Dr Phil Kieran: Should I worry if my son is still limping five weeks after a toe injury?

We used the RICE method — rest, ice, compression, elevation — and buddy taping to treat my son's injured toe. Did we do the right thing?

It is important to help him get back to walking normally, as limping for extended periods risks weakening some muscles used in normal walking, causing others to become stronger than they should be. Picture: iStock

My 12-year-old son hurt one of his toes during soccer practice. We assumed it was broken and treated it at home following the RICE method — rest, ice, compression, elevation — and buddy taping. It’s now five weeks since he had the accident, and while the pain has almost gone, I’ve noticed he’s still limping. Should I bring him to see the doctor?

RICE is one of my favourite medical acronyms, as it is clear and concise and also offers pretty good advice. The only major change is a recent move towards moderation — we don’t want to completely reduce or halt the inflammatory cycle, as it is important for healing.

Restricting cold treatment to no more than the first eight hours, only for pain relief after the injury, and being careful with compression (it shouldn’t be uncomfortable), is the current advice.

A toe injury is definitely something you can initially look after at home except in a few specific cases.

If you think the big toe might be broken, if the toe looks crooked or rotated, or if the pain is very severe, I would recommend seeing a doctor.

Also, if you have reduced sensation in your feet, such as with neuropathy or diabetes, you should always get the foot injury checked out.

Buddy strapping is the process of taping the toe to the one next to it. This technique helps reduce pain by splinting the toe to its neighbour and could also help to keep the toe in the correct position.

Soft tissue injuries or non-severe fractures of the toes take on average four to six weeks to settle down, so it sounds like your son is following the expected course. If the toe is still sore or if it looks abnormal, I would suggest seeing your doctor to ensure no further action is needed.

You mention that he is still limping.

This is something that can happen due to either ongoing pain or habit. As I’ve said, if he is still in significant pain (maybe he is putting a brave face on it), you should get him checked out.

If the pain is nearly gone and he can move the toe normally again, the limp may be at least partly habit.

Encouraging him to be aware of how he walks (his gait) and how he places his foot may be all it takes to resolve this.

Encourage him to put his foot flat on the ground and to put his weight through the front of his foot when he steps forward, rather than lifting the foot straight up before he moves to his toes.

If he finds this approach tricky to follow, seeing a physiotherapist would be a good idea to assess his joints and, if needed, recommend specific exercises to help him resume normal walking.

It is important to help him get back to walking normally, as limping for extended periods risks weakening some muscles used in normal walking, causing others to become stronger than they should be.

• If you have a question for child psychotherapist Dr Phil Kieran, please send it to [e-mail]