A couple of days ago, I injured my left foot. It’s a trivial injury and I’m confident that it will heal in a few days, but I thought that I would make use of it as an example of PIP form-filling.
The PIP moving-around test is about whether you can stand, and then move, outdoors, without too much pain, in a reasonable time, whenever you might need to in the day. It includes looking at whether you can manage kerbs.
So, if my injury was a long term thing and I needed to claim PIP mobility, this is what I would tell them in the form:
Sitting
When I am sitting, with my feet flat on the floor I have continuous pain in my left foot.
There is a band of pain that runs from the outside of my ankle, across the front of my ankle to the inner side.
Also there is a patch of pain that runs from my ankle up the left side of my shin for about 15 cm
There is tingling-numbness that covers the left part of the top of my foot, from my ankle to just behind my middle, fourth and little toe
This is all low-grade pain (3/10) that is present all the time, but it can get quite a lot worse (5/10) in the evening.
While sitting there is no significant pain in the sole of my foot.
Standing
I can stand-from-sitting easily, putting most of my weight on my right leg.
Having stood up, if I put my weight evenly through both feet I get significant pain in the heel and the ball of my left foot. (4/10)
If any pressure is applied to the arch of my foot, this is very painful (6/10 or 7/10).
While standing I get jets of short sharp pain from my ankle, up the left hand side of my shin.
All of these pains become much more intense as the day goes on.
Walking
Because putting weight on my left foot is so painful my gait has become very laboured.
If I dorsiflex my ankle (bringing my toes closer to my knee) the continuous pain in my ankle, and the pressure-related pain in the bottom of my foot both become much more severe.
I cannot put my right foot in front of my left foot because doing so causes the severely painful dorsiflexion. Even having my feet together causes this.
So, standing with my left foot about 15 cm in front of the right, walking forward would go like this:
…..With my weight on my right foot, I move my left foot forward about 30cm (a foot)
…..I shift my weight to my left foot, causing a lot of pain, and briskly bring my right foot to about 15cm behind the left
…..I put my right foot down, putting my weight upon it and relieving the pain in the left
I can do this maybe thirty times before I need to stop.
I then stand with my weight on my right foot, lift my left foot slightly and slowly rotate it mobilising the ankle five or six times, and then I begin walking again.
I can use a walking stick to help me stay balanced as I hobble along, but it does not fundamentally change what I have described.
During the day I could walk more than 200 meters in this way but all walking causes an unacceptable degree of pain.
My walking speed is much slower than normal, taking, over any distance, much more than twice as long as it did before my injury.
All of these difficulties become much more severe as the day goes on. I would not attempt to walk more than a few meters, outside, during the evening.
Kerbs
Because I cannot bear weight on my left foot without pain, kerbs are difficult.
Stepping up, I lift my right foot onto the kerb, causing significant pain while the weight is on the left, and then as quickly as I can, I put my weight onto the right foot to relieve the pain in the left, and bring the left foot up to the higher level.
Stepping down is easier, because I can very quickly drop my right foot down on to the lower level, so the pain in my left foot is much shorter.