Rain is no stranger to the colder months here in the Pacific Northwest. This winter has not only seen a fair share of rain but also a higher than normal amount of snowfall. With those falls typically comes a trip to the emergency room and a subsequent series of xrays to rule out a fracture of some kind. However, more often than not those xrays show up to be negative and instead result in a larger medical bill, radiation exposure, and time loss. Luckily there is a checklist that exists called the Ottawa Ankle Rules to help patients identify whether an xray is necessary.
If there is pain in the malleolar zone (the malleoli are the bony bumps on inside and outside of the level of the ankle) then an xray is indicated if you also have just one of the following symptoms.
1. Tenderness along the tip or backside of the medial malleolus (inside ankle bump).
2. Tenderness along the tip or backside of the lateral malleolus (outside ankle bump).
3. Inability to bear weight for four steps. (note: inability does not mean that it is painful to bear weight. Pain is to be expected!)
If there is pain in the midfoot zone (region of the arch is, or the middle 1/3 of the foot) then an xray is indicated if you also have just one of the following symptoms.
1. Tenderness at the base of the fifth metatarsal (usually directly in the middle of the outer edge of the foot).
2. Tenderness at the navicular bone (the bone just above the arch of the foot).
3. Inability to bear weight for four steps.
If your symptoms qualify you for a xray, you may still have a negative radiograph result. However, if you do NOT qualify under these guidelines then you can be pretty positive that you do not have a foot or ankle fracture. Regardless of the outcome of these guidelines, your best bet for a proper recovery and reduced risk of re-injury is to find a physical therapist that will ensure your mobility and strength return to normal quickly and appropriately.