If it's not one thing, it's another. . . .

[Judge Pen]

The good news is that my surgically repaired knee held up. The bad news is my ankle didn't.

I landed wrong last night in class and my ankle buckled. It didn't hurt at the time, but it's stiff and painful for weight bearing right now. I think it's just a sprain, but I've been fortunate to have avoided and ankly sprains in the past. What's the ETA on healing? If I don't get better soon, how long should I wait to have an x-ray or an MRI?

[Golden Tiger]

you big wussy!!!!!! just kidding. if its not broke (and you would probably know) then just keep the ice on it. Ankles heal pretty quick. If you all have A and B down there, I would recommend that to, a couple of times a day

[MasterKiller]

Welcome to the gimp club.

[sean_stonehart]

Dang... that blows.

Give it a rest & rotate ice/warm/anti-inflammatories/SoCo & Cherry Coke for a full recovery. :eek: :D

[Martial Joel]

Thats unlucky. Hope it heals sometime soon, i know how they feel, i used to always hurt my ankle

[Judge Pen]

Welcome to the gimp club.

I've been gimpy for the last year and a half.

[MasterKiller]

A true gimp has multiple injuries at the same time. You are just starting to realize your gimpiness.

[Chief Fox]

Hey, I've got a sore hip and tendoitis in my shoulder! I've achieved Gimpness. :D

JP, I've got a lace up ankle brace sorta like this: http://www.muellersportsmed.com/laceupanklebrace.htm

I got it at a local drug store. It's a nice little support until you get your ankle back to full strength.

[Ray Pina]

What do you mean by "landed wrong"? Were you thrown by someone or doing acrobatics?

You're not a kid anymore. You guys do internal too, right? I'd focus on repairing your joints and making everything strong. Health is most important. Than just train the important stuff. Leave the jumping and dangerous weapons (chain whips, etc) for the kids man.

I do an excercise where I squate down and -- while keeping the heal on the ground -- rock forward so thje knees extend beyong the knee. It strecthed both the knee and back of the ankle.

I blew my knees out playing ball in H.S. and college and then again surfing about 2.5 years ago. My master showed me this excersice, and as long as I do it a minimum of three times a week (3 sets of 12) I'm OK. If I don't, even the rain bothers me.

[Scott R. Brown]

Hi Judge Pen,

How long an injury takes to heal depends upon a number of factors:

1) What is the injury? (i.e., sprain, strain, tear, fracture, etc.)
2) How bad is it injured?
3) How soon and how often your perform R.I.C.E. during the first four days?
4) Are you taking a non-steroidal anti-inflammatory?

R.I.C.E. = Rest, Ice, Compress, and Elevate

The very first thing that should be done when an acute injury occurs is to elevate and ice. Ice reduces the inflammation. The sooner ice is applied the less the swelling and the less damage will occur. Icing should last from 15-25 minutes.(No longer than 25 minutes or it has the opposite effect than the one desired.) Ice every two hours as often as possible for the first 3-4 days and then you may alternate heat and ice every 2 hours for another 4 days or so. Be sure to place a barrier between the ice and the skin so you don’t give yourself an ice burn. I use a thin cloth like a bandana.

Rest: To avoid further damage and promote healing.

Compression: Use an ACE wrap or a neoprene ankle support to reduce swelling and provide protective support. It should be removed for 15-30 minutes every 2 hours.

Elevation: Helps to reduce swelling.

Anti-Inflammatory: I recommend Motrin 600mg (3 tabs) every 6 hours or 800mg (4 tabs) every 8 hours. The dosage on the bottle is for headaches and common aches and pains not for the anti-inflammatory effect. Since you are not taking the larger dosage for more than a few weeks it should not pose any problem.

Really the most important thing is the Ice and then the anti-inflammatory. In my younger days I never took care of my injuries properly. By the time I turned 30 I learned from a physical therapist how to take care of my injuries. I have found that my injuries will heal 75%-90% faster with these simple treatments.

As the ankle starts to feel better perform ankle strengthening exercises. If you need to learn some let me know and I will list some. You need to do more that just ankle raises.

Hope this helps!!

