula surgery
by: Mary

My 17 year old son was in a car accident, broke both his fibula and tibula and ankle.

He underwent surgery to have the titanium rod placed since his growth plates were closed. Its been 15 days since the accident and 7 days since the wrappings came off and his ortho placed him in a walking boot.

Every night he wakes in excruciating pain at this shin and ankle. Pain meds dont seem to work and neither does icing for the swelling that he still has.

He has a follow up 10/20 to remove stitches.

What can be the cause of his pain and what do I need to have the ortho look for. No over the counter pain relief helps and I hate to see my child in so much pain. I don't know what could be causing this.

Possibly a pinched nerve, blood clot,,etc?? Im kinda of grasping at straws here and need some help.


Joshua Comments:

Hi Mary.

1. Ouch.

2. "What can be the cause of his pain"

He broke multiple bones (which required massive traumatic/blunt force/impact to the body).

Then he had surgery, which cut a lot of flesh, and had metal drilled and pounded into his bones.

And he's only two weeks from that.

I appreciate that you don't like seeing him in pain. And, your boy's been smashed up. He's going to hurt.

3. Having said that, there's all sorts of factors than can be accentuating his pain.

- Maybe he's got a pinched nerve...but there's nothing to be done about that. He got smashed up. There's all sorts of bruising and swelling and what not. And the surgeons did cut through flesh and everything else in the way.

Little nerves got cut. Maybe/maybe not any big ones, no way to tell at the moment.

- If he's got a blood clot, that's a life threatening issue. Go to the ER or doctor and get an ultrasound to rule it out.

There is also symptomology that comes with blood clots...doctors might not even do an ultrasound without those symptoms (but you can still yell at them until the do the test).

Better safe than sorry.

- Maybe he body is rejecting the titanium (super rare), but aside from that, he's had a metal rod hammered into his bone.

That's going to hurt. A LOT

4. "Pain meds dont seem to work"

A. He's in major trauma still (having been smashed up), with massive Bone Bruise mechanism.

Meaning, there are various things ACTIVELY sending pain signal to the brain. He didn't 'step on a nail' two weeks ago..but it's like he still has a nail in him.

In fact, he does. And it's in his bone. The body does NOT like that intrusion, so he's not actually two weeks 'past' the trauma. It's still a fresh trauma.

B. Having said that, how much pain meds is he on? What kind?

I'm no expert there. Talk with your doctor see what options are available.

I'm not a big fan of pain meds, but give them a big thumbs up to get one through the day/through the night FOR A SHORT PERIOD OF TIME.

But you gotta do what you gotta do.

First we have to just get him through the tough stage of post-trauma recovery. Which includes a bunch of pain.

"Sorry kid, it's the way of the world. Welcome to your mortality."

5. "neither does icing for the swelling that he still has."

Is he in a cast?

Are you ice packing? 20 minutes a time, etc? how much are are you covering?

Elevating the leg, etc?

6. Summary:

A. He's still in acute mode, with active trauma (metal in his bones, and healing bones, and bone bruise).

B. He's got A LOT going on. 2 weeks isn't long enough to expect a whole lot of reduction in symptoms.

C. He might have 'worse' things going on causing pain, but his level of pain isn't surprising to me 2 weeks out.

D. Talk to the doctor, see what they have to offer re: pain meds.

7. What you should do now:

A. Rule out blood clot if you're worried about it. Via ultrasound.

B. As soon as you can, start ice dipping the lower leg. 10-20 second dips, as often as possible. More often than possible.

He probably isn't up to that right now, so 'as big and heavy as possible ice packs, 5 mins on, repeated as often as possible (let the flesh warm up at least 5 minutes before putting icepack back on).

C. Tell him to keep his toes moving. The body is going to want to tighten EVERYTHING in there up. Keeping the toes moving does all sorts of important thing that will make a big difference in the long run (not the short run).

D. Get the Reversing Achilles Tendonitis program.

For a variety of reasons including:

- Your son should go heavy on nutrition right now (the nutrition in the program). I'm not going to explain why right here. But I will stress that nutrition is SUPER IMPORTANT for his short and long term future.

- He's going to have (and currently has) all the factors of tendonitis...i.e. muscle and connective tissue tightness, inflammation, and nutritional insufficiency. The program is how you deal with that and keep the body mobile and functional...even (post)trauma like your son has experienced.

- It's a self care plan he should follow for recovery. I wouldn't leave it to 'time'. Time does heal all wounds, but often not very well.

We want him to recover as optimally as possible.

8. Ask more questions.

Oct 27, 2016
8 weeks broken fibula pain
by: Carol

I'm a 67 yo female who broke my left fibula Sept. 2 falling from my bike.

It was a clean, nondiplaced break.

Put in a splint in the ER then went three days later to the dr. who had performed a fasciotomy on same foot in July. No cast. Use boot and stay off of it.

Family complained I didn't see an orthopedic dr so I went to one a week and half after the break.

He said I could start putting a shoe on and to try walking a little each day. So, getting two different opinions, I continued to wear the Air Cast and only lightly put weight on foot while using a walker.

I continued seeing my first dr and continued trying to stay off it. After almost 7 weeks, the x-rays showed about 80% healing. Continue with boot and try shoes a few times a day.

OK, that brings me to about now. The thing is, up until a week ago, I wasn't feeling much pain or discomfort when I tried walking with shoes. Now I feel twinges of pain and discomfort with both shoes and the air cast. The pain is around the ankle but sometimes up my shin area. Sometimes stocking feet feels better.

I still try to put foot up with ice a couple/few times a day. I take 600mg calcium with 800 Vit. D3 a day.


Joshua Comments:

Hi Carol.

Your fibula had a fracture, or a complete break?

I'm guessing fracture if they didn't put you in a cast.

1. Do you know your Vitamin D level?

2. Why are you only taking 800i.u. of Vit D?

3. You're taking Calcium but no Magnesium? (magnesium and vit d are both required to utilize calcium).

4. the pain more around the break, or more around the foot (previous plantar fascia surgery)?

Oct 27, 2016
ankle break 8 weeks broken fibula pain
by: Anonymous

Thank you for quick response. The ER paperwork says fracture and I believe the dr said fracture, but I also thought he said all the way through.

The bones in the x-ray stack up very neatly with no space between. Nondisplaced fracture.

About the Vit. D I don't know my level, but several years ago was deficient. Looked at last winter's lab to find they didn't test it.

I looked for the bottle of vitamins, but realized I must have run out of the 1000 iu and never replenished. The 800 is included in the calcium tablets which do not include magnesium.
The pains are usually around the ankle not foot and they can go up the side of the shin. The pains are kind of pinchy and sharp but are not constant.


Joshua Comments:

Hi again.

It's almost certain that you are still Vit D deficient. You haven't taken enough to ever bring your levels up (from what you've told me here). 1,000i.u./day isn't going to do it.

If you want your bones to heal strong/fast etc, you MUST have enough Vit D and Magnesium. (Do not take more magnesium in the form of calcium/magnesium combo pills as you'll get WAY too much calcium).

Whether that low vit d has anything to do with your current pain we have no way to know. But low vit d equals decreased bone health and function and and and.

It sounds like you had an extensive fracture but not a 'break' per se. A break is a level worse beyond fracture and would require a cast.

