Post-Fracture Pain: Sharp Sensations After Light Exercise

After a fracture, experiencing a tingling sensation in the affected area after slight movement?

Hello Doctor, my right ankle was fractured last October due to a fall from a height.
At that time, I had a plate inserted and needed to rely on a walker to move around.
In January of this year, my attending physician said I could walk without the walker.
I then started to gradually rehabilitate, and subsequent X-rays indicated that my ankle had mostly healed, although there might still be a slight gap between the bones.
Because of this, I have been hesitant to run or engage in high-impact activities.
Occasionally, I go to the gym to do some cycling (I can't use the treadmill as it feels uncomfortable for my foot).
A couple of days ago, I attended a group class at the gym (TRX), which included a single-leg squat movement.
I only did it once or twice before stopping.
After returning home, I felt a tingling sensation in my foot, but I wasn't sure if it was muscle pain or bone pain.
I applied some ice briefly.
The next morning, I experienced a cramping sensation, but it improved by the evening.
I would like to ask if this is normal.
If I experience this sensation again, should I apply ice or heat? Thank you, Doctor!

Xiao Jun, 20~29 year old female. Ask Date: 2020/04/01

Dr. Chen Yongxue reply Orthopedics

Hello, if it has been more than six weeks after a fracture surgery and with the approval of the attending physician, it is generally acceptable to begin weight-bearing training.
Once training starts, there may be some initial discomfort, which will gradually improve over time.
If there is no injury or swelling during activity, you can start with ice therapy to reduce swelling, followed by heat therapy.
Thank you.

Reply Date: 2020/04/01

More Info

After experiencing a fracture, it is common to encounter various sensations, including sharp pain, especially when engaging in light exercise or rehabilitation activities. Your situation, where you sustained an ankle fracture and have gradually returned to physical activity, is not unusual. The healing process can vary significantly from person to person, and it is essential to understand the underlying factors contributing to your discomfort.

Firstly, it is important to recognize that after a fracture, the body undergoes a complex healing process. While your X-rays indicate that the bone is healing, the presence of a small gap between the bone fragments suggests that the healing is not yet complete. This can lead to residual pain or discomfort, particularly when you start to engage in activities that place stress on the affected area. The sharp pain you experienced after participating in a TRX class, especially during single-leg squats, could be attributed to several factors:
1. Muscle Fatigue and Strain: After a period of immobilization, your muscles may not be fully conditioned for the demands of certain exercises. Engaging in activities that require strength and stability can lead to muscle fatigue, which may manifest as sharp pain or discomfort.

2. Nerve Sensitivity: Following an injury, nerves in the area can become more sensitive. This heightened sensitivity can result in sharp pain sensations, particularly when the area is stressed or moved in ways that it has not been accustomed to.

3. Incomplete Healing: As mentioned, the presence of a gap in the bone may indicate that the healing process is still ongoing. Engaging in activities that put stress on the ankle before it is fully healed can lead to pain, as the bone and surrounding tissues may not yet be ready to handle such loads.

Regarding your question about whether this experience is normal, it is not uncommon for individuals recovering from fractures to experience discomfort during rehabilitation. However, it is crucial to differentiate between normal post-exercise soreness and pain that may indicate a problem. If the pain persists or worsens, it would be advisable to consult your healthcare provider for further evaluation.

When it comes to managing pain after exercise, the application of ice or heat can be beneficial, but it depends on the nature of the pain:
- Ice Therapy: Ice is generally recommended for acute pain, especially if there is swelling. It helps reduce inflammation and numbs the area, providing relief from sharp pain sensations. If you experience pain immediately after exercise, applying ice for 15-20 minutes can be effective.

- Heat Therapy: Heat can be beneficial for muscle soreness or stiffness, particularly after the initial inflammation has subsided. If your pain is more related to muscle tightness or discomfort rather than acute injury, applying heat may help relax the muscles and improve blood flow to the area.

In summary, while experiencing sharp pain after light exercise post-fracture can be common, it is essential to listen to your body and adjust your activities accordingly. Gradually increasing the intensity of your exercises, focusing on strengthening and flexibility, and ensuring proper warm-up and cool-down routines can aid in your recovery. If pain persists or you have concerns about your healing process, do not hesitate to reach out to your healthcare provider for personalized advice and potential imaging studies to assess your recovery.

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