Q+A: Rehabilitating a sprained ankle

Our experts answer real-life questions


Posted: 9 September 2000
by Martin Haines

Q: I recently turned my ankle and suffered a pulled ligament as a result. After 10 days in a cast and a week in an ankle support, I’m now able to run again. But I’m concerned about long-term weakness. Is there anything I can do to strengthen the ankle, and should I run in a support?

A: Once you have been in plaster, your calf muscles – and leg muscles generally – will waste. If specific work is not performed to rectify this, there is a chance that, sooner or later, further injury will occur. So you are absolutely right: you do need to strengthen and re-educate the ankle.

Get hold of a latex rubber strip – usually called a cliniband or dynaband – which you can use to strengthen the calf. Try sitting on the floor with your leg straight and hooking the band around the forefoot. Attach the other end to a table leg (or something immobile at the height of your foot) so that you can use the band as a resistance to strengthen your ankle. Position yourself so that the band resists both the flexion and rotation of your foot. Do three sets of 12–15 repetitions of each every day.

In addition, you lose proprioception in a joint that has been injured and immobilised. This means the cells in the ankle that would normally tell your brain where the joint is in space (without you having to look), are temporarily switched off. You need to stimulate them into action by performing balancing exercises. Try standing on one leg with your eyes closed for two minutes. Make sure that you’re near something you can hold on to in case your balance isn’t as good as you thought.

As for an ankle support, one may be helpful if the ligament is stretched to such an extent that it can’t function properly. Ligaments act as strain gauges, and normally give information to your brain to tell the muscles to contract to protect the joint. If the ligaments are loose, the joint can be damaged before the ligaments recognise that it’s being put under pressure. In this case, a support can be helpful to physically limit the movement in a joint.

—Martin Haines, chartered physiotherapist and sports injury specialist


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ankle, cliniband, sprain, proprioception
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Ian
I was doing so well! Then on Wednesday I went over on my foot and caused a massive sprain. It came up like a balloon - a black and blue one. No breaks but a big haematoma and torn ligaments. I'm doing the usual RICE and taking Arnica but how long does it take to recover from a thing like that? At the moment it hurts to walk on it let alone run. But its better than yesterday. I can still cycle and have started cross training to maintain what fitness I can. Any other suggestions?
Posted: 09/08/2002 at 16:15

Ian, Bad Luck.

I did my ankle really badly over 20 years ago and can still feel it now (it's just started raining - no co-incidence!). It took me months to be able to walk without using 2 sticks - the hospital told me it was worse than a break really.

I couldn't afford much physio then - but if you can, try and see one asap - as they'll be able to assess it and advise you what you can and can't do, and when.

This is absolutely no substitute for professional advice with this injury - if you blow it now it'll haunt you for years. But if you can't get to a good physio for a bit (the best ones are usually full for upto a week ahead / on holiday when you need them!) I would have thought complete rest for at least a week - maybe 10 days - with just gentle ankle rotations - you'll be surprised how little fitness you'll lose in that time (pretend you're tapering for a marathon!) and then possibly remedial exercise in the swimming poool - then in the gym - I still have to do ankle flexes now to compensate for the weak ligaments.

Also - I find magnets brilliant for speeding up healing. Enter Magno-pulse into a search engine as they make really good ones.

Rhus Tox and /or Ruta Grav (I can never remember which to use for what - one's more for bones - one's more for muscles - but I usually chuck them both down as they won't harm and are also good for helping to recover from acute injuries as is the Arnica).

Once it's on the mend properly and you want to start pushing your fitness without impact - the rower / bike and elliptical trainer are brilliant.

Hope you heal well

Shattered
Posted: 09/08/2002 at 22:32

I originally strained mine falling 2m from a climbing wall 5 years ago and it's still a bit of a problem.

Go to a good physio soon and work on your BALANCE. Do not rely on NHS physios, they really don't care so long as you can just about walk.

I didn't get it seen to properly at the time and have lost count of the number of times I've gone over on it. Since seeing a physio last year it has been much better.