See: Magnesium For Tendonitis

See: How To Reduce Inflammation and ice dip the lower leg as described as many times as you're motivated to do for a few days and see how the leg feels with that. It should/will lower pain levels.

Jan 26, 2017
Malleolus fibula fracture from splitting wood
by: Kristie

Hi, 43 yr old female here.

While using a foot pedal kindling splitter, my ankle rolled and I ended up with malleolus fibula fracture.

The bone broke in two and I had to have surgery to place a hook plate and screws to secure it.

The bone and incision seem fine, little sore but fine.

My issue is the achilles tendon is VERY swollen and painful. I can't really flex or exercise my foot like the doc said to.

I ice and elevate 3-4 times a day. I can't dunk yet, the surgery was only 5 days ago.

What will help this aching and swelling of the tendon???


Joshua Comments:

Hi Kristie.

Joshua Comments:

Hi Kristie.

You broke a bone in half, and then had surgery (injury from cutting into your flesh, and then had metal screws screwed into your bone.

I'm surprised you don't have A LOT more pain 5 days later (everybody is different, I have a lowish pain tolerance for that kind of thing, I can't help but think I'd have to be comatose on painkillers for a month).


1. The good news is, you don't have a lot of pain. That's a huge plus.

2. You do have pain in the achilles tendon.

I imagine that the muscles attached to the achilles tendon contracted HARD when you broke the bone. And continued to contract to try to guard and protect.

Just that big contraction can make you sore, but you're not complaining of sore muscles, you're complaining of sore and swollen tendon.

3. There was enough force to snap a bone in half, there would have been plenty enough force to tug on/pull on/overstretch the achilles tendon and/or it's attachment to the bone.

Did the xray show anything around the achilles attachment?

Just an xray? No MRI?

4. How exactly is the achilles tendon swollen? Like, visibly? Can you see it? Or does the tendon just feel swollen?

Maybe you have a little tearing of the tendon/tendon attachment. Wouldn't be surprising, and wouldn't show up on an xray (unless the tendon pulled a big bone chip off).

5. Maybe the tendon hurts and is swollen just because of all the trauma that happened near it. It might hurt/be swollen but not have anything wrong with it.

6. Short of an MRI, there's no way to tell right now. We'll have to pay attention and see how things go.

7. Once the incision heals, and depending on what kind of casting you're in, I'd ice dip as many times per day as you're motivated to do.

5 gallon bucket (or bigger), frozen water bottles, and/or ice so it's arctic cold, and 10-20 second ice dips. 20 minutes of ice pack is a waste of 19 minutes.

8. There's massage (later), but for right now ice dipping is your #1.

You're fresh out of trauma and surgery trauma. Short of pain killer and staying off it and elevation, there's not much to do for it but suck it up and let some time pass.

Then ice dip it like crazy.

Then you'll need to do some serious massage work to get all that too tight connective tissue open and loose again.

Make sure your Vit D level is between 60-80ng/ml and take some magnesium so your body can utilize calcium better and heal the break better/faster.

Mar 19, 2017
10 year old with Fractured Fibula
by: John

Hi Joshua,

My son fractured his Fibula on 4th Dec 2016.
We were told it was only muscular by 3 nurses, and the pain seemed to go away and he said he was ready to play football again. He got kicked in the same place 4 weeks later and was in a lot of pain like the first time.

He'd had an MRI just before the second kick and we had to wait ages for the results. The MRI showed undisplaced healing fracture right proximal third, soft tissue oedema.

Its been rested now from Jan 3rd to Feb 22 (6 weeks on top of the previous 4 weeks).

He's had pain all the way through the last 6 weeks and has a lot of pain if trying to run on a hard surface (sharp pain like the original injury).

The latest XRay (today) shows the bone healing with a callous, and no sign of any fracture.

What could be causing the pain?

Its odd the pain is more so since the second knock to the Callous area, as after 4 weeks initially the pain had almost gone totally.

Can I do anything to help ease it and speed recovery?

What would normally be the time to return to contact sport (nearly 12 weeks in now)

Many Thanks


Joshua Comments:

Hi John.

1. How old is your son?

2. Don't take this wrong, but you son got kicked so hard it fractured his bone, and then not too long later, before it was healed, got kicked again in the same spot (fractured bone).

So it's entirely unsurprising that he still hurts.

3. There's more than just bone to consider. There's:
A. the periosteum, the connective tissue that shrinkwraps bone. An impact fracture means it's going to be bruised/swollen painful.

B. Bone fractures cause bone bruise. A Bone Bruise is a painful, stubbornly long lasting thing (you can speed up the recovery, but still).

C. Speed of healing: What is your son's Vit D level? Chances are it's low. All in all that equals slower/less quality healing.

Youth only goes so far.....damage is damage. And 'worse' than damage, is how the body responds to it.

D. Is it bone pain or regular/general pain? Inflammation releases chemical that enhances one's senstitivity to pain (meaning, it dumps chemical which makes things hurt).

Read this entire thread and the two threads linked to below, that should answer your 'what to do' question(s).

Then come back to answer the above, ask questions, etc.

See Related: Broken Fibula Low Vitamin D

See Related: Myositis Ossificans and Anterior Compartment Syndrome Symptoms Kicked In THe Side Of The Calf And Shin Twice While Playing Soccer

Mar 24, 2017
follow up to previous question re 10 year old
by: John

Hi Joshua,

Thanks for the reply. About 14 weeks after the injury (he's 10 years old), he woke up one morning and said my legs stopped hurting!

For no obvious reason he now has a pain below his ankle bone.

Could this be some form of deferred pain...hes been taking 400 iu daily. How long is it advisable to keep taking it for?



< b>Joshua Comments:

How long should he take vitamin D? Forever. For the rest of his life. He needs a lifelong Vit D level of between 60-80ng/ml (40-60 is good too but not technically optimal).

WHat's his Vit D level? (it's worth it to get it tested so you know what level an intake of 400i.u./day gives him.

"For no obvious reason " Yeah...kicked and fractured is obvious.

What's not obvious is what happens after than, how the body responds (innon-optimal ways_ to pain, how it adapts and adjusts.

Probably he was limping around/compensating for the pain, etc. And as a general theorization, his below ankle pain is a result of that.

Said another way, I'm not sure what you mean by 'deferred' pain, but it's likely it's a result of having been in pain previously.

Ice dip, massage, nutrition.

May 07, 2017
Stiff knee
by: Andrew

Hi - I had a car accident and broke my tibia and fibula. It was an open injury so had to wait for injury to heal before I was placed on cast. 11 months later, cast was taken off but it appears my knee is so stiff and can barely bend it also, I can't move my feet. I have tried to exercise it but to no avail.

Please advice what to do. Thanks.


Joshua Comments:

Hi Andrew.

The short answer is, all the immobilization has caused/allowed all the connective tissue to shrink wrap down.

Now it's stuck short, compressing everything. Imagine a half squeezed sponge tightly wrapped in saran wrap. That's you.

Good news/bad news, you need to force all that connective tissue to lengthen, to stretch, if you want to regain mobility.

Jun 25, 2017
Broken Fibula
by: Anonymous

I broke my ankle May 27, 17. Clean break as I didn't need surgery. Funny thing is I didn't think I broke it. Pain was not bad at all.

