How to Tell and What Not To Do

Why and when it’s important to seek medical evaluation?

When taking medical history, I ask a range of questions. Do you walk barefooted? Do you recall anything falling on your foot? Do you recall jumping around and seeing stars from stumping your toe? Did you wear any extremely narrow or tight shoes? Maybe it happened while stumbling around your house barefoot in the dark. Maybe it was while running barefoot up a flight of stairs. But we’ve all done it; stubbed a toe hard. In those first few moments of blinding pain, you might wonder if you’ve broken your toe.

Things you hear

If I can walk on it, I’m sure that it’s ok; that’s not necessarily true! The same goes for the idea that if you can wiggle your toes, your foot is just fine.

Obvious signs that medical attention is needed include:

• Bleeding under the toenail.
• A fracture that protrudes through the skin (or any other open cut).
• Swelling that makes it hard to fit into a shoe.
• A possible fracture that goes into a joint.

Is that foot broken or just bruised? If the baby toe you caught on the edge of the bed is broken, is there anything a doctor or podiatrist can do for you, that you can’t do at home with some tape and ice? Good questions, with not always clear answers. For most of us, thankfully, the pain subsides and things get back to normal fairly quickly.

If you’re uncertain however about the severity of the injury, it’s a good idea to check it out, get an X-ray, and dispel any doubt. It’s fairly common for patients to linger in denial, cringing through weeks of serious foot injuries. And sometimes they wait so long, that repair and recovery get more complicated. (Nobody wants a surgeon to have to re-break a bone so it can heal properly.)

Help your toe heal right

Your doctor or podiatrist will likely use an x-ray to determine if your toe is broken, and what treatment is needed. If the break is a simple fracture, in which the parts of your bone are still lined up properly, your doctor will probably put you in a walking boot for a few weeks. The walking boot keeps your toes immobile, so the bones can knit back together in alignment.

If your toe bone is at an incorrect angle, your doctor may numb the toe and then straighten it immediately. If you have significant displacement, or your toe is dislocated, you might need surgery to realign the bone.

Should I just tape it?

Taping a suspected broken toe can help alleviate pain if the break is simple, and the bones are aligned. However, this won’t help the break to heal correctly; so it’s important to see a doctor or podiatrist. If you had a bad break, taping your toes could actually make things worse.

One way to know whether your toe is broken, is if you can put weight on the foot. If you can walk on it without pain or limping, it probably is not broken. If so, try icing the injury and taking an over-the-counter anti-inflammatory medication.

Also observe your injured toe carefully. If it has a deep cut or wound, your bone might be exposed to air, and so should be evaluated professionally. Other clues to a broken toe include swelling, discolouration, and bruising. If your toe is at a different angle than the toe on the other side, and it wasn’t before your injury, seek medical help right away.

Most minor injuries are going to be a lot better in a week or two. If you’re still limping after two weeks, it’s something more than just a minor strain or sprain. Tenderness right over a bone and not in the nearby soft tissue, can be a sign of a break, as can pain when the end of the toe is pushed or pulled.

How is a sprained toe diagnosed?

To diagnose a sprained toe, your doctor or podiatrist will start by asking about any movements that make the pain in your toe worse. Be sure to tell them what you think might have caused it. This can help to pinpoint the site and extent of your sprain.

Next, your doctor or podiatrist may try to move your toe a bit. This is to help ascertain how severe the sprain is, and whether or not your joint is still stable. Based on your exam,  imaging tests maybe ordered. A foot x-ray will help to rule out any broken bones.

Sprains are classified into grades based on severity, as listed:

• Grade 1. Your ligament has some minor tearing, known as microtearing.
• Grade 2. Your ligament is partially torn and you have mild joint instability.
• Grade 3. Your ligament is severely or completely torn and you have significant joint instability.

Regardless of how severe your sprain is, follow these tips to reduce pain and swelling:

• Rest your foot and toe as much as possible.
• Apply a cold compress to your toe for 15 to 20 minutes several times a day, for several days after the injury.
• Elevate your foot when sitting or lying down.
• Take a nonsteroidal anti-inflammatory to help with the pain.
• Wear shoes with a stiff sole or padding in the front to help protect your toe.

A sprained toe usually takes about three to six weeks to fully heal. The more severe your sprain is, the longer you’ll need to allow for recovery.

Your feet mirror your general health . . . cherish them!