Swimming breast stroke seemd to help me too.
Good luck.
Posted: 10/08/2002 at 18:28

Did mine 10 years ago & I still have to be carefull now. Good advice above, ankle rotations, balance etc.
For balance stand on one leg for 30 secs with eyes open & then with eyes closed, it'll take a few days/weeks to perfect this. There is also a special balancing board on the market to help with perfecting your balance, try some of the physio sites. I think I once saw it in a RW article about a year ago or more (if you've got back issues).
Buy some surgical elastic for strengthening.
Get an ankle surport, this will prove vital until you've rebuilt your tendons & muscles.
Good luck with it. You shouldn't be out of running for too long, you now need to look at prevention.
PM
Posted: 10/08/2002 at 21:25

There's a brilliant device called 'Aircast', it's American-made,but where I live in Germany it's used often for injuries like yours. I sprained my ankle badly last year, tearing the ligaments and also chipping the bone. Once the swelling went down, I asked my doc for an Aircast, and was able to resume light training almost at once. 5 weeks later I competed successfully in Ironman Germany. The Aircast is 2 very light plastic air-filled pieces which are fitted to the sides of your ankle and calf, with a soft underfoot strap and two Velcro tapes which go around the leg. It's designed to be worn with a running shoe. The other advantage is you can remove it for bathing and sleeping. Coincidentally my husband suffered the same thing on the other foot a year before me, and completed Ironman while wearing the Aircast for support! So now we have one for each foot, just in case of future damage.
Posted: 11/08/2002 at 11:39


Ian
Thanks for all the advice and support. I've certainly started the balancing exercises. I'm wearing Tubigrip day and night. I'll see how it is by Wednesday when the swelling should have subsided and see about a physio. I may well treat myself to a wobble board. I'll check out the WWW about Aircast. Thanks again.
Posted: 12/08/2002 at 13:18

For a rehabilitation program click here

Will
Posted: 12/08/2002 at 13:29

can i run through a sprain , with ice daily
Posted: 15/08/2003 at 18:57

Thankyou for all those who have had an input on this subject, I too fell over and tore a tendon on my right foot and I was under the illusion that I would never get back to ultra events and tri's. You have all made me feel better as I hobble around the house and I am now also seeing a Physio and planning my next event.Thanyou.
Posted: 02/04/2004 at 20:53

try lasinol cream, it has heperin in it. brilliant for bruises, you can buy it over the counter, not prescription
Posted: 02/04/2004 at 21:47

I fell down the stairs 3 weeks ago, no problems afterwards. During th Wilmslow Half had a pain in ankle at 5 and ran till 11. Still can't run and FLM in two weeks. I've been swimming but can't see and end. The overstrech is on the inside of the left ankle, feels like I've been kicked. Very little swelling though and no bruising. Any advice??
Posted: 02/04/2004 at 21:55

Tony M. Are you one and the same from the Frankfurt marathon? How you doing? Apart from having a sprain!! Any more marathons since? Joolz
Posted: 03/04/2004 at 09:04

Turned my ankle quite badly at the weekend swollen and bruised, painful to walk, how long before I can start running again?
Posted: 15/12/2004 at 13:03

Yup, add me to the list of ankle injuries! I managed a spectacular twist and fall! It was not very, very painful at the time, and out of embarrassment more than anything, I put on a brave face and ran home. By the time I got home it was swollen and red, but has not bruised. I applied the traditional 'bag of peas' on it - limped the next day but have felt only slight pain and tenderness since (8 days so far). The swelling has almost gone away but not entirely and it feels as though the tendons are still quite sensitive. I had my leg in a cast around 15 years ago from a torn ligament - and I am scared to go out and run again before it is entirely strenghtened again - I would not encourage anyone to overdo it before they are completely comfortable again...frustrating as it is!!!
Posted: 20/06/2006 at 21:20

Me, me, me! I've had one too! Sprained my ankle just over a week ago, it's not too bad now provided I don't do any eccentric movements with it. It is still rather swollen, especially round that err...knobbly ankle bony bit. Does anyone know whether the remaining swelling should be any cause for concern? I am running (cautiously) on it again now, with no problems...

Any thoughts gratefully received.

L
Posted: 05/08/2006 at 20:06

Help!! did a fab run in rain but next day couldnt put any pressure on my foot and inner ankle painful .Dr said tissue damage but 4 weeks on and still cant run...driving me mad... any suggestions to get me running again SOON!!??
Posted: 03/09/2006 at 21:39

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