| By: Julie Eibensteiner PT, DPT, CSCS Another good question! Many of our topics are generated by actual situations & questions we get asked during the week. ——————————- Whether it’s getting a foot stomped on in a soccer game, twisting an ankle on the court, or crashing skate-first into the boards during hockey – you can wind up in a lot of pain. How do I know if I broke a bone? 3 Signs You Likely Need an X-Ray. Oh, Canada. 🇨🇦 The Ottawa Ankle Rules were developed by an emergency doc in Ontario in the 1990s and are still widely regarded as a best practice for the initial assessment of acute ankle & foot injuries. These clinical decision rules are used to help determine whether an X-ray is necessary, reducing unnecessary imaging and healthcare costs (an urgent care visit in the US for an ankle x-ray averages $400-$500). They remain highly validated, reliable and very good for detecting fractures (that’s Canadian for broken bones) from injuries immediately after a traumatic event such as direct contact, falling, slipping, twisting, etc.The rules recommend X-rays if there is: Bone tenderness along the posterior edge or tip of the lateral or medial malleolus (those are your “ankle bones” on each side of your ankle) Inability to bear weight for four steps both immediately after the injury and later on at home or at the emergency room. Bone tenderness at the base of the 5th metatarsal or the navicular for foot injuries. (see arrows 2 and 4 below)  |
| Quick Recap: You need an X-ray: You have pain at 1 of the 4 sites in the picture above or you can’t walk for more than 4 steps both immediately after the injury and later on after the initial injury. You don’t need an X-ray: You can physically bear weight (even if limping) for 4 steps and you don’t have “OUCH” type pain at those 4 spots. In this case, complete rest usually slows down the healing process. Moderate, safe activity can be a super power when used right. Keep in mind: X-rays are really a tool to look at bones and not other structures. You still may have sprained ligaments (connects bones to bones) or injured tendons (connects muscles to bones). Being seen by physical therapist or health care provider within 24 hours of the injury can speed up the healing process and/or fast track further professional evaluation. |