Medical Consultation Notes

Bruising and Pain Assessment

• Initial pain location: Initially hurting in a specific area, which still hurts a lot.
• Later pain onset: Pain in another area developed later.
• Absence of foot X-ray: No foot X-ray was initially done as the foot wasn't bothering the patient then.
• Possible cause: Questioning if the pain is just from bruising.

Injury Context and Examination

• Two injuries: Mention of having two injuries, where one may overshadow the other initially.
• Location check: Checking the foot to ensure there are no overlooked issues.
• X-ray review: Only one X-ray was previously taken.
• Time since injury: The injury occurred two weeks and two days ago.

Upcoming Activities and Concerns

• Upcoming tournament: The patient has a tournament this weekend and another in Sweden the last weekend of the month.
• Injury sensitivity: The injury remains a little sensitive.

X-ray and Ligament Assessment

• X-ray results: X-ray looks okay.
• Bruising effect: Bruising may have spread, causing irritation.
• Sprain definition: A sprain is defined as ligament tearing.
• Ligament irritation: Possible ligament irritation.

Treatment Plan

• Physical therapy: Physical therapy is recommended.
• Brace usage: Comfortable walking in the brace should continue.
• Boot option: The boot can be used if needed for extra support.
• Home activity: Start doing things at home; begin physical therapy to get going.

Restrictions and Practice

• Practice restriction: Foregoing practice next week to allow irritation to subside.
• No full contact: No scrimmage or contact during practice. Dribbling and shooting are permitted.
• Therapy visits: After two therapy visits, an increase in activity is allowed.
• Light practice: Light practice recommended all of the following week.
• Full practice: Unrestricted full practice can begin in ten days, using the brace.

Concerns and Precautions

• Potential setback: Concern that running up and down could increase irritation and cause a setback.
• Protective approach: Being more protective due to not fully clearing for action immediately.
• Follow-up: If struggling in ten days, further examination with MRI might be necessary.

Recommended Activities This Week

• Stationary bike: Stationary bike for exercise and conditioning.

Long-Term Plan

• Full return: Full practice in ten days; unrestricted return after that.
• Brace usage: Wear the brace for the rest of the season.
• Summer: Can discontinue brace in the summer, provided the foot has strengthened.
• Follow-up: See the doctor if there are any problems or bumps.
• Contingency: If a full return causes a flare-up, consult the doctor.

Reassurance and Final Thoughts

• Incremental improvements: Patient is getting better with each visit.
• Extra time: The injury could use a little extra time to heal.

Activity Restrictions & Physical Therapy Readiness

• Avoiding aggravation: Playing this weekend could aggravate the injury.
• Physical therapy readiness: Ready for therapy if able to walk comfortably during regular activities.
• Therapy approach: Therapy starts with gentle exercises and gradually progresses.