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The First 48 Hours After An Injury (or Surgery)

Brandt R Gibson, DPM
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Podiatrist, Neuropathy Doctor, Father of 11 and Founder of Mountain West Foot & Ankle Institute
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After breaking my foot on Saturday, the area began to progressively swell and the pain seemed to increase.  I was able to walk on the foot, but only with significant pain that was getting worse as the hours passed.  Shoes were a problem, in fact, they increased the pain (except my Crocs that gave me the necessary room in the area).  So what was I expecting (and had happen) during the first 48 hours?

  • Swelling: The primary process the body utilizes to start the healing process is through swelling the area (edema).  This serves two purposes:  1) Splinting of the area to protect the injured area.  2) Cause migration of healing cells to the area of injury.  In my case, the swelling was significant right to the area of fracture, and got worse through the next 2 days even with ice.  Maintaining it in the walking boot with a compressive wrap (ace wrap) in place helped significantly.

  • Increasing Pain:  Pain is the bodies protection mechanism and is designed to reduce activity during healing.  Depending on the injury, pain can be caused by bone rubbing on bone or just the swelling pressure to the area (and associated nerves).  In my case, the pain increased over the first day, but improved some with the boot (since it stabilized the ankle and the foot).  Night was the worst and sleeping wasn't as good as it could have been had I taken something for pain.

  • Bruising:  Bruising may occur immediately, depending on the tissues injured, but often presents over the first several days.  This often spreads to the farthest areas of the foot (toes and heel) and may not present where the actually injury is.  I have significant bruising to the toes and to the heel, even with the fracture elsewhere in the foot.

Bruising Pattern

The first 48 hours will be the hardest, but after that time, the pain will be more manageable, the swelling will be easier to control and the walking will be better.  I know that now by personal experience.
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