Bodyworks: Ankle Sprain

How to recognise it, how to overcome it


Posted: 5 June 2000
by Patrick Milroy

Symptoms
You must have experienced ankle sprains before – an awkward footplant, followed by a sickening pain as your ankle twists inward and the agony of any further movement.

Signs
Following the injury, rapid bruising and swelling confirm your injury, but the severity will vary. Tenderness over the horizontal anterior talofibular ligament (see illustration) indicates less damage than if the major calcaneofibular ligament is torn. There is always the possibility that a sprain may involve other bones and ligaments, too.

Medical investigations
If you only have local tenderness over the ligaments, a case can be made for not x-raying the ankle. Any suspicion of a fracture as indicated by bone pain makes an x-ray mandatory – otherwise you can justifiably sue your doctor! Oddly enough, a simple sprain may cause you much more swelling and bruising than a fracture!

What else could it be?
As the injury can span anything from a simple sprain to major bone disruption, chronic injuries may require MRI scanning or arthroscopy to eliminate damage to the peroneal tendon and nerve which run around the outside of the joint.

Self-treatment
If you do not apply RICE immediately, you deserve long-term pain! Tubigrip folded over on itself provides reasonable compression for minor sprains, but if weight-bearing is particularly tender, you may need to wear an ankle stirrup brace. You’ll inevitably experience a loss of fine balance, which you can restore by doing wobble-board exercises or bouncing a ball while standing on the injured foot. You should start this as rapidly as possible after 48 hours.

Medical treatment
If your ligament is completely ruptured (if it is, you probably won’t be able to bear weight or fully point your toes), there is a risk of chronic instability. A plaster cast encourages muscle wasting and joint stiffness, but a careful programme of ultrasound and massage will usually provide a cure. Your problems will need reassessment if they continue beyond six weeks, which may culminate in surgery to reunite severed ligaments and prevent the ankle persistently giving way.

Can you run through it?
See below.

Recovery time
Six hours to six months, depending on the severity of the sprain and how intensively you treat and rehabilitate it. A minor sprain may simply make you hobble for a few minutes before it eases completely, but a severe tear that makes weight-bearing painful could stop you completely for two or three weeks.


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Discuss this article

All ye people out there

I'll not be the first I know, nor the last, but......
After spraining my ankle (not severely, as I have unfortunately done it before, which was severe)I want to train again. I'm only on a beginner's schedule (run/walk) but had been out for two weeks three times a week. I've missed four days now - just as I was noticing some progress.

Is it too soon to try tomorrow? Should I just give it a go and see if it hurts - and if not - keep going as per my schedule?

I have this memory of the sickening pain that sprained ankles bring and am a bit wary of trying. What do you professionals suggest?

I'm eager to get back to it

Jay
Posted: 01/11/2002 at 22:08

Hi Jaybird

Is it hurting now? If so,then rest. Consider ice and, possibly, anti-inflammatories (although I say that with the usual disclaimer as I'm not medically qualified!!)

If you don't mind me asking... how did you sprain your ankle? I'm just wondering for example whether you need trainers with more stability?

Best wishes

H-R

Posted: 01/11/2002 at 22:14

Hi H-R

Thanks for the reply. No it's not bad now - slight discomfort but tons better than it was. I actually sprained it while walking in a pair of 'sensible Clark's' shoes. I just put my foot down wrong on the pavement where it was sloped to allow for someone's drive entry - know what I mean?

As I said I've sprained it badly before (3 years since) when I 'went over' on a pair of silly sandals with a heel.

I did the same but tore ligaments and pieces of bone with the other ankle. In fact I was told at casualty when I initially did the other ankle that I 'merely had a sprain' and no x-ray was required. A later 're-injury' and first x-ray revealed the initial 'simple sprain' had been ligaments tearing chunks of bone from various areas of my ankle....

So as a result I now have two dodgy ankles. I'm overweight at the mo so that doesn't help, but I never wear 'heels' on my shoes that are higher than an inch.