Put in half cast because of swelling. Swelling went down and put in air cast with no weight bearing. It has been 4 weeks with no weight bearing yet but I'm having aching around the area where I broke my ankle. It's not every day but it comes and goes.

After reading all the comments I need to up my Vit D. And magnesium. I'm just hoping that the aching feeling is the sign of healing.


Joshua Comments:

The good news is, it doesn't hurt much (lucky you!).

There is no bad news, as far as I can tell. Just an ache 4 weeks after a complete break is AWESOME.

Wouldn't hurt to do some ice dipping to very possible reduce that ache (and yes, the nutrition).

Aug 09, 2017
by: Tiffany


I had a non-displaced fracture 15 days ago, and was ordered to a boot and crutches for six weeks. The doctor says that at the three week mark, I should be able to move my ankle a lot more, however, my foot and ankle are still swollen. Is this normal?

1. After 15 days, is my foot and ankle still supposed to be swollen. I have another Ortho appointment in 5 days and at this appointment he says I should be able to have more mobility in my ankle/foot. I'm worried that the swelling will prevent this.

I have another appointment in 5 days but I am getting a bit worried. I'm 30 and have played sports all of my life, and this is my only serious injury.

Also, if my foot is not propped straight out, like a 90 degree angle if I'm sitting, it feels as though all of the blood rushes to my ankle and it feels heavy. Is this also normal?

Other than this discomfort, I've had minimal pain so I'm counting myself blessed there. Thanks for your time and I look forward to hearing from you.


Joshua Comments:

Hi Tiffany.

1. Yes, when your foot is down fluids flow down to your foot. That's normal.

You just feel it more when injured, for a variety of reasons.

2. Is it normal to be swollen 15 days after a traumatic event including enough force to break your bone?


Not ideal, obviously, and that's why solid casts should be done away with and replaced with removable casts so one can ice dip daily, but hey.

Let us know how the follow with the doc goes.

Sep 06, 2017
Lateral malleolus fracture from ankle twist playing football
by: Anonymous

7 days ago, while playing football, i twisted my ankle and fell down, resulting in a non displaced lateral malleolus fracture.

I have been in a cast for one week, and now my dr said i should start walking on my broken leg little by little.

My question is can i start walking on a broken fibula, or it will delay the healing process?
Thanking you for your help

Best regards


Joshua Comments:

Hi Anonymous.

Presuming you're still in a cast, I wouldn't walk on it*, but I WOULD keep your toes and ankle muscles (everything you can, really), moving firing at least a little inside the confined space of the cast.

Immobilization is bad for muscles and connective tissue.

You want to keep your toes moving, push your foot up/down left/right rotate/rotate as much as you can, as frequently as you can.

This keeps nerve impulse firing, this keeps a little bit of length/shortness movement happening in the muscles/connective tissue/joints.

This will help your recovery in and out of the cast. (everything shrink wraps down when immobilized...ideally you get out of the hard cast and into a removable cast asap...not required but it's way better than a hard cast).

* You could put weight on it if it doesn't hurt, and do 'reps' of putting some weight on it, that's good stimulus for the bone (and everything else) and can help healing.

But depending on how big/bad that fracture is, it may or may not be wise to stay off it. That's your call there, whether to walk on it or not. Pay attention, if it feels ok, ok. If it doesn't feel ok, give it some time.

Giving broken bones some pressure stimulus is good. But you can't 'push' them to heal faster.

Sep 14, 2017
Fractured fibula 9 MONTHS ago
by: Anonymous

Very glad to hear that I am not the only one experiencing this.

Back in December 2016, I fractured my fibula (not displaced) from playing volleyball. Long story short, I landed on someones foot and came down and rolled my ankle, which actually ended up pulling hard enough to fracture my fibula.

I was put into a hard cast for 4 weeks. Went to get rescanned and found out the break did not heal, so I got another cast for 3 weeks. I was non weight bearing the entire time.

After that cast came off, they said it looked like the fracture was pretty much healed so they let me do a walking boot. I could not walk at this point due to the swelling and pain in my ankle.

I was in a walking boot for quite some time and went from using crutches and a scooter, to just walking on the boot. I have been out of the boot and weight bearing since about Mid April and I have not had 1 pain free day yet.

I have done about 6 weeks of physical therapy and continue to do my exercises at home. My doctor tells me I need to be patient and that this is normal. From what I can tell in this post, this is anything BUT normal.

What steps do I take next? Being in pain everyday for 9 months is taking a huge toll on my emotional and physical well being.


Joshua Comments:

Hi Anonymous.

If your bone fracture (not break) didn't heal at all in 4 weeks, that's a nutritional issue.

So even though it's healed since then, I'd still put a focus on nutrition. Also, pain, inflammation, and tight muscles eat up nutrition, and you've had and had all that. So again, nutrition should be a focus.

You have a lot of pain, that's in large part due to all the pain enhancing chemical getting pumped out by the inflammation process.

Chemical out, pain goes down, brain stops freaking out so much.

You were in a cast for at least 7 weeks. The body doesn't like being immobilized, so muscles and connective tissue tightened up. And when structures are tight they don't work as well as they should.

And every step you take is not causing an OVERSTRETCH signal to the brain, the brain tries to protect you....with more tightness and pain unfortunately, etc.

Multiple factors are at play. I'm biased obviously, but I suggest you get and start working with the Reversing Achilles Tendonitis program.

You don't have achilles tendonitis per se, but you have all the factors, and your problem is the entire lower leg (plus nutrition, plus inflammation process) it would serve you best to have a complete plan.

That's all the work you need to do anyway...and as everything gets better we'll be better able to asses if there's anything more serious in there, like you tore a tendon/ligament (did they do an MRI or just an xray?).

Sep 14, 2017
by: Anonymous

Hi again,

Thank you for your first reply.

As i told you before, i had a non displaced lateral malleolus fracture while playing football.

Now after two weeks, and while i still in the cast i started putting some weight on it while walking with the help of crutches, and i am facing no pain or discomfort.

I went to see another doctor who said i should be off of it till the third week.

2 different opinions, i am confused.

Could you plz help???


Joshua Comments:

Hi Anonymous.

When you don't put your name in, I have no idea who or what you may or may not have said before. There's hundreds and hundreds of anonymous posters on here..

There's two schools of thought: On is is that you should push it and that will help heal it, especially if it's not hurting when you put weight on it.

The other is that you should just stay off it and let the bone heal. Maybe you don't accurately feel whether there's pain or not, maybe you don't feel pain the the bone injury doesn't like the pressure, etc.

There's no 100% answer for you. You're probably ok walking around some, but when injuries don't hurt people tend to do more on them than they should and end up causing an increase in pain/ the time they feel it it's too late.

You're probably fine putting some pressure on it as long as you keep with the crutches. And, there's something to be said for playing it safe. So you could find some middle ground and mostly stay off it but also put some pressure on it.

Sep 30, 2017
Lateral malleolus fracture
by: Saria

Dear Joshua,

My name is Saria, and i got a non displaced lateral malleolus fracture while playing football one month ago,

I had a cast for one month and had done repeated x rays that showed non displacement.