[Golden Tiger]

I recommend Motrin 600mg (3 tabs) every 6 hours or 800mg (4 tabs) every 8 hours.

That will work except for the fact that you may develop stomach ulcers and bleed out! Not sure where you are getting this recommendation from but that is a mega dose. If you need an anti-inflamatory, go to the Dr. and get one (Prednisone or other steroidal based med) will work very well (but might give you boobs j/k).

[Scott R. Brown]

I am sorry Golden Tiger you don’t know what you are talking about!

The dose I gave IS the dose the Doctor would give you. It is for relatively short term use and should of course be taken with food. It will NOT cause you to bleed out!

The last thing you want is Prednisone. It is for extremely severe injuries. It has ten times the side effects of Motrin! NO responsible Doctor would prescribe it for a sprained ankle unless maybe you are a professional athlete.

[GunnedDownAtrocity]

rest it for a couple days (icing it and everything like scott said would be even better ... not so sure about the motrin though) and you shouldnt have to miss more than one class.

just wear a wrap and dont be an idiot on it and you'll be fine.

[GunnedDownAtrocity]

wow ... i dont know about bleeding out your stomach, but i sure wouldnt take prednisone either.

i just dont like to take any medicine unless i have to. those who know my history will have a good understanding of why.

[MasterKiller]

2 Tylenol + 1 Motrin = 1 Loritab.

[PangQuan]

refer all future injury threads to my sig...

oh, ya, get well soon.

[Scott R. Brown]

The thing about Tylenol is that it is not an anti-inflammatory.

What you missed about the Lortab is that it contains Hydrocodone which is a highly addictive Narcotic. Think of it a Vicodin on steroids and it is not an anti-inflammatory. What we are looking for is the anti-inflammatory effect not the pain relieving effect.

Here is my background for the ill-informed and the Doubting Thomas's:

20 years as a nurse working in various fields, but also in a clinic where we treated sports and acute injuries. Guess what the Doctors prescribed?

One year as a fitness trainer in a Major metropolitan Physical therapy facility. Guess what the Doctors prescribed there?

Here are two links for those who prefer to do their own research and some excerpts from the literature for those who don't want to do the work:

Pfizer (http://www.pfizer.com/pfizer/download/uspi_motrin.pdf)

Answer.com (http://www.answers.com/topic/ibuprofen)

Pfizer:


Suggested Dosage: 1200 mg-3200 mg daily (300 mg qid;
400 mg, 600 mg or 800 mg tid or qid). [TID= 3 times a day, QID= 4 times a day]


Individual patients may
show a better response to 3200 mg daily, as compared with
2400 mg, although in well-controlled clinical trials patients on
3200 mg did not show a better mean response in terms of efficacy.
Therefore, when treating patients with 3200 mg/day, the physician
should observe sufficient increased clinical benefits to offset potential
increased risk.

The dose should be tailored to each patient, and may be lowered
or raised depending on the severity of symptoms either at time of
initiating drug therapy or as the patient responds or fails to respond.
In general, patients with rheumatoid arthritis seem to require
higher doses of MOTRIN than do patients with osteoarthritis.
The smallest dose of MOTRIN that yields acceptable control
should be employed. A linear blood level dose-response relationship
exists with single doses up to 800 mg (See CLINICAL PHARMACOLOGY for effects of food on rate of absorption).
The availability of four tablet strengths facilitates dosage adjustment.
In chronic conditions, a therapeutic response to therapy with
MOTRIN is sometimes seen in a few days to a week but most often
is observed by two weeks. After a satisfactory response has been
achieved, the patient’s dose should be reviewed and adjusted as
required.

Answer.com

ibuprofen (ī'byūprō'fən) , nonsteroidal anti-inflammatory drug (NSAID) that reduces pain, fever, and inflammation. Along with naproxen and ketoprofen, ibuprofen belongs to the propionic acid class of NSAIDs. It was first made available in 1967. Like other NSAIDs, it acts by inhibiting the body's production of prostaglandins. Available over the counter in a variety of preparations (e.g., Advil, Motrin, Nuprin), it is commonly used to treat rheumatoid arthritis, gout, and painful menstruation. Side effects include rash, alteration of platelet function and bleeding, and intestinal upset, which can lead to gastritis. Like other NSAIDS, it appears to have no potential for abuse or physical dependence. It should not be used by those who are allergic to aspirin.


