A runner's guide to a sprained ankle: how to prevent, treat and recover

An ankle sprain is one of the most common running injuries and sadly it can happen to the best of us.

A runner's guide to a sprained ankle: how to prevent, treat and recover

Sprained ankles often happen when your foot lands incorrectly, causing it to twist or roll onto the outside of your foot, damaging the soft tissues and ligaments. It can easily be identified by pain and swelling.

For tips on how to treat and prevent ankle injuries, we asked the the experts at PhysioMed to share their knowledge to help keep you running.

Symptoms of a sprained ankle

Pain

A misstep or an accidental trip and fall that results in a sprain will hurt. You may feel a throbbing pain in the joint, which usually worsens if you press around your ankle or move your foot in certain directions. You definitely won't be able to keep running and you may find it difficult to walk on it.

Swelling

Ankle injuries often have the most swelling due to increased fluid in the tissue.

Bruising and discolouration

Your ankle and foot will probably be a variety of colours, including blue, purple and yellow from bruising, but how bruised your foot is is determined by the severity of the sprain.

Redness and warmth

Your foot and ankle will feel hot to the touch and areas not bruised may be bright red. This is completely normal, as your body will increase blood flow to the area to help with the healing process.

Long-term symptoms

If you've sprained your ankle before, unfortunately you're more likely to sprain it again.
 
Your ankle may feel like it turns in when you run (this is known as ankle instability). When this happens, you may lose confidence in your ankle and its ability to support you, especially on uneven ground.

Swelling and pain around the ankle may not fully go away either, usually caused by a reflex where your body turns off the muscles around the joint. This will give you the feeling of a weak ankle, like it could give way at any moment, and you're more likely to twist it again. Luckily, this is easily fixed by retraining your ankle balance and stability.

Causes and prevention of a sprained ankle

Poor foot control or ill-fitting shoes

If you have flat feet and/or a tendency to overpronate, you increase the twisting strain on your ankle ligaments. Ensure you're wearing the correct shoes for your gait to help keep ankle and foot stability.

Calf tightness or reduced ankle movement

Often tight calves can be the cause of ankle problems. Keep a good range of movement in the calf and ankle by ensuring you use dynamic stretches to warm up and static stretches to cool down.

Poor balance

Bad balance is a good predictor of future ankle sprains. Focusing on balance training will help strengthen the necessary ligaments.

Unstable ground

Uneven pavements or trail runs, and wet or icy surfaces especially in winter, are more likely to cause a misstep and for your ankle to roll. If you're unsure of the surface you're running on keep an eye on what's ahead and walk if you feel particularly unsure.

At-home recovery for a sprained ankle

The best results after a ankle sprain come when treatment is started right away. A simple way to remember the essential steps of initial treatment is by the letters in the word RICE. These stand for rest, ice, compression, and elevation.

Rest

The injured tissues in and around the ankle need time to heal. Rest prevents further injury and reduces the stress on already inflamed tissues. If the injury is severe crutches or a walking stick (placed in the opposite hand to the injury) will prevent too much weight being placed on the ankle in the early days of injury when walking is essential.

Ice

Applying ice will help ease pain and reduce the swelling and warmth. You should apply the ice as soon after the injury as you can to prevent as much of the inflammation developing as possible. This will help ensure a speedy recovery. It is advised to apply ice in the form of crushed ice cubes, frozen peas or an ice pack. DO NOT apply directly to your skin, oil can be applied to protect the area. All of these are to be wrapped in a damp tea towel and applied to the ankle for approximately 15 minutes every two hours. It is advised that you check the skin every five minutes to avoid the possibility of an ice burn from the cold temperature. Apply frequently in the first two days.

Compression

Use tubigrip (elasticated tubular bandage available at the chemist) on your ankle, this will help prevent inflammation and swelling.  It should be placed from the base of your toes and extend a third of the way up your shin, but make sure it is not too tight and take it off at night time.

Elevation

Supporting your ankle above the level of your heart helps to control swelling by aiding your body to reabsorb the fluid that has leaked into the tissue. Ideally lie on your bed or the sofa or floor and prop your knee up on pillows or a chair so that it is higher than your heart. Even propping your ankle up on a chair if you are unable to lie down (e.g. at work) is beneficial.

Further help

  • If swelling in the ankle is severe, self-massage can help. Apply massage strokes from the ankle toward the knee with your leg kept in an elevated position. This helps get the excess tissue fluid moving out of the ankle and back into circulation.
  • Mild pain relievers may help with the discomfort. Anti-inflammatory medications can help ease pain and swelling and get people back to activity sooner. These medications include common over the counter drugs such as ibuprofen. Talk to your Doctor or Pharmacist if you have specific questions about which pain reliever is right for you.

Range of movement and strengthening exercises

Please discuss with your physiotherapist which exercises are right for you. The type, duration, and frequency of the exercises will depend on the structure and grade of your injury and where you are in the recovery phase.

Balance exercises

Small nerve sensors inside the ligament are injured when a ligament is stretched or torn. These nerve sensors give your brain information about the position of your joints, a sensation called proprioception or position sense. For example, nerve sensors in your arm and hand give you the ability to touch your nose when your eyes are closed.

The ligaments in the ankle work the same way. They send information to your nervous system to alert you about the position of your ankle joint – essential for balance.

They work in addition to our eyes and our inner ears.

Proprioception (balance) exercises can help you recover more quickly from an ankle sprain and should actually be performed as part of a prevention programme. Poor balance is a good predictor of future ankle sprains. After an ankle injury, balance training is essential to recovery.

When can I start running again?

Unfortunately, it's important not to start running again until you are completely pain-free and have a full range of motion in your ankle.

Usually this will happen within a couple of weeks, but for more severe sprains it can be up to 12 weeks. Just remember to work on strengthening your ankle and follow these tips on how to maintain fitness when you can't run.

Once you start running again, ensure you warm up properly and if you feel any pain return, stop running and walk until it subsides.

Please remember to use this advice under the guidance of your physiotherapist.

For more tips on how to treat and prevent running injuries visit the experts at PhysioMed.

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