Injury Prevention
Injuries
Injury Tips, by Deborah Watts Povinelli, MPT, MPH
Ankle Sprains
Ankle sprains are are fairly common, and more so in runners who include trail running or “ice” running in their training – which includes many of us who live in New England. Ankle sprains range from mild to severe, and in most cases require rest and some rehab to get back to the roads. An ankle sprain is an injury to the ligaments of the ankle.
Signs/Symptoms: Ankle sprains can occur as either inversion or eversion sprains, depending on whether the ankle rolls in or out. The importance of whether you roll in or out is that it determines which ligaments are damaged. Sprains are identified by pain (local and diffuse), swelling, bruising, stiffness and often the inability to bear weight.
Causes: Ankle sprains are generally the result of twisting the ankle, either while falling or while running on an uneven surface. There is no underlying cause, however people with previous sprains are often at risk for additional sprains, particularly if they do not adequately strengthen the foot and ankle following the sprain.
Treatment: Ankle sprains are most always treated with RICE: Rest, Ice, Compression and Elevation. If you sprain your ankle during a run, you should try to stand and if you are able to bear weight, walk slowly to determine the severity of your ankle. If you cannot walk without pain, you should end your run and return home. But don’t run home! Rest can be anywhere from no running for a few days to requiring a cast — your symptoms will often determine what level of treatment you require. If you are unable to bear weight you should go for an X-ray to rule out a fracture. Severe sprains (a complete tear or rupture of tendons) may require immobilization for some period of time. If you are not casted, or are able to bear weight, you should immediately put ice on the ankle, elevate it above your heart and wrap it with an ace bandage to minimize swelling. Ice can be used for approximately 20 minutes each hour following a sprain. If you are able to bear weight, you should walk a bit right away and throughout your recovery to minimize stiffness. You should begin doing ankle circles and ankle pumps immediately if you are not able to walk to minimize stiffness. Anti-inflammatories (ibuprofen) may be beneficial in minimizing pain and swelling. Once you are able to bear weight on the ankle, you should begin strengthening exercises — toe raises, single leg balancing and heel walking.
Prevention: Strengthening is the best defense against ankle sprains. Focus on toe raises, balancing activities and heel walking. More exercises can be added as strength increases.