Ibuprofen is widely used for the relief of headache including migraine. It is also widely marketed as an analgesic agent (rather than as an anti-inflammatory) and is often used for general pain conditions including those that arise from various injuries (such as sporting injuries), illnesses (such as influenza, shingles, gout), and post-operative pain.

Preparations: Tablets of 200, 400, 600, and 800 mg; Chewable tablets of 50 and 100 mg; Capsules of 200 mg; Suspension of 100 mg/2.5 ml and 100 mg/5 ml; Oral drops of 40 mg/ml.

Storage: Ibuprofen should be stored at room temperature, between 15-30°C (59-86°F).

Prescribed For: Ibuprofen is used for the treatment of mild to moderate pain, inflammation and fever.

Dosing: For minor aches, mild to moderate pain, menstrual cramps and fever the usual adult dose is 200 or 400 mg every 4 to 6 hours. Arthritis is treated with 300 to 800 mg 3 or 4 times daily. When under the care of a physician, the maximum dose of ibuprofen is 3.2 g daily. Otherwise, the maximum dose is 1.2 g daily. Individuals should not use ibuprofen for more than 10 days for the treatment of pain or more than 3 days for the treatment of a fever unless directed by a physician.

[Golden Tiger]

20 years as a nurse nuff said......

and by the way, Vicodin=Loratab different trademarks, same chemical make up.

Tylenol #3 containing codine is what you were probably thinking of MK.

Scott, lots of nice quotes but JP sprained his ankle, he didn't get arthritis. Big difference.

As for Pred., just about every GP and most Orthro's will perscribe it to QUICKLY reduce inflamation. The side effects are nil because you are weened off of it by the second week. Surgeons are against it because it slows the healing of tissue in the event they have to cut.


Ibuprofen
Prescription: Motrin 1,200 to 3,200 mg per day in 3 or 4 doses
Non–prescription: Advil, Motrin IB, Nuprin 200 to 400 mg every 4 to 6 hours as needed, no more than 1,200 mg per day

source: arthritis.org

Manufacturers' Warnings In Clinical States: Ulceration, perforation and bleeding of the stomach, small intestine or large intestine, sometimes severe and occasionally fatal have been reported during therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen.

Dosage And Administration: Rheumatoid arthritis and osteoarthritis: The initial daily dosage in adults is 1 200 mg divided into 3 or 4 equal doses. Depending on the therapeutic response, the dose may be adjusted downward or upward. The daily dosage should not exceed 2 400 mg.

Maintenance therapy, once maximum response is obtained, will range from 800 to 1 200 mg per day.

Mild to moderate pain accompanied by inflammation or dysmenorrhea: 400 mg repeated as required every 4 to 6 hours. The daily dosage should not exceed 2 400 mg.

source: rxmed.com


Being a nurse, one would think that you would check Merck or the PDR instead of "answer.com".....mmmmmkay

[Scott R. Brown]

Hi Golden Tiger,

It is unnecessary to belittle the nursing profession or myself to make your point. Those who cannot formulate a reasoned argument frequently demonstrate their immaturity and lack of ability by reducing the discussion to ridicule. Let us not go there!

I am not going to play tit for tat games! I have years of experience with Motrin personally and clinically. My purpose here is to help Judge Pen with his injury by citing a method that is universally used by physical therapists and Doctors and one I have personally use numerous times for over 15 years. The second most frequently prescribed non-steroidal anti-inflammatory is Naprosyn, another medication I have personal and clinical experience with. Naprosyn is also prescribed at higher than listed doses for its anti-inflammatory effects. I have never experienced the agony of any of the horrific side effects you mention nor have any of my patients. I have even taken them on an empty stomach. Side effects of most medications fall within a specific and small minority of the population. When they do occur another medication may be substituted.

The side effects you mentioned are very rare and primarily occur with long term use along with ingestion on an empty stomach or with individuals with pre-existing conditions such as stomach ulcers.

