How do I know if my mom needs rehab for her ankle/foot pain?

My mom fell and kept complaining about her foot and able. She really fractured her pelvis in 2 places and her back. She is in rehab now. Today is the first care plan I am going to. Keep us posted!

I was going to pipe in and say "find a good podiatrist!" and someone else mentioned that. Foot pain is awful and plantar fasciitis is excruciating. It doesn't "show up" on any scans!
ER's are notorious for mis-diagnosing--esp with elderly people who present with a host of symptoms unrelated to the reason they're there NOW!
Yes, you need to advocate for her. My hubby had a motorcycle accident (should have died, but miraculously lived) was taken to a small ER and released within an HOUR. Our friend picked him up and brought him home--I took one look at him and was calling 911 immediately. He was bleeding internally and had a major concussion. Had he "gone home and gone to bed" he would have died. It didn't help that he knew I'd ne furious (I was) and he kept insisting he was fine, but they did not even X ray him--much less do any kind of scan that would have shown the ruptured artery and broken skull.
I went to the ER FOUR times before I was correctly dxed with gallbladder disease. You have to be your own advocate and if you do not feel good about the dx you're given, go somewhere else.
Good luck with this---it is exhausting.

You really are at the mercy of the doctor/radiologist who reads the exray. If something seems unresolved, seek out an orthopedist and be your own patient advocate! Tell them you want something done to resolve the issue and not just yet another script for pills!

Several years ago, I developed a knee pain that made it almost impossible to walk, wouldn't bend enough for me to drive. Had xrays and an mri scan and they couldn't find anything. My daughter had a friend who was a sports-medicine chiropractor and she spent about an hour working with it, and found that there was something out of line in my ankle that had stressed the rest of my leg. Haven't had any problem with it since (my hmo called me back in for more tests about a month later...) .
Compression socks can help a wound heal; I had a spider bite on my ankle that ulcerated and it finally healed with compression).

Could it be plantar fasciitis? Painful tendon problem that will not show up on X-ray !

Christine73 mentioned one of the points I was going to make - ER is exactly what it says it is - Emergency Room. Now on some level yes, this woman's pain was sudden onset and often this happens at the wrong time of day/week to get an appointment with a regular doctor or a specialist, so this is the route we have to go.

That said, X-rays do NOT always tell the story (and doctors/radiologists CAN and DO miss breaks and other issues). The ER *should* bring in specialist consult while she is there, but that does not always happen, and even if it does, that doctor does not know your mom or her history (or might not be competent or the kind of doctor that is needed).

Just as further examples, my son (17 at the time) broke a bone in his foot - we went to primary care (was late on a Friday afternoon, so forget getting any specialist to see him then!) and he sent us to ER (the insurance we had then required that referral). Anyway, the triage person took all the info and proceeded to put a pen dot over the middle bone in his foot. We finally (again this is ER, someone bleeding profusely or in imminent danger gets priority, as they should) get X-rays and doctor says nothing broken, rotated his foot around, no pain, and questions why are you here? He could not put weight on it either and walking was O-U-T. After some additional questioning, we were sent back for more X-rays, so I made sure someone got that "dot" area. Sure enough, the triage person was right! He broke that middle bone in his foot! Walking boot until it healed.

No guarantees outside the ER - you really have to know a specialist or get referrals from people you know. Granted I did not run to the ER or a doctor at the time I injured my foot (if this happened to one of my kids, off to the doc - me personally? suck it up!), and with the severe bruising perhaps they might have taken more time to evaluate - about 2 months after the fact I went in with foot pain complaint to an orthopedist. After X-rays, THREE times he says to me "I don't think it is broken." Ummm, you don't THINK - how's about you just don't know, and investigate further? He gave me some stupid little arch support, no other instructions and sent me away. About a month later, after a nasty fall because I was carrying my son (certain pressure on the foot would buckle my leg and he was about 3-4 at that time) and could not catch my balance without dropping him, I went to another orthopedist. He, I believe, was ready to write me off as well, but took his own X-rays on site and came back to say not only is it broken, it has gotten worse. There are two sesamoid bones that make up the ball of your foot. In my case I shattered one. HAD it been treated properly, it would have probably healed ok. At this point, the pieces had all separated. Depending on what I was doing, it could cause pain and/or cause my leg to buckle. He tried various non-invasive treatments, but none worked. Eventually I talked him into removing it. It has been over 25 years now and no problems, BUT if that first boob had immobilized my foot, told me to stay out of heels, etc, all that might have been avoided!
Also, my mother had a lot of pain in her foot due to a severe bunion.

So, long stories to say yes find the right doctor to make this assessment. Orthopedics, podiatrist are a good place to start. If you do not get answers from them, move on to another! Every doctor's expertise and skill set is different.

If the x-ray showed nothing, they should have done an MRI. That would show a torn tendon or ligament (very painful). Also, an orthopedist should evaluate her for plantar fasciitis, a symptom of which is a stabbing pain in the bottom of the foot. Emergency rooms will only do enough testing to rule out an emergency, or something that needs acute attention right then and there, such as setting a broken bone. They should have advised your mom to follow up with an orthopedist. He can check for tendonitis and plantar fasciitis and he should also order an MRI to see if any of her tendons or ligaments are torn. I would insist on all of those things. You can't move forward with treatment if you don't know what the problem is, and pt isn't always the answer. Good luck.