One month passed, i went back to my ottho, he removed the cast, and i had another x ray done, showing no sign of healing, so the dr made me wear an aircast, but i will be non weight bearing for another one month.

So what i need to know is the following:, is it normal to take this time yo heal?

And when do u expect i can start walking again?
Ps:my blood test showed normal levels ov vit D and B, Ca and Mg.

Thanking you in advance for any kind of help you might provide.

Best regards,


Joshua Comments:

"is it normal to take this time yo heal? "

NO. No it is not.

What was your Vit D blood level?

What was your magnesium blood level?

Oct 05, 2017
Lateral malleolus fracture
by: Saria

Mg: 21 mg/L
Vit D:111nmol/L


Joshua Comments:

Hmm. That's a pretty good Vit D level (60-80 is optimal but 40-60 is perfectly fine [though you're at the low end of that]).

And that's the high end of the magnesium blood level range (though the blood level results are pretty useless as the body will always keep magnesium RBC levels in range). Still, it's not on the low end of the range.

And the bone still didn't heal much/at all? Hmmmm.

It's possible you're short on calcium (but usually we get enough from even bad diets but don't utilize enough of it because of low magnesium and Vit D.

1. Do you have any other health issues?

2. Did the doctor offer any explanations/theories as to why the bone didn't heal at all?

Oct 07, 2017
Lateral malleolus fracture
by: Saria

No, i am perfectly healthy 29 years old girl, with a very healthy lifestyle (diet and sport).
The only explanation that the dr gave is that this kind of fracture needs this time.
It might be a spiral fibula fracture.

What should I do?
Could you help me plz?


Joshua Comments:

Well, did it not heal at all, or was it not fully healed? Big difference there.

After a month, it -should- be solidly filled in if not finished healing.

But everybody's different.

All I can recommend is more magnesium and Vit D, maybe some calcium for a month or so, more protein. Vitamin K2 (helps Vit D work better).

Nutrition is the big factor in bone healing. Nothing else is really going to help (icing reduces pain, massage helps other things, but not bone healing specifically).

Oct 07, 2017
Lateral malleolus fracture
by: Saria

Well, first of all, i just wanted to thank u for ur replies, it really mean something to me to be able to express my fears.

Secondly the x rays didn't show any solid filling the fractured bones, i asked my dr if i should do an MRI to be able to detect any new tissues, he said it's early.

My nutrition is optimal 5 nutritious meals a day containing complex carbs, healthy fats and lean proteins, with plenty of water and fruits.

I even perform light activities targeting my upper body and core (push ups, sit ups, crunches, back, shouders, bi_tri, chest...). And if i don't try to put any weight on it, i won't have No pain nor swelling

I will take ur advice and start having supplements and hope it will be better soon. Again Thank u a lot..

Nov 07, 2017
Pain won't go away!
by: Anonymous

I was hit by a car on July 6th but was in shock and running on adrenaline.

I was released based on the fact that I could walk. The car struck my mid-thigh. The femur was bruised but not broken.

I went back a week later due to pain in my knee. Nothing showed on X-Ray but was told to do an MRI. I was diagnosed with a fracture of the fibula head in August. Was given a brace (crappy one) and started doing physio. It's now november and I'm still in pain.

The colder the weather gets or if it rains and it feels like the bone is being pulled in different directions. I can walk and stand, I was always able to but some days not even lose does morphine pills will help with the pain.

MRI didn't show any tearing either. What could be wrong, why is the pain not going away?


Joshua Comments:

How exactly were you hit? Details details details (speed of car, you walking or flatfooted or on a bike or..., how did you move after the hit, etc)

Nov 18, 2017
Spiral fracture of the fibular
by: Tammy

I broke my right fibula jumping off a wall doing a tough mudder on Aug 5th. I was casted for 4 weeks.

I had a boot for 4 weeks and then a wrap for 2 weeks.

I am in severe pain whilst walking or putting pressure on the leg. It not only hurts on the outside where I broke it, it hurts more on the inside of the same leg. I use pain reliever & elevate as necessary. How long will the pain last? I'm 52 year old female.


Joshua Comments:

Hi Tammy.


1. Have you had a follow up xray to make sure that the break has healed.

2. What kind of break? Complete break or big fracture or small fracture?

3. What's your vitamin D level? (this is a relevant question)

4. Where exactly did you break the bone?

5. Has walking resulted in severe pain this whole time, or just recently?

Nov 24, 2017
Spiral fracture of the fibular
by: Tammy

Hi Joshua. My answers are as follows;
1. Have you had a follow up xray to make sure that the break has healed. Yes, every time I went for an appointment. So more than 3.

2. What kind of break? Complete break or big fracture or small fracture? It was a spiral fracture. Small crack that went down and around the bone.

3. What's your vitamin D level? (this is a relevant question) I do not take any supplements. However, we just bought 5 acres & I've spent a lot of time in the sun raking NY fall leaves.

4. Where exactly did you break the bone? Approximately 3-4 inches above the ankle bone.

5. Has walking resulted in severe pain this whole time, or just recently? It hurt while casted due to the swelling. It did not hurt in the boot. It has been bothering me since I got the boot off, almost 2 months ago. Mostly the interior portion of the leg, some of the front. I cannot squat down without extreme pain in the front of the leg, where the leg meets the foot and the inside of the leg, again where it meets the foot.


Joshua Comments:

Well, if the xrays show's the bone has healed, then that's unlikely to be the source of pain.

But there's a lot of other factors at play.

1. Get a Vit D level, just so you know. Fun fact: There's no vit d from the sun north of san francisco to boston latitude from October to March.

2. It's a safe bet that you have a lot of inflammation going on. INflammation process releases pain enhancing chemical. Makes things hurt, makes muscle etc tight (and it was already tight).

3. You very likely have pain from bone bruising (see link in this thread).

4. One thing that would be very helpful is to ice dip. See the How To Reduce Inflammation page.

Dec 01, 2017
Fractured fibula day 69
by: Denise

I fractured my fibula into places by twisting my ankle outward. X-ray initially showed no break but a week later it showed up two places.

I was put in a boot and told to elevate rest ice and compress which I did for a solid seven weeks putting no pressure at all on my foot.

I did some exercises with the ankle to keep it a little mobile but it was very swollen and bruised for a long time about five weeks.

I’ve been to the doctor twice since for follow up x-rays and it does show that it is healing.

My doctor told me I could’ve ply partial weight to the ankle using crutches and I’ve slowly graduated to using one crutch and not always wearing the boot.

I have some very good orthopedic shoes that I wore they fit well and we’re comfortable on my feet.

The problem is now the pain is like a fan on top of my foot from the second go to the little tail we are the Toe bones meet the Footbone.

I still wrap and ace bandage around the foot and ankle and have a copper compression brace that I wear intermittently. I now feel pulling along side the ankle and sometimes have heel pain especially first in the morning like planter fasciitis.

My doctor says I do not need PT but I find that I am walking funny and I’m terrified of doing more damage. The top of the foot in that area sometimes it shows which I know is nerve related.

I have upped my vitamin D levels with the calcium and magnesium I eat very healthy for the most part I don’t eat meat .

I have been icing it but I didn’t know about this ice dipping so I will start that ASAP.

