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. Youll 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 wont 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.
Discuss this article
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'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
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
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
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