My trainers are new and good - Ladies Nike Air 'pumona' or something similar, and were ok for the GNR.

Whaddya think?

Jay

Posted: 01/11/2002 at 22:27

Jay

For what it's worth, I think you should be guided by your body but be prepared to become the boss if you need to. I know that sounds contradictory, so I'll try to explain.

With a new (last few days) injury - if it hurts at rest, stay resting, as HE says.

If it's OK at rest but hurts when you are moving it, that's your body saying that you are doing more damage or preventing the healing. Keep resting for a day or two.

After that, a minor injury (over-extended ligaments/muscles etc) get set in their ways and they will start to hurt when you try to get them back to a full range of motion. That's when you need to boss them around. Walk and run-walk to get them going but be aware of the level of discomfort - it should be discomfort only, not pain.

Whatever, build up gradually. Don't expect or try to do your normal distance for a few sessions.

In the mean time, try a low-impact exercise, bike, swim etc to keep the cardio-vascular fitness building.

I do waffle on, don't I? Better shut up now!

Saxplayer
Posted: 03/11/2002 at 11:08

I also hurt my ankle whilst doing the Womens 10k in Glasgow May 18th, crossing from road to pavement to avoid the walkers! I didn't exercise for a few weeks then started going to the gym (not the treadmill) and on my bike. As it was still tender, I went to see a physio who advised various exercises although it is still tender at times. I am keen to start running again for a 10k in September, what is the best thing to do. I obviously don't want to aggravate it anymore. Thanks
Posted: 10/07/2003 at 02:28

I too hurt my ankle and found that cross training such as swimming will keep your fitness level until you can run again, when you feel you can run again, try runing on the beech or soft level ground. to exercise the ankle stand one foot, using the injured ankle to balance.
Posted: 29/07/2005 at 13:50

I was having pain in my lower back extending down my left leg and one time when I was out running my leg felt numb and I had to stop running. I went for a sports massage and he said that my muscles were so tight that they couldn't stretch when I was running hence the pain. This may be related to the previous ankle injury. The massage was very sore at the time but well worth it and I will definetely be having regular massages!
Posted: 01/08/2005 at 11:02

I too am recovering from a badly sprained ankle 5 weeks ago, the whole foot swollen, and black and blue. I have gradually started training again as I am entered for GNR. I still experience discomfort at the start of a run, which disappears as the run progresses. However in the morning before getting out of bed it really hurts and is very stiff as I hobble around the bedroom. does anybody know if this is normal and will it be ok to up my training?
Posted: 12/08/2005 at 16:50

Hi to Patrick, Clare and Michele

Wow! This thread is so old I thought I would never have any more contacts, but here we are - I've struck gold!


Patrick - running on the beach is a good one - it seems to cushion and caress an injury, even tho' it's hard going. (Just got back from a sea sand and sun holiday and know just what you mean.)

I'm going to leave my family I think and find a home by the sea - just for me!!!!!Wake up; go walk/run; breakfast;Daily paper and coffee;deal with the day!

Nice.

Clare - you are right. It's strange that an ankle injury can manifest itself in an area so far away?
Think about how you balance every day and which muscle groups are involved in just standing upright?
A massage by a competent person is so good and like you say, can throw up an answer to an injury. Good going to ya!
Oh and - Hope he's good-looking?!


Michele
Have you had a medical opinion on your ankle? It takes an age to 'mend'and dare I say it - if severely strained/sprained is never quite the same again.

I am at the moment soooooo overweight - and find that my 'weakened' ankle (severely sprained a few years ago)becomes uncomfortable during the day and really quite painful in the evening.

It is still very stiff and painful in the morning even now, but i think this is due to my excess weight.

However if you really badly 'knackered' your ankle you will probably find it is very sensitive first thing in a morning and needs 'breaking in gently'during the course of the day.

If it really hurts then rest it. Hospitals/doctors are not always correct in their diagnoses and seem to err on the side of 'walking wounded.'