I am due to see my doctor next week but he is not very proactive about supplements or physical therapy. I am wondering if what I have on the top of my foot is extension tendinitis whenever I curl my toes polls.

Should I continue to massage that area and the chairs and roll the feet on the ice water bottle?

Thanks Sorry for such a long post but I’m approaching 10 I am 54 years old never broke a bone before.


Joshua Comments:

Could be 'tendonitis', but it's definitely due to the too tight muscle and connective tissue caused by A. the response to the break pain and B. immobilization in the cast. Plus inflammation (tightness and pain) and needing more nutrition.

I wouldn't worry about the name so much as the dynamic, the factors at play.

And yes, unfortunatley, too many doctors are all blase about your pain. "I put you in a cast and took it off, why are you here bothering me with complaints of pain? You're fixed!"

The ice dipping should reduce pain if you do it enough (dip as high up towards the knee as possible).

Jan 04, 2018
Fibular Stress Fracture
by: Sarah

First of all, thank you so much for taking the time to answer so many of the questions above. I am sure you are helping so many people and putting them at ease.

I have a suspected stress fracture in my left fibula) not showing up in x-ray but the doctor says an MRI would only confirm the diagnosis, and if not, treatment would probably be the same.

I am vitamin D deficient and my injury began because I went from being sedentary to figure skating 4 hours a week (which doesn't actually sound like that much). This involved jumping onto the left leg repeatedly. I had pain when I pressed on a specific spot on my fibula and also while walking. I was put in an air cast for 3 weeks and started to feel no pain. Now in the 4th week, some minor pain is back. Two questions:

1. Is residual pain/pain in the tendons/fracture spot normal during the healing process? Is it normal to have no pain for two weeks and then all of a sudden have some pain again? Or is it a sign that I am not healing properly?

2. Since my activity level did not seem that absurd (at least to me), I suspect that my vitamin D deficiency is a sign of how weak my bones are. Besides taking D, Calcium, and Magnesium, is there anything else I can do? Should I do a bone density test?

I would like to return to skating but do not want to injure myself in the future.


Joshua Comments:

You're very welcome. I'm glad you're here.

Treatment would be the same. THere's nothing a doctor can do for such a minor non-visible stress fracture other than 'hey, take it easy for a while'. So no need for the expense of an mri to confirm what you already know: your bone hurts right there.

YOu could do tests to rule out bone cancer, but doctors probably wouldn't even do that since what you describe makes sense (sedentary, vit d deficient, sudden shift from the couch to repetetitive high-impact jumping/landing).

1. Yes.
I don't know.

2. No need to do a bone density test unless there's some reason it's medically necessary.

If you know you're vit d deficient, then you know your body isn't processing calcium into bone correctly.

My quesiton to you is, why are you STILL Vit D deficient?

A. What was your Vit D level? When was the level taken?
B. How much of what kind of VIt D are you taking now?

THat's smart to want to avoid further injury. The smartest way to do that is to get your vit d levels up asap and give your body some time to strengthen your bones.

Do keep skating, maybe don't do jumps etc for a while. There's lots of other exercise/skill training you can do without high 'stress' jumps/landings.

Mar 04, 2018
Will I ever recover?
by: Moni Ade

Went to ER with deep pain in my ankle,and two swollen veins. X-Ray taken and told to just take anti-inflammatories and stop fussing.

Ankle swelled up over 10 days, got admitted for a night - for an attempted aspiration and DVT scan and x-ray. Again, nothing found.

Discharged with a note on my file for an 'urgent' recall to the fracture clinic for an MRI by 5th January. GP keeps chasing up for me and finally arranges a scan with an external MRI provider for 28th January, where they discover a fractured minimally displaced fibula. Excruciating pain has by now spread to heel, calf and foot (screw in large toe from previous op.)

1st February,GP requests 'urgent' appointment with Fracture Clinic who finally call me in for 26th February-i.e. 2 months after the fracture. Fracture clinic do another x-ray and say 'yep we can see the break now but it's too late to treat - looks as if it's 'healing well' so off you go and just keep bearing weight on it!'

Will I ever recover from this excruciating pain?


Joshua Comments:

Well, if it's 'healing well', that's hopefully good.

But....why did you get a fracture in the first place?

Sounds more like a break, if it 'displaced'.

Sports? Activity? Or......?

Mar 21, 2018
Random Question
by: Laura

I broke my fibula 11-7-17. Air cast first nine days. Hard cast for two weeks. Air boot till 1-1-18. Crutches till 12-25-17. No surgery. Last X-ray about a month ago you could see healing but you could also see the break. Doing PT since January. Still a good deal of discomfort and some paint daily. No swelling. Doc said if I still had pain by 3-15-18 he would do an MRI. Not really feeling the point of an MRI because they said the procedure wouldn’t change of what we do. At a loss. Ready to feel good and walk daily and not have pain. Am I normal? 😬


Joshua Comments:

Hi Laura.

Did you break it or did you fracture it. That will make a big difference in my response.

Mar 21, 2018
fibular break
by: Steven

Hi, 4/2/2018, I broke my right fibula right through on about a 30 degree angle a third of the way up from my ankle and had a stress line through the tibia in line with the fibular break and a stress line running up the tibia on the other tibia side to the fibular, looked like a tee shape on its side with the bottom of the tee lining up with the fibular break.

I high-sided my motorcycle during a dirt bike ride and broke ribs and damaged my thigh. I was put in a back slab to get back to my city and 4 days later put into a boot.

4 days ago it was removed and i am receiving physio. the bottom of the fibula is the outwards facing ankle bone which has swollen up quite large and that and my leg and ankle is extremely painful ( coding and paracetamol now).

I have swelling in my lower leg (edema) and its hard to walk.

I realize 6 weeks in a boot restricting ankle movement has caused tendons and ligaments to seize up and it will come right, but its like another injury and time recovering.

I know it will get better as I have broken numerous bones in my 36 years of motorcycling and other sports.


Joshua Comments:

1. Ouch.

2. It's unsurprising it still hurts, as A. you're not as young and vital as you were the last time your broke stuff, and B. it takes a massive amount if force impacting your body to break bone like that (and fracture the tibia too! which means the joints and everything else were impacted/compacted/etc).

3. And, you have less nutrition available to your body to deal with all this than you did in the past.

Pain, trauma, injury, etc etc, and the resulting quickly progressed tendonitis dynamic (see Pain Causing Dynamic) eat up various nutriiton.

The resulting acute and chronic inflammation process eats up nutrition.

THen, the NEXT time your body smashes into something (this time), it's less able to happily deal with the trauma.

So slower healing times, larger 'protective' responses like swelling, etc.

4. Time and rest, etc, have a certain amount of necessary role here. And, it's a safe bet you will speed up your recovery time with adequate nutrition in.

For instance, if your vitamin d levels are low, which they probably are becasue most everybody's are, then your body can't keep your bones as strong/healthy/resilient which also means your breaks won't heal as fast and strong as they would if your body had enough of what it needs to work optimally.

5. I'd get my Reversing Achilles Tendonitis program, it covers the bulk of the nutrition that will make a big difference for you.

You don't have achilles tendonitis per se, but in effect you have a huge and acute tendonitis dynamic: too tight muscle and connective tissue, inflammation process, and nutritional lack.

