“It’s Not That Bad” Is Risky

Published

June 1, 2015

Publication

Bottom Line Health

Source

Richard Richard, MD

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Donna had just turned 50. Even though her husband and family threw her a big birthday party with lots of gifts, what she really wanted was a treadmill so that she could work out no matter what the weather and lose the weight she had gained in the last few years. Within a week, her husband purchased her a fancy home treadmill and had wiring installed so that she could watch cable TV by remote control while she exercised.

For the first few weeks, Donna walked a mile or two daily and was careful not to overdo it. She was so focused on the exercise that she didn’t even turn on the TV. By the fourth week, she added some jogging to her routine. Feeling more confident, Donna then began watching her favorite daytime TV show while exercising on the treadmill. After several days of this more challenging routine, however, boredom set in and Donna decided to “channel surf.” That’s when the remote control slipped out of her hand, and she reached down to reclaim it while running in place.

You guessed it. Next thing she knew, Donna was lying on the basement floor, feeling dazed and groggy. She was sore all over, but her right ankle was very painful. Slowly, she got herself up and told herself, “It’s not that bad.” She then wrapped an elastic bandage on her ankle and slipped on her padded bedroom slippers. Donna did her best to go about her normal day doing some light housework. She just couldn’t bear much weight on her ankle.

When Donna’s husband got home from work, he noticed that she was limping and that her right ankle had swollen to about twice the size as her other ankle. When she tried to move the joint or stand on it, the pain had become excruciating. The skin over Donna’s ankle was turning black and blue.

At that point, Donna’s husband loaded her into the car and took her to the nearest ER. That’s where I met the couple. After a full workup, including a CT scan that ruled out a head or neck injury, an X-ray confirmed that Donna’s ankle was fractured. When I asked Donna how she was able to walk around on a fractured ankle for the better part of a day, she said, “I just ignored the pain.” Fortunately, she had gotten to an ER in time for us to treat her injury.

After Donna had worn a splint, then a cast for about six weeks, and completed some physical therapy,her husband called to give me an update.Donna’s ankle had healed, and she was once again walking on her treadmill—but she had happily given up the TV so that she wouldn’t be distracted.

Lesson learned: People often wonder whether a fall or any other type of injury is “bad enough” to warrant an X-ray or medical care. If the injured joint is markedly swollen compared with the uninjured side or if you have trouble moving the joint or experience severe pain when doing so, you should be examined right away. Significant pain is the body’s way of telling you that you need help! This is definitely true if there’s any misalignment or instability of the joint—especially if you experienced a “pop” (this can signal a serious injury such as a ripped tendon or ligament). Continuing to use an injured joint can make a simple problem much worse—and may even cause additional damage that requires surgery!