(Personal experience)

:-)


Posted: 12/08/2005 at 23:48

Hi all - just found this thread.

I seem to be having trouble with my ankle that I badly sprained 2 years ago (at time "grinned and beared it" - but think I really should have got treatment).

It's not really hurting - but it does ache just about where I went over on it.

Any hints and tips for dealing with it?? Seems like you guys have had similar troubles?

Currently wearing an ankle support when I run.
Posted: 14/09/2005 at 14:19

Wow thought I was the only daft person to throw themselves on the floor while out for a run but obviously not.
Was told I sprained my ankle nearly a month ago and have just started running again. No X ray was taken and I am still unable to move my ankle properly. Can move my toes and no pain when I run but just no flexibility. Is it worth getting an x ray or would a trip to the physio sort it out?

Posted: 14/09/2005 at 15:33

Hi shortie 100 and julie B 70
If i was in your position I would seek a professional opinion and in the meentime cross train. On soft level grass or beech would be good for keeping the run fitnes up, swimming will maintain a aerobic fitness for you,and you can allways use the belt in the pool to run, this can give you a good workout without the impact.
Posted: 15/09/2005 at 08:35

I have just sprained my ankle, I have been to the doctors, she checked it out and said that I have torn my ligaments and I may have chipped a piece of bone from the bottom of my ankle joint. I am frustrated as I will now have to miss running for at least 3 weeks, I am going to continue with the swimming but am not sure about cycling, it's low impact but I am not sure if it will damage my ankle further. I have now resigned myself to the fact that I'm not going to be doing a few races that I have planned in the next month but I needed the advice of the doctor to convince me. I think that if anyone is unsure about the severity of their injury they should seek medical advice rather than just keep going.
Posted: 14/07/2006 at 20:59

Agreed 100%, IV.
Posted: 17/07/2006 at 18:50

I fell off the back doorstep on Monday! (stone cold sober AND wearing my stability trainers btw...)

Bad sprain to right ankle, but xray reveals no break. I've been on crutches for 3 or 4 days, but decided to leave them at home today and hobble to work. Foot from toes to mid calf is blue and swollen still. The joint feels a little tender, but mostly just stiff - I think it is improving quite quickly, and certainly nothing like the excrutiating pain when i first did it!

If it's not actually hurting, and is mostly just stiff from the swelling, is it OK to start walking/stretching it more? Someone gave me the tip of 'writing the alphabet' with the bad foot (I sit at a desk all day) as that should encompass the full range of movements in the ankle. Should I start doing this or leave it another couple of days?

I only started runing in the summer for the Windsor RFL, but I think the injury would have been worse if I'd been totally unfit - I want to get back to the running ASAP tho....
Posted: 11/08/2006 at 12:40

Oh, I think it's best to wait until any swelling has completely disappeared before you start to do anything Gopher, as you may just aggravate the tissue damage.
Posted: 11/08/2006 at 13:13

I agree when i sprained mine last year i kept trying to run with differing degrees of success- it either bothered me during the run or after. By chance i have reduced the amount of running this year due to other commitments and have done more short runs and long walks (Trailwalk) and my ankle appears completely fine, no pain and no stiffness i can even kneel down with my ankle underneath me, someting not poss a few months ago.-- about time i got back to some serious running!!!!
Posted: 11/08/2006 at 16:23

Thanks Wee Stumpy and Michele - I'm taking your advice. It's been over 2 weeks now, and it's still swollen and stiff although not so sore - I am seeing a physio tomorrow.

:¬(

I guess I was over-eager and dosed up on co-codamol before - this is going to take weeks/months to resolve I now think...

Oh well - I shall have to sit on the sofa and eat pies!
Posted: 23/08/2006 at 13:35

I'm gobsmacked! I posted this original thread in '02 and it's been picked up again!
Just to let you know the long term effects of my original injury, now seven years ago. Day to day movement is ok, I find I don't have the range of movement in my ankle that I had before the injury and if I try to bend my ankle 'inwards' it really pulls and is uncomfortable. Strangely, I feel it 'tweaking' when my ankle is relaxed, while swimming using the leg/foot movements for breast stroke.