Just a thought. That sudden onset and inability to tolerate weight on the foot is exactly what happened to me and I went online and figured out it was plantar fasciitis. (Doctor confirmed that when I went to her.) VERY painful, especially when one first gets up in the morning or from a long sitting spell. Like needles and pins shooting into every inch of your foot with the slightest pressure, yet there's nothing visibly wrong. What worked for me is a combination of (1) frozen bottles of water rolled back and forth under my feet (Wow! The relief!); (2) stretching my foot both ways -- pulling the toes up toward my leg then down away from my body 5-10 times; (3) Stretching exercises on the stairs, especially standing with toes on stairs and letting body weight stretch the heels down toward the floor. (Remember to hang onto something as you're doing this.). Your Mom may not be able to do all of this, but if some of this does help, it might indicate that it was, in fact, plantar fasciitis. Good luck! There's nothing worse than knowing you hurt and having someone in authority start hinting that you're faking! NOT their job!

Yes, it sounds like she needs to get up and walk more. If the foot or ankle is not broken, this could also be a sign of arthritis or as mentioned, hear an old injury coming back to haunt her.

What you can do is take her to a foot and ankle specialist called a podiatrist. They may actually end up taping her foot with some kind of walking tape designed to stay on between appointments. Sometimes the way you walk can actually strain a foot or ankle. I recall having a foot taped for a time because I was always having pain in one of my feet to the point I actually would collapse. Come to find out it was a strain and a podiatrist ended up taping my foot. The tape is changed at every appointment and I was eventually able to start going without the tape as my situation improved

ALG1447 yes being in the hospital for days and having to be her advocate IS exhausting. I've been there too and know exactly how you feel. On top of that hospital staff, just aren't like they used to be and an advocate is necessary. I hope they find the source of pain soon...and you can get a bit of respite afterwards. If you have to pay extra for her incontinence needs or hire a caregiver to be with her during the day, it's essential you take care of you. I nearly had a mental breakdown after my dad's hospital stay. He had his appendix out at age 95!!! "Calgon take me away!"

Hoping your Mom has her diagnosis and is headed for a speedy healing.

Good for you for getting them to run the test! You are so right about someone with dementia needing an advocate. I hope they get things straightened out with your mom so she has the best possible recovery!

Did the E.R. wrap the foot, ankle?
Immobilize it?
Guessing not.....
Insist on, advocate for a second opinion.

You or others may ask why this is important if she has alzheimers...it is important.

Also, by observation, experienced in the E.R., that original x-rays did not show a fracture, but they showed up 3 days later on several patients, as told to me by the E.R. physician that I worked for when these patients came to the office. Just F.Y.I.

She is not that mobile. Uses a walker. Its leaning more towards gout. She hasn't been released to rehab yet. She also might have a low grade Uti. Running another test for gout. This might buy her another night at the hospital and maybe she can get on her feet. She could put weight on it today. I swear the most important thing for elderly folks is having a patient advocate. She has dementia and cannot explain how she feels. If I hadn't been here yesterday, the ER would have just discharged her to rehab. I'm an only child so I'm the only person that can sit at the hospital, ask questions, advocate for her care. It's exhausting.

My mom had a fall before the holidays which according to the staff who saw it didn't involve her foot or ankle at all but she was in extreme pain and couldn't stand or walk - it was however quite swollen and ortho examined and took X-rays ordered therapy and still no clue what she damaged - compression socks were suggested but I know she'd hate them so we didn't bother - she now barely walks and stays in her wheelchair but she is nearly 94

Mom can have therapy at her facility and I imagine the AL would provide incontinence care for a higher fee?

That is so true about them not being able to describe or point out the pain. But a good orthopedist should be able to examine your mom in such a way that she will react when the dr manipulates the problem spot. They should be able to tell where the pain is coming from: muscle, nerves, bones, or something else. Once they can determine the source of the pain, then they will recommend what kind of rehab would be useful. I do not understand why the doctor sent your mom to rehab without a diagnosis - it could do more harm than good.

If she has a stress fracture, it might not show up on the x-ray (unless it gets worse). Those are painful and are usually treated by babying the foot -- plenty of rest, keeping weight off that foot. So if that's what's causing her pain, rehab will not help her foot. (Though doing PT exercises for her strength might be beneficial, especially if she's not getting around much.)

Your poor mom! Was she pretty mobile before this happened?

Good point. One of my daughters walked on a broken ankle for a month after a negative xray.

Personal experience here:
My foot was x-rayed, negative. A year later my ANKLE was x-rayed after a fall, and there was the "old fracture" on the other side of my ANKLE. Having been sent home with pain killers, (not good for me),  I have always wondered how many x-rays, how many body parts x-rayed would it take to get a proper diagnosis....and treatment.

Recalling Dmanbro's mother was sent to rehab and screamed in pain when physical therapy was tried...this went on for quite awhile....as many thought she was faking.  Turns out she had a broken pelvis.

Advising an orthopedist consult to discover the fracture; and determine if she has ostopenia causing bones to break and get that treated. Request consult while she is still in the hospital,
if it is not too late. imo. imo.

Did they stay anything beside her foot? Her knee, her hip? Dementia patients are notoriously bad at localizing pain.