It's smart self care that will serve you well (probably right now for at least a few weeks you'll just deal with the nutrition and inflammation..and get to the manual self care later when pain levels are down/acute stage is dialed down, etc).

Let me know if you have any questions.

May 07, 2018
Second opinion?
by: Christina

On the 14th of April 2018, i fell in walmart and fractured my fibula, a spiral fracture a couple inches away from my ankle. I had surgery the 18th of april.

Saturday i blacked out and went to the er monday the 23rd, they found massive blood clots in my lungs and one in my leg tuesday morning, the 24th.

While there, i asked them to look because my stitches were being irritated, i thought from the guaze in the splint.

Orgininally, i was suppose to have a splint for two weeks, then a cast for two weeks, then a boot and physical therapy. The day of my surgery, they said the splint for two weeks and then the boot.

I was in excruciating pain, doctors refused to up my meds, was prescribed 5mg Percocets, which didnt do nothing for the pain. While the pain has died down some, i hurt all the time. My foot constantly has a tingle, and i keep getting spasms that feel like a knife being stabbed in my foot.

My ankle itself wasnt hurting, until recently. My issue is that normally when i explain something to the doctor, they just tell me its normal.

I've never broke anything before. But my foot doesnt feel normal. What do you think? Thank you.


Joshua Comments:

Hi Christina.

How extensive was the surgery (that was presumably to do something about the spiral fracture)?

May 07, 2018
Second opinion?
by: Christina

They put a plate and screws in. Im not sure what it looks like, as i dont have access to any photos post surgery. I have the xray and see the break, and have pictures of the cut with stitches. It was over within an hour and a half.


Joshua Comments:


1. A spiral fracture is a serious trauma to the body.

2. Drilling screws in to attach metal plates is also a serious trauma.

3. It's not unlikely that big/small nerves were cut during the surgery process.

A. It's going to hurt, and hurt for a while. There's A LOT going on from all that's going to hurt.

Doctors should pay more attention to your complaints etc. But other than flood you with more painkillers, there's nothing they can do for you post-surgery.

B. If nerves were severed or nicked, that's going to be very problematic. Again, nothing doctors can do about that other then pretend it's not a result of the surgery.

C. If you had blood clots in your lungs etc from the surgery, there's a whole host of medical issues going on I'm not qualified to comment on. That's definitely a conversation for your doctors.

May 08, 2018
Second opinion?
by: Christina

They all seem a bit confused as to whats going on. I tried explaining how much pain i was in, and its like they shrugged their shoulders at me. I have an appointment in the morning, so ill be able to update you on what he says. Is there anything i should be asking my orthopaedic surgeon/doctor?


Joshua Comments:

Yeah....I'm pretty sure that 'shrugging' it off is because they have no idea why you're in so much pain and having nerve symptoms.

Which generaly turns into that it's somehow your fault (because their surgery couldn't possibly have made things worse).

In their defense, a spiral fracture is a BIG deal. But so is the trauma of screws etc to plate the bone (I'll give them the benefit of the doubt that that was necessary).


1. Why do I have constant tingling?

2. What is my Vitamin D level?

3. Why am I having cramping that feels like I'm getting stabbedin the foot.

4. Why are my pain levels so high the pain meds aren't helping.

5. What caused the blood clots?

May 09, 2018
Second opinion?
by: Christina

So at my appointment, the stitches were taken out, xrays done. Theres a thin plate, with four screws, one at an angle.

Met with the doctors assistant, who said the tingling was most likely from the nerve block and that it could last till three months later. He told me something about genetic testing for certain things that could cause blood clots, because for my age, even with smoking, being on birth control, and then having a baby four weeks prior, that i shouldn't have had any blood clot issues, also was taking the recommended 325mg asprin once a day. The pain behind my knee, he said to talk to the general doctor, regarding the blood clot there.

They asked about the appointment with my Pulmunary doctor. They put it in a cast, for two weeks, then i go back for more xrays, and from there they said the boot and then starting back weightbearing. At 25%, then so on. I asked how i would know how much weight to use, he said to estimate, but still didn't quite answer. Regarding the vit d, i asked about it, but being on blood thinners, he wasnt sure if it would affect , adding the supplements. Told me to ask the pulmonary doctor.


Joshua Comments:

Yep, with the blod clots etc, you should go through your doctor for everything.

Vitamin D shouldn't be a problem, but depending on any number of it by your doctor.

If the blod clots were surgery related, that's one thing. But if you have a health scenario that lends itself towards blot clots.....

RE: the nerve symptoms. They could very well be from the nerve block, etc. Unfortunately the only way to know for sure is to wait it out and see what happens.

May 11, 2018
6 months unattended zipline accident
by: Maria

I had a zipline accident 6 months ago that injured my lower calf leg which was bruised (purple blue color) over a month.

I was zipping at 30mph backwards and the back of my leg slammed onto the metal stand. Here it is 6 months later and I never had it looked at had been hurting ever since but I just stayed in bed most of the days and nights (bed ridden).

It hurts to put weight on it and it keeps me up at night. Having my leg hanging from the chair or bed hurts and my ankle also hurts. The injured area has a throbbing pain and I'm really tired of hurting.

Any idea why I'm in so much pain after 6 months? There's no discoloration or swelling of the injured area. My blood pressure gets extremely high when I'm in severe pain. I am fentanyl patch and oxycodone for prior injury that can't take the pain aeay in my calf injured area.

The pain doesn't travel up or down my leg, it's extreme pain where I slammed my calf on the metal stand going 30mph. No doctor had looked at it. Please help.


Joshua Comments:

What's the previous injury?

I'd see a doctor and get an x-ray. If you do or don't see evidence of a fracture, that's good to know. If you do or don't see evidence of Myositis Ossificans (calcified hematoma), that would be good to know.

You had a major impact injury. Bone bruises are bad. BAD bone bruises are worse.

You could have had tissue rip/tear damage (meaning, like popping a balloon, the sudden impact could have burst flesh there in the interior).

Besides the x-ray, i'd start ice dipping like crazy as described on the How To Reduce Inflammation page (see links in this thread).

Jul 17, 2018
9 weeks post fibula fracture
by: Jan

I fell downstairs and my foot went one way and leg the other and I heard the snap. My fibula fracture was a classic clean stick type break I was in a boot with crutches for 6 weeks then after updated xray showed healing I was discharged from the fracture clinic and told to weight bear slowly and gently. I am 60 years old on oral steroids for other problems taking Calcium with Vit D and weekly Osteoporosis tablet.

I have been using Diclofenac gel and paracetamol with codeine for pain as I can't take oral anti inflammatorys due to my other medication. The pain I'm getting is along the line of the fracture , it's not a sharp pain but more of a toothache type pain and it gets worse at night .

Any advice would be helpful.


Joshua COmments:

Hi Jan.


You were in a cast for a while too, yes??

6 weeks in a when exactly was the break?

What's the 'osteoporosis tablet'?