Having said that, it's got me round the GNR a good few times since and coped with my heavy weight! I'm still careful about 'fashion' shoes and can't go for a 'high' heel, but then at my age I probably shouldn't anyway!

So although it's not the same as it was before injury, it's not too bad either. I would urge you though, if you feel things are not right after an initial diagnosis and continue to have bad pain, get it checked out again - I wish I had, knowing what I know now.

RW Forum's a Godsend isn't it! Happy running.

Jaybird
Posted: 24/08/2006 at 09:36

I'm so glad I found this forum and am going to attempt to get it started again.

I sprained my ankle nearly 3 weeks ago and am really missing running after having to miss out on a run this weekend, so am really wanting to get back into it. It was a bad sprain, I had it Xrayed and as it was in Switzerland I was given an aircast and crutches. i went to casualty on my return to Britain and the nurse told me aircasts are excellent but not given out here because they are so expensive. I took her advise - iced it, took anti inflamatory tablets and started to walk on it like she told me to. After a day I stopped using the crutches and after about a week I started walking without the cast.

The swelling has gone down, but ankle is still slightly swollen and a bit bruised as is the foot (right ankle right outside part of foot). I can walk on it ok but slightly painful especially after a lot of walking.

I know I can't run yet so will start swimming/riding - I was thinking of waiting until I can comfortably walk down stairs. I was just wondering how long it took other people before they actually started running again - it's obviously different depending on seriousness of injury but just to give me a rough idea I'd really appreciate it.
Posted: 16/04/2007 at 12:03

Looks like I am one of this group aswell but here's my story. As you read it think of Simon Bates Radio 1 show / song...no tears please!

After a injury plaged last 6 years i'm back posting on here for some advice and guidance

Ok the last injury was when i went over on my ankle in June 2005....Xrays showed not breaks/cracks but was badly swollen...the swelling is very small now and i still cant sit down and put pressure on my outside ankle bone its still painful

The hospital would not give me crutches and suggested i put weight on as quickly as possible to recover quicker. I'm sure this was bad advice but im no doctor

My balance & stability was poor. I used a balance mat to get some of it back.
Tried running again in the November lasted 2 weeks then i started to get shooting burning pain on the inside of the ankle just below...I rested and eventually it went. All the time my ankle around the outside of the joint has been stiff and still throbs...accupunture helped for a while.

So now for the update. I went running last week for 30 mins easy. Felt ok but the next day i bent down and got a almighty pain again under the inside of the ankle. Felt like ripping to pieces of cloth. Ive had this now for 3 weeks and each time i bend down / move the foot it happens..I have strapped the foot and stopped bending down. I also iced it but that made the pain worse. I can walk ok but feel I have done some serious and perhaps I should have an xray and scan again.

Any ideas what this is? Is it the tendon or archilles?...how can i get rid of this problem and also my ankle still has a dull throbbing pain around the outside of the joint. I do some stretches maybe not enough.

Any help would be appreciated. I wont go into detail about my other long standing problems pain under both arches...I am seeing my consultant about this tomorrow morning and the podiatist PM to try orthotics again and re-analyse my walking / running gait

please reply thanks
Posted: 16/04/2007 at 22:04


Sky
Hi there,
Advice needed please. I am a teaching assistant and fell off a table trying to reach something off a top shelf for a child - sober as a judge (not that they all are I suspect) last year which resulted in a torn ligament - well that's what the doctor said anyway . . .
Well this year I've lost nearly 4 stone and started running with a friend. We're doing the 'Race for Life' in 3 weeks time and I know it's only 3 1/2 miles but even so . . . I have sustained an ankle injury (probably reacurring - see above)through the training and I'm in agony. Not only through the injury itself but through actually not being able to run for a week. We only run 3/4 times weekly and approx 4 miles a go.
I have taken it upon myself to treat this with ibuprofen (anti-inflamitory) and diclofenac spray. This has not worked at all and now I'm struggling with everything. I want to run as it means I can eat what I like (in moderation) and have a happy and slim life! I also don't want to let my running partner down.

