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How A Runner Can Recover After Ankle Sprains

To prevent injuries it can be helpful to incorporate rest, rehabilitation, and prevention into your running routine.

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For us runners, the agony of an injury is all too real. Ugh, shin splints! Stress fractures are a terrible problem. And the plantar fasciitis, which I didn’t expect to be so painful.

Although these are all examples of overuse injuries, the most heartbreaking are the sudden injuries that force us to stop our running routines. If you want to see a great example of one of these injuries? Sprained ankles.

Inevitably, every runner, and trail runners in particular, will suffer an ankle sprain at some point in their careers. About 2 million occur annually in the United States alone (and that’s just the reported cases), making it one of the most common musculoskeletal injuries. What would the total be if they included those who hobbled home to treat their injuries with ice and rest?

You’ve probably suffered from at least one ankle sprain in your lifetime, but can you define it for me? And how can one best recover from such a setback? So, here’s the deal:

Ankle Sprain: What It Really Means

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John Nguyen P.T., D.P.T., clinic director at SporTherapy, defines a sprained ankle as damage to the ligaments in the foot and ankle. It is possible to tear the ligaments that serve as stabilizers for the foot and ankle joint if they are stretched or pulled beyond their tensile strength.

One cause is “a sudden and high force inversion injury,” as described by Alex McDonald, M.D., a family doctor who focuses on sports medicine. Keep in mind the various terrains you run on, such as gravel, cracked sidewalks, and trail roots, all of which can be hazardous to your sprained ankles. An occasional ankle sprain can be expected due to the repetitive nature and impact of running.

What Can Cause a Sprained Ankle?

If your ankle is sprained, you can expect to feel pain, swelling, and tenderness “acutely and immediately” after the injury, as stated by Dr. Nguyen.

“Most ankle sprains are the result of sport injuries, but sprains can occur in a variety of ways,” he says. Turning your ankle while walking on uneven surfaces or stepping off a curb are two other common mechanisms of ankle injuries. In most cases, the deltoid ligaments on the inside of the ankle are damaged when an ankle is sprained, but the lateral collateral ligaments are also at risk.

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Identification of Ankle Sprains

You have probably self-diagnosed an ankle sprain at some point during your running career. If you think the injury is minor and your ankle improves after two days of RICE (rest, ice, compression, and elevation), then you can probably treat it at home.

However, if you are unable to put any weight on the ankle, if there is significant bruising or swelling, or if the pain doesn’t improve within a week or so, it is advised that you see a doctor for further examination to rule out more serious injuries. Nguyen notes that you should rule out more serious injuries like a fracture or a torn muscle tendon.

He explains that once in the clinic, a doctor can examine the patient thoroughly and run orthopedic tests to determine the severity of the injury. “An MRI can be done to check for soft tissue damage to the ligaments if it is necessary.”

The severity of ankle sprains ranges from “Grade I” (mild) to “Grade III” (severe).

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According to McDonald, the most common type of ankle sprain is a Grade I sprain, which entails no more than a “scratching” of the lateral ankle ligaments and typically heals in two to three weeks with the right care. Partial or microtears within the ligament characterize the less common Grade II ankle sprain. With the right care, you should be able to get back to normal in about a month. A complete ligament tear, as in a Grade III sprain, may necessitate surgical repair. Treatment needs greatly affect the likelihood of a successful recovery.

On the basis of findings from various examinations, your doctor will determine the severity of your wound.

When it comes to treating ankle sprains, this is the approach that has proven to be most effective.

The acronym “PRICE,” a play on the more common “RICE,” can be used as a treatment protocol. For “Protect, Recover, Ice, Compress, Elevate,” see the above. Nguyen explains that within the rehabilitation community, the letter “P” is interpreted as “Prevention” to highlight the value of doing injury-prevention exercises.

Nguyen recommends icing the area for 15-30 minutes every hour for 2-3 days, or until the swelling has subsided.

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While “every waking hour” is excessive, “the more frequently they do it, the better they will manage the swelling initially,” he says.

After two or three days, when the swelling has subsided, applying heat is advised because it increases blood flow to the area and speeds healing of torn ligaments.

In addition, McDonald says, “I recommend NSAIDs and ice only for acute symptoms, followed by heat, daily mobilization, and early strengthening exercises with resistance bands.” For comfort, a short-term ankle brace or support may be worn.

