Make It Better Than It Was (Sprained Ankle)

Isn't it a horrible feeling when you sprain your ankle? I don't mean just physically, but mentally as well. You take that step, you realize your ankle is on it's side, and three things flash (yell) in your brain, all at the same instant:

• "This hurts like hell!"
• "Totally collapse all limbs right now! Get weight off that leg as quickly as possible."
• "It may be multiple months before I run again!"

Many people think they simply need to give their ankle time to heal, like any other injury. While healing time is important, in my opinion, rehabilitation is equally important. When you roll an ankle all sorts of bad things can and do happen. Tendons and ligaments get stretched, sometimes torn. Nerves can be damaged. And let the swelling begin! Holy cow - sprained ankles can look horrible.

The immediate treatment protocol has been written about ad nauseum: Rest, Ice, Compression, Elevation. (RICE). A good overview of the initial 24-48 hour treatment recommendations can be found here. And don't forget to go to the doctor! You want to be sure nothing is broken, or cracked and about to be broken.

To rehabilitate the ankle my PT had me do the following:

• Strength. Stand on one leg. At the beginning you're working on basic strength. It's amazing how quickly it feels fatigued. Try to build up to 2-3 minutes. As it gets stronger do heel raises. Stand with your feet a little bit apart. Raise your heels so you're standing on the balls of your feet.
  
• Flexibility. Do standard calf stretches. Do the calf stretch where feet are shoulder width apart, one a bit in front of the other. Bend at the knees and you can get an extra degree of shin-over-the-foot flexibility. Take care of the opposite movement: While sitting in chair slide your foot (while flat on the floor) as far forward as it will go.
• Balance. Balance on one foot. Get those nerves better at firing as they should. When you can do that well make it more challenging. Fold your arms across your chest. Close your eyes. You want to improve proprioception - the body's ability to determine where a limb is in space from the muscles and tendons themselves.

How do you know when you can try running on it? A rule of thumb I've heard is to jump up and down on the injured ankle for 2 minutes. If you feel no pain you can try running. Notice I said "no pain". I didn't say "a little", or "tolerable" or some other weasel word.

I've read that the biggest risk factor for spraining your ankle is having previously sprained your ankle. So get it rehabilitated well and reduce the chances of it happening again.

Jim