Please, PLEASE help me with a solution . . .
I have a docs appointment this Thurs but he'll only tell me to rest it won't he!!!

This won't do at all - Aaaargh
Posted: 21/05/2007 at 18:23

Not an expert but I would say rest it as much as you can before the RFL, you sound fit enough to be able to get round without much of a problem. A hot water bottle increases bloodflow to the area and an pack reduces the swelling.

In the meantime how about going swimming or using the gym to exercise the non-injured leg muscles. If you push yourself on an injury, as I did previous Sunday, then it takes much longer to recover.


Posted: 21/05/2007 at 19:57

I "went over" on my left ankle about 8 weeks ago, attended at the hospital with all the usual severe swelling etc. I was told it wasn`t broken and told to rest. I still cant run as there is pain shooting up both the inside and outside of my ankle. I can walk normally although after a while my ankle does begin to throb. I still have swelling to the outside of the ankle which funny enough is not "soft" the way swelling should be, it feel hard like bone.......Anyone got any ideas?
Posted: 28/06/2007 at 00:09

Noddyploddy, recovery depends on the severity of your sprain and the amount of fibres damaged.

Swelling may be scar tissue, so I would get to a sports physio to address that because swelling is the number one enemy in healing (prevents full range of motiion).

In the meantime try to regularly write the alphabet with your big toe, point toes and pull toes towards shin to stretch it. When resting put foot up higher than hip level. Work on balance exercises too for nerver re-education.
Posted: 28/06/2007 at 14:02


Sky
Hi Jaybird,
I'm not a proffessional runner by any means but one such person did help me with my ankle sprain. He / She sent me a link to this website

http://www.return2fitness.co.uk/Supports_And_Braces/Ankle_Supports/md101ankle

where I bought this ankle brace. . . . It's marvelous! I still had aches when I ran but I did continue to run (just short distances) and packed my foot with ice on my return . . Whilst crying with the pain. I'm not joking. Gradually after 2 weeks I had no pain and was able to wake up in the morning and once again spring out on my run. I continue to wear the brace while running as support but no longer wear it all day, as I did in the beginning.

Hope this helps.
Sky x
Posted: 28/06/2007 at 19:32

hii all ....i just wanted to ask a question ???...i sprained my ankle four weeks ago and my injurie was at the deltoid ligament or (medial malleolus) because i had an eversion sprain on my ankle and i think it was a little tear but at the begining of 2 weeks it was so difficult to run, jog or bend ...now my ankle seems okkk but it is so weak and when i run doesnt hurt me but while im running when i take a quick turn( left or right) it hurts me a little and i cant bend all my ankle...same thing when i sprint too ...my question is:::: IS MY ANKLE SO STRONG TO SUPPORT A 90 MIN. GAME BECASUSE I PLAY SOCCER AND I NEED TO GO ON THE PITCH QUICKLY......AND WHAT ELSE SHOULD I DO TO TREAT 100 % MY ANKLE ....PLEASEEEEE HELLPPP MEEE..????
Posted: 13/12/2011 at 22:12

Hi Silver Golden,

One of the best sites to check out is the Sports Injury Clinic as I always get good information from there when advising my players from my own football team.  I've also had a bad grade 3 injury many moons ago and some of the exercises they advise you to do on this site are more or less what I carried out, once the plaster came off, on advise of my physio.

The wobble board is a really good rehabilitation piece of equipment.

One of the other strengthing exercises I did was to use a bench, that you normally get in the school or some sturdy box, stand facing it so it's in front of and then place the injured foot on it, your other foot should still be on the floor and then from their push up, with the foot that's on the floor and then without touching the bench you kind of step over the bench and place your foot on the floor on the other side of the bench and then back and that counts as one rep, you should be able to complete 10 reps and then change foot and work your good ankle.