According to Nguyen, if your sprain is particularly severe, your doctor may recommend physical therapy to help you regain full function by strengthening your ankle and guiding you through the healing process.

Running Again After an Ankle Sprain: When and How to Do It

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You should start by sleeping until the pain has subsided.

As a runner, you’re probably wondering, “How soon can I get back to running?” What is it? While the idea of gradually increasing your activity level and strengthening your ankle through exercises probably isn’t music to your ears, it will help prevent future sprains.

According to McDonald, “returning to running after an ankle sprain depends on the severity of the sprain and other factors,” such as weekly running mileage and running terrain. The majority of ankle sprains can be returned to full activity within a week or two of beginning mobility and strengthening exercises.

Combine that with agility and strength, and you have a

Ankle alphabets (drawing the alphabet with your foot) can be recommended as early as one to two days after injury, following rest, but the healing progression depends on the level of severity of the initial injury, says Nguyen. Standing exercises, such as heel raises, can be introduced “once you are able to walk and/or stand pain-free and swelling is minimal to none.”

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To improve your strength and flexibility, Nguyen recommends the following exercises: The heel raise that involves squeezing a small ball (like a tennis or lacrosse ball) between your heels is one of my favorites, as Nguyen explains. “This will assist in activating your gastroc and posterior tibialis muscles while you run.” Start with two sets of 10 to 15 reps, adjusting the number of times per set based on your strength and exercise tolerance, and squeeze the ball the entire time as you lift your heels off the floor.

Towel curls are great for strengthening the plantar fascia and ankle joint. They are performed by standing erect with a towel under one’s foot. Pull in more of the towel with your toes by grabbing the edge with them and letting go.

Band-resisted dorsiflexion (up), inversion (in), eversion (out), and plantarflexion (down) are also recommended by Nguyen (down). Supination, in which the foot is simultaneously brought upwards and inwards, is a good example of a combined motion that can be beneficial for the ankle in some people. Strengthen your ankle in all directions by performing these exercises with a resistance band.

Increase the intensity of your moves.

If an athlete isn’t fully recovered before returning to their sport, Nguyen won’t push them into high-impact movements.

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As a physical therapist, he is constantly monitoring his patients’ reactions to various dynamic exercises like lunging, squatting, and one-legged balancing. When they have reached a point where they can perform these actions without discomfort, I introduce the agility ladder and small hopping drills (a couple inches off the floor). If they make it through those exercises without losing control or experiencing pain, I progress them to more impactful activities like running, squat jumps, and hopping off a plyometric box. Ultimately, pain is one of the best indicators of how well our body is healing, as was previously mentioned.

For optimal results in improving ankle stability, it’s also crucial to incorporate lateral activity into your workout routine. In order to strengthen the ankle, it is recommended to perform basic hopping drills, beginning with double-leg hopping and progressing to single-leg hopping. As long as it doesn’t cause any discomfort, I’ll tape a line on the floor in the clinic and have patients hop in various patterns across it.

Include cardiovascular exercise in your routine.

If you want to get your heart rate up quickly, McDonald suggests cycling as soon as possible (as soon as you can bike with minimal to no pain within the first week after the injury), then using an elliptical, and finally doing some light jogging.

I recommend starting out slowly by alternating between walking and running on a treadmill or track to ease back into your running routine. To avoid further injury, he advises starting at 50% of the daily and weekly running volume prior to injury, and then gradually building up to the full volume at a rate of 10% per week.

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Future Ankle Sprains: What You Need to Know

The risk of reinjuring the ankle is low if you ease back into running and include daily strengthening exercises. But a sprained ankle is one of those annoying injuries that can keep coming back.

“Unfortunately, your risk of suffering another ankle sprain is more likely than someone who never suffered one, and that risk increases with more incidences,” Nguyen says.

Prevention is the best weapon against injury, and runners can do their part by including ankle stability exercises (like the ones listed above) in their regular routines.

According to McDonald, preventing future ankle sprains requires at least 16 weeks of rehabilitation, either at home or under the supervision of a trained professional.

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For runners, “ankle sprains, like other injuries, can be extremely frustrating,” says Nguyen. Active people can stay that way for much longer if they take preventative and recovery measures. There are a variety of ways for runners to get back on track after an injury. If you want to get back to doing the things you enjoy more quickly, see a physical therapist or a doctor of sports medicine.