The most common use of Motrin is for pain, thus it is marketed for that purpose. Most information you find will discuss the over counter uses. You cleverly glossed over the fact it may be taken in doses up to 3.2 grams per day an assertion you claim WILL lead to gastric hemorrhage. My recommendation was limited to 2.4 grams per day for merely 10-14 days. Of course if gastric hemorrhage were a common side effect it could not be prescribed in such high dosages, especially to the elderly who would be most susceptible to gastric hemorrhage.

While the primary indication for such high doses is for arthritis, which by the way is a long term use, one secondary indication for Motrin is as a short term anti-inflammatory wherein it is most commonly prescribed for 10-14 days as I have indicated. I would not expect anyone without extensive personal or clinical experience to be aware to this fact which I why I have mentioned it here. You might consider it insider information. That is why you see the larger dosage listed under Prescriptions. I included the information to demonstrate that it CAN and IS given in the higher doses you have warned against. One may thus go to the doctor and pay $50-$100 for the appointment just to have him write a prescription for something you can get over the counter or you can just go down to the local drug store and purchase some and take it as I have indicated.

You are correct that Vicodin and Lortab are the same medication. They come in various dosages the most common is 5/500 which is 5mg Hydrocodone and 500mg Acetaminophen. A Tylenol #3 which is the most commonly prescribed form of Tylenol with codeine is 10mg Codeine and 300mg Acetaminophen. 15mg of Hydrocodone is generally considered to be equivalent to 10mg of morphine. However 15mg of Hydrocodone orally administered is considered to be equivalent to 100mg of codeine. I should have said that Lortab is a Tylenol #3 on steroids. I apologize for the error. I will not bicker about these figures for medications affect each individual differently and there is some variation within all populations.

Prednisone does have side effects even when it is titred down as is properly indicated. I will not list the possible side effects here. Anyone may look them up and I see it will only lead to a tit for tat conversation. However, prednisone is NEVER the first treatment of choice for ankle sprains. The treatment of choice is as I have indicated. If you don’t believe me just put ankle sprains in Google and see what you find. Or better yet put in a search for Prednisone and see how many times it is recommended for ankle sprains. Prednisone is indicated most commonly for severe and systemic inflammation, not sports injuries.

Do not expect any further posting from me on this thread. My advice is in response to a question posed by Judge Pen and not for the purpose of engaging in futile arguments!

[g0pher]

Just use a heat pad and some pain reliever of your choice if the ankle is sprained. I wouldn't use ice. Ice makes everything worse, and more painful. Whenever I sprain an ankle I'm out for about a week and a half. But each person varies. Bottom line is just get a heat pad on it.

[Judge Pen]

Hey, I've got a sore hip and tendoitis in my shoulder! I've achieved Gimpness. :D

JP, I've got a lace up ankle brace sorta like this: http://www.muellersportsmed.com/laceupanklebrace.htm

I got it at a local drug store. It's a nice little support until you get your ankle back to full strength.

I picked one up this weekend. I put ice and jow on it and kept it elevated in the evenings, but I was moving into my new home this weekend, so I had to stay on it to get the work done. It's feeling a lot better now. I should be 100% soon., but man it was scary the next day--couldn't put but a slight amount of weight on it.

[Judge Pen]

What do you mean by "landed wrong"? Were you thrown by someone or doing acrobatics?

You're not a kid anymore. You guys do internal too, right? I'd focus on repairing your joints and making everything strong. Health is most important. Than just train the important stuff. Leave the jumping and dangerous weapons (chain whips, etc) for the kids man.


I was working on a fight routine with me teacher for a upcoming demonstration.

Yes we do internal too. But I like the jumping and dangerous weapons. It's all part of what we do. Different strokes for different folks.

[Judge Pen]

As for the anti-inflammatories, I've been using Aleve. It seems to be working fine.

[Kymus]

If I were you JP, I'd rub in some Huo Luo (Wood Lock) oil 3x a day. That's what I should be doing to my jammed thumb right now, but I don't feel like getting those vapors all over my keyboard (that stuff smells strong!) :p