Jul 17, 2018
Stress Fracture Fibula (an inch above ankle)
by: Vasundhara Singh

I had a stress fracture fibula, about an inch above my anke, thats is above the lateral malleolus on 17th of June 2018 and have been in a plaster cast since 4 weeks now, (4th week completed on 16th July), My orthopaedic doc told me that the cast will come off after 6 weeks that is on 30th July. But i have exams from 25th July and I might get it removed on 23rd. (that is after completion of 5 weeks)

I have two questions -

(1) Is it okay if I remove my plaster cast at 5 weeks? I do feel some pain inside the plaster on moving my foot, but its between mild and moderate. Will I have pain after removing my plaster cast on walking?
to give the exam i have to climb 6 staircases. please tell me.

(2) should I start wearing an ankle brace (aircast) as soon as my plaster comes off for better support while walking?


Joshua Comments:

1. 5 weeks is probably fine as long as your careful and don't do too much on it, and don't have any trip and fall events.

Having said that...."Will I have pain after removing my plaster cast on walking?" It's very unlikely that you can go from 5 weeks in a cast to walking around with no problem. It's only 6 flights of stairs but I'm guessing it will be a long slow climb.

If you're young, great. If you're older...not so great.

Probably you'll be fine. But you better show up early and give yourself lots of time, and you better bring a crutch or something just in case.

2. Probably yes. It's neither smart nor wise to come out of a cast and then walk around as normal. Or at least, it's not a very realistic expectation.

Jul 22, 2018
9 weeks post fibula fracture
by: Jan

Hi Joshua, I wasn't put in a cast at all (in the UK) just had a knee high walking boot strapped on - one with a heel and given crutches.

My osteoporosis medication is alendronic acid 70mg, one a week.


Joshua Comments:

Well, that's western medicine for you...instead of showing you the simple nutritional way to avoid/reverse decreased bone density, they just prescribe a pharmaceutical with known serious potential bone damaging side effects. (do some research on fosamax [brittle bones, etc].)

1. Did the doctors do any bloodwork? What is your Vitamin D3 level?

2. How long have you been on the alendronic acid? Before or only after the break?

3. If you have bone density issues, then it makes sense you're going to have pain/more pain/longer healing.

4. It took a fair amount of force to cause that break, which equals 'trauma'. So again, a bunch of pain is to be expected.

5. I'm really surprised they put you in a boot and not a cast. Granted you broke your fibula and not your tibia, so ok.

I would get a 5 gallon bucket (or equivalent) and frozen water bottles (arctic cold water) and do 10-15 second ice dips (as covering as high up the leg as possible. DO as many dips as you can (it may take a couple days, or you may notice immediate results) that can/should/will reduce pain levels. (THat's PRESUMING that it's safe to take the boot off and move around a litttle [non-weight bearing]).

Jul 24, 2018
Stress fracture fibula (part 2)
by: Vasundhara Singh

Hey Joshua! Thank you for the reply to my previous comment.

My cast was removed today and as it turns out, you were right, i am in hell lot of pain (when i put my foot down and try to put weight on it) the ankle was swollen but when I pressed on it there was only mild pain.. but rotating it and flexing it was painful, it felt like a big fat stone and was so so SORE. I got so scared, I started crying.. because I expected to walk as soon as the cast came off. I am 21 years old so pretty young, but im heavy and weigh 80kgs, so maybe thats why I had more pain? In fact i was on my way to weight loss when this unfortunate fracture happened and gained more because of staying on the bed for 5 long weeks.

So, now my physical therapy person told me to get an aircast walking boot and told me to walk normally in it.. (i am missing my college exams 😞)

But my orthopaedician told me to walk on the foot so it can heal (crazy or not?) i asked him about the boot (since it is India, it is pretty expensive here) and he said that it was an expnesive thing to buy, however he did not comment on whether i should buy the walking boot or not.

I have actually bought an aircast ankle ‘brace’ (not delivered to me as of yet)

So, my questions are..

1. When will the soreness go away?

2. When will I be able to walk normally again?

3. Should I try to walk normally on it? (I use a walker and put some weight on it, but very less)

4. Wil it heal back to how it was originally?

5. Will i be able to run again? 😞 I desperately want to loose weight and become healthy.

6. Should I buy the walking boot or the ankle brace would be fine?

Please answer asap Joshua, Thanks again!


Joshua Comments:

1. I don't know when the soreness will go away. Breaks usually hurt a good long while in the best of scenarios.

2. You should be able to, yes.

3. I'd say it's way too soon to try to walk normal on it. Putting a little load on is fine, but the bone itself needs to heal..and if you put too much load on it before it does that, at the very minimum it's going to hurt a lot.

4. PRetty close to how it was, yes. There may be some extra bone produced as it's healing so a bump/lump/ridge of new bone would not be surprising.

5. Eventually. In the mean time, there's swimming, stationary or regular bike, various exercise machines, etc. Combine with eating less process foods and sugar, etc.

6. Probably fine with a brace now, but you want to ease back into normal use. Don't just go thinking youre going to walk regularly on it right away. MOstly stay off it for a while.

Jul 25, 2018
Jan - 9 weeks post fibula fracture pain
by: Anonymous


Joshua Comments:

Well, that's western medicine for you...instead of showing you the simple nutritional way to avoid/reverse decreased bone density, they just prescribe a pharmaceutical with known serious potential bone damaging side effects. (do some research on fosamax [brittle bones, etc].)

1. Did the doctors do any bloodwork? What is your Vitamin D3 level?

2. How long have you been on the alendronic acid? Before or only after the break?

3. If you have bone density issues, then it makes sense you're going to have pain/more pain/longer healing.

4. It took a fair amount of force to cause that break, which equals 'trauma'. So again, a bunch of pain is to be expected.

5. I'm really surprised they put you in a boot and not a cast. Granted you broke your fibula and not your tibia, so ok.

I would get a 5 gallon bucket (or equivalent) and frozen water bottles (arctic cold water) and do 10-15 second ice dips (as covering as high up the leg as possible. DO as many dips as you can (it may take a couple days, or you may notice immediate results) that can/should/will reduce pain levels. (THat's PRESUMING that it's safe to take the boot off and move around a litttle [non-weight bearing]).
I've been on Alendronic acid for several years as an antidote to the potential damage the oral prednisolone I take can cause I have yearly bone density checks and the last one was fine.
My blood results were also good and I also supplement my diet with calcium rich foods.
I actually stopped wearing the boot at 6 weeks and it's now 9 weeks post fracture and I've been wearing normal shoes and trainers and fully weight bearing

Jul 30, 2018
6 weeks post fractured fibula
by: Betsy

Hi Joshua.

Wonderful thread you have going here. Thank you for your insight.

I fractured my fibula late evening on Father's day. Thinking it was a bad sprain I iced it down and hobbled to work the next day at 5am...lasted till 1230 till swelling became bothersome. Was recommended by friends that I should get an x-ray just in case.

I did and it showed the fracture about half an inch from where the fibula and tibia meet for the ankle. Ankle was stable, but fracture was a broken twig at a diagonal...I wish I could upload a pic.

Slightly bone extension on the bottom part of break toward the outside of ankle. Wore my air cast for 4wks. At my 4wk appt Ortho said I could start practicing walking safely around house progressing to walking outside on terrain.

Started immediately and doing side to side motions with Theraband...I have been doing the ABC'S for about 5wks. Swelling is good with just some residual swelling as I go about my day it is on the outside towards the back and same spot on the inner part...almost on either side of the's a nuacance(sp).

