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.