This worked for me along with other exercises, however, I need to stress that I'm not a medical trained person but I have suffered many injuries and have managed to keep a good knowledge of what works and do try to pass on anything that I've gained in my experience, so don't send the lawyers around if it doesn't work.

Any way I hope you're back playing soon.


Posted: 14/12/2011 at 13:31

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Posted: 08/02/2012 at 11:41

Good day to all readers,
I had a serious sprain on my right ankle during a basketball game when I was 13 years old, and I immediately wrapped with ice to prevent any further swelling. After that I wrapped the ankle with warm towel and massage the ankle for few weeks. After a few months I continued playing basketball without any pain. After a few months I sprained the same ankle during a basketball match and after that during the years I sprained the same ankle. I am still playing basketball but without spraining my ankle for the past 2 years. I got interested in football after slowing down basketball although I am still playing. I have been coached for football and every time I kick the ball even with the correct technic, the ankle pains like having a sprain but after resting the ankle for 20-30 minutes and I continue to kick the ball the pain comes back again and it is so frustrating and the pain is unbearable. I have seen a doctor and taken an x-ray but the x-ray shows nothing and the doctor tells me that it is better if I stop playing football. Are there any exercises that I can do to strengthen my ankle muscle?

Posted: 08/02/2012 at 11:42

I've been training for a 10k and the race is on Sunday (in 3 days). I've been getting myself in best condition possible and excited about the race. Then yesterday I was walking along the pavement (in smart work attire, not training) and somehow managed to be ultra clumsy and trip on a kerb and go over on my ankle. Of all weeks to happen - pretty annoyed.

 I had some fairly intense pain in the evening which thankfully died down with some RICE and ibroprufen. This morning it doesn't feel too bad to walk on, but any side to side movements of the ankle is a sharp pain.

My hope is if I avoid doing any more training now and just rest it I might be okay for Sunday. If its still sore, does anyone find strapping up the ankle helps? Anyone else had a similar incident?


Posted: 29/03/2012 at 10:17

How did the race go James? I just did the same thing... Same symptoms... Similar race time pressures... Do-able?
Posted: 02/06/2012 at 21:31

Hello,

 

I don't know if anyone still reads this thread, but it has been really helpful. If anyone has any help they could offer me or advice, I would be really grateful...

I think I sprained my ankle 3 weeks ago. Self-inflicted - I stood on tip-toes, lent over to the right for 2 hours (at a gig...I am short and couldn't see!). 2 days later I went for a run and 3 miles in had searing pain in sole of foot and from ankle along outside of my foot (where ligaments are). I literally could not weight bear for 3 days, but have since slowly improved and can now walk, albeit with a bit of a limp.

I have no pain for the majority of the time, but if I stand for a long time or walk for more than 20 minutes, it gets sore along the right side of my foot. My ankle doesn't feel very stable and feels like it turns out (away from body) as I take each step. There is some discomfort and general ache in the ankle area also.

I am DESPERATE to get back out running but am fearful of injuring it further. I tried a little run this week, 3 miles, but it was quite painful after. I sit with my foot raised when possible. I am using a band to do extension exercises and using a wobble board once per day (for the last 4 days).

When can I try to run? Do I wait for it to be ok to walk on first? 

 

Thank you for any help! 


Posted: 16/12/2012 at 20:10

I sort of sprain my ankle in the dark street of uk, in combination of absent of street light in certain section, cobble stone, pacing 2 girls from behind, watching the padestrian from front. I stepped into an uneven path and kinda sprain my ankle a little.. I go on and complete my 6 miles run, did not feel much discomfort but definitely different on my ankle,

 my ankle is slight swollen today, no pain but feels that i need rest.. wondering how long it would take.

 


Posted: 15/01/2013 at 15:40

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