I have been getting pain at the flat front of my ankle and the arch as I get out of the car or coming up from a seated position when pressure is applied(stepping motion). It shoots for the first 4/5 steps then subsides...normal? I have been practicing walking down steps normally and staying next to the rail for slight leverage. I do nightly full ankle massage's. I just bought a bottle of Cal(1000),Mag(400),& Zinc(15) + V D3(600iu).

My last Ortho appt(7/12)he said it still looked pretty gnarly but it was a bad break and that when he preceded to tell me to start walking in the house. It does still tend to ache and get mildly tender around that break spot.

I did buy a neoprene slide on ankle brace and a laterally supported neoprene blend figure 8 brace. Does all of this seem normal and coincides with the healing time? I go back to work on the 8/8 and our annual beach day is 8/5. I told my doc about the beach day and he said it was perfectly fine😱...I'm happy but I was like "are you sure" ..."should I wear a brace"...he said no not if you don't want....the sand has more cushion and give unlike grass or pavement and therefore less likely to reinjure.

Thoughts? Thank you very much! fracture happened on a wave ramp at our local skate park...I am 35yrs old and my Vitamin D tested low a couple years ago. I took the pill once a week for the six weeks and nothing else was said after that.


Joshua Comments:

1. How low was the D3 level? What was the number? How long ago.

2. 'The Pill' was, I presume, prescription Vit D2, which raises levels but provides little to no benefit. And nothing else was said about it.....yeah....:(

And of course, there was no follow up to see if the level actually came up or not.

3. From what you've said, your level is still effectively low. And the 600i.u.'s per day you're doing now isn't even an infant's dose.

4. 1,000mg of calcium is a lot (fine for a short time, but a lot). Generally we get enough calcium from even the standard american diet, but don't have enough mangesium and vit d3 and thus the body can't utilize it.

5. Having said all that, a big impact like a skate boarding accident can break even perfectly strong/healthy bones.

6. Still, you want your Vit D3 level between 40-60ng/ml (60-80ng/ml is ideal). Forever.

7. "He said...the sand has more cushion and give unlike grass or pavement and therefore less likely to reinjure. "

**rolls eyes dramatically** Sure sand has more cusion, but that's like 5% of what's going on when stepping/walking/etc.

Function, ability of the lower leg/foot to function correctly is FAR more a factor than how much padding the foot is stepping on.

8. still have a jagged edge of bone sticking out (from the smooth shape of the bone, not out the skin).

Aug 02, 2018
6 weeks post fractured fibula response
by: Betsy

I took the Vitamin D pills about 2yrs ago. My yearly bloodwork from this year... nothing was ever said...I assumed no news is good news.

The break zone just feels like a small hard lump on the bone sometimes not even noticeable...till I've been on it all day and it becomes a little sore. It wasn't a compound fracture.


Joshua Comments:

Unfortunately with vitamin d and doctors, that assumption is a bad one. Give them a call and find out your Vit D3 level in ng/ml.

Ok that bone sticking out doesn't sound as bad as when I first read it. SOme new bone bump is normal, new bone is laying down/growing to fix teh break.

Overall, bone breaks and even bruises are long painful things. With low nutrition (vit D, for instance) even longer.

Sep 28, 2018
Broke my fibula and a year on still have a deep ankle pain
by: Chris

Im 27 and a year broke my fibula playing rugby. My ankle was also badly sprained in the injury. I was put in a cast for a week then got in a moon boot.

After a few weeks was out and back at work and going to physio 3 times a week, it was healing but I kept getting sharp pains.

Then the sharp pain got worse feel in the ankle and I was struggling to put weight on it straight away in mornings.

If I biked on a bike at the gym in the morning I would find it helped during the day.

I've been to specialists and no one seems to know what's going on, if changed my trainers and work boots to better footwear and that helped a bit

Recently had a cortisone and have been put in a cast for 6 weeks and on crutches.

1 week to go and I have recently tried putting weight on and I can still feel the pain in the ankle =(

I take fish oil, mag, glucosamine tablets daily.

Any ideas on what is going on ?

Many thanks Chris


Joshua Comments:

Hi Chris.

I wonder if you injured your ankle in the initial accident/event.

Having said that, that scenario is not a requirement.

1. Big impact, hard enough to break bone.

2. Doctors see that cracked bone in isolation. As if it's not connected to everything else around it, not affected by or affecting any of it's surroundings.

This is mind bogglingly stupid, but here, such is modern medicine.

3. So, you had an impact big enough to crack bone. What happens then? Tightness, inflammation, and increased nutriitonal requirements.

4. What does immobilization do? Probably good for bone healing, but all other tissue shrink wraps down.

Then yuou come out of the cast/boot, and you're walking around with a lower leg/foot ecology consisting ot TOO TIGHT tissue, inflammation, and lack of nutriiton.

So muscles can't work correctly, so they're not absorbing force like they are supposed to. That force has to go somewhere (like,the ankle).

And, all that tightness, pulling on everything too much. That causes pain/problem/irritated tissue and irritated structures, etc.

What was the corticosteroid injection? A blind hope with no rational justification.

What was the extra time in a boot? A blind hope with no rational justification.

What should have been done? The same thing there is to do now: Open up the too tight muscle and connective tissue, decrease the inflammation process, and replete the body of nutrition.

Sep 30, 2018
you didnt answer me
by: Anonymous

Jan - 9 weeks post fibula fracture pain
by: Anonymous


Joshua Comments:

Well, that's western medicine for you...instead of showing you the simple nutritional way to avoid/reverse decreased bone density, they just prescribe a pharmaceutical with known serious potential bone damaging side effects. (do some research on fosamax [brittle bones, etc].)

1. Did the doctors do any bloodwork? What is your Vitamin D3 level?

2. How long have you been on the alendronic acid? Before or only after the break?

3. If you have bone density issues, then it makes sense you're going to have pain/more pain/longer healing.

4. It took a fair amount of force to cause that break, which equals 'trauma'. So again, a bunch of pain is to be expected.

5. I'm really surprised they put you in a boot and not a cast. Granted you broke your fibula and not your tibia, so ok.

I would get a 5 gallon bucket (or equivalent) and frozen water bottles (arctic cold water) and do 10-15 second ice dips (as covering as high up the leg as possible. DO as many dips as you can (it may take a couple days, or you may notice immediate results) that can/should/will reduce pain levels. (THat's PRESUMING that it's safe to take the boot off and move around a litttle [non-weight bearing]).

I've been on Alendronic acid for several years as an antidote to the potential damage the oral prednisolone I take can cause I have yearly bone density checks and the last one was fine.
My blood results were also good and I also supplement my diet with calcium rich foods.

I actually stopped wearing the boot at 6 weeks and it's now 9 weeks post fracture and I've been wearing normal shoes and trainers and fully weight bearing.

Click here to add your own comments

Return to Ask The Tendonitis Expert .

Enjoy this page? Please pay it forward. Here's how...

Would you prefer to share this page with others by linking to it?

  1. Click on the HTML link code below.
  2. Copy and paste it, adding a note of your own, into your blog, a Web page, forums, a blog comment, your Facebook account, or anywhere that someone would find this page valuable.