Ankle Sprain Treatment
for Runners

You've been out running and somehow twisted your ankle - here's ankle sprain treatment once you've made it home.

Your first action should be to apply ice to the ankle for 15-20 minutes, followed quickly by wrapping the ankle tightly in a compression bandage (but make sure it does not cut off circulation to the ankle).

Continue to reapply ice every hour, and always wrap with the bandage afterwards.

Sleep with your foot elevated above the level of your heart, on a pillow.

When you are able to limp to the pharmacy, get a one-piece neoprene ankle compression sleeve, which will give your ankle more support than standard bandages. These braces are great, and can fit into your running shoes. Make sure you get the right size sleeve—if it is too large or too small it will not provide enough compression to contain the swelling, or be so tight that it restricts blood flow to the area.

If the ankle is painful, over the counter anti-inflammatory and pain killing medications will help reduce your suffering as you shuffle around.

Now, you’ll have to find out whether you will need physical therapy to speed up the healing process. Your sports medicine doctor will recommend the best course of ankle sprain treatment.

My recommendation is that you visit a sports medicine physician, even for something as simple as a sprained ankle—this is because they’ve seen this injury hundreds of times before and can immediately tell, from some simple tests, whether it is a mild, moderate or severe sprain. (You can also find more information on my other page about sprained ankle causes, risks and actions).

If you have difficulty bearing weight during your first week after the accident, it’s very likely you have a severe sprain and that your rehabilitation will take several weeks, even months.

If you go to physical therapy for ankle sprain treatment, follow their advice closely and do the exercises that they show you at the clinic. Your therapist will use several popular devices to help rehab your ankle, from exercises using towels or surgical tubing, to balancing on platforms and discs. Your therapist might also recommend warming up before therapy with stationary cycling or swimming.

Ankle Sprain Treatment at Home

If your doctor decides physical theraphy is not necessary, avoid weight-bearing exercise (and definitely running!) until the swelling is gone and there is no pain when walking. What to do when the swelling and pain subside?

Obviously, the speed of your return to running will depend on the severity of the injury. Most mildly sprained ankles can easily be turned around within a week or two. Start by gently moving your ankle around and forwards. Point your toes downward and then upward for 60 seconds, a few times each day. If this movement feels okay, progress to standing and raising yourself up onto your toes, then gently lowering yourself down.

Don't start running again yet! Read on....

It is here that many runners go wrong — by starting running again too early. A “test walk” of 10-20 minutes is needed before beginning slow running again. Warm the ankle up with a hot water bottle for 5-10 minutes, or by putting it into a bucket of hot (but not painful) water. Put your running shoes on (with tight laces), walk slowly on a soft surface, and gradually speed up your walking pace. If there is no pain, and the ankle feels comfortable (without pain) you can try the next step.

In the next step you walk around in a wide figure 8, slowly to start with. If the ankle feels fine, narrow your figure 8 walk, until it is only a few yards across, and you’re constantly turning.

If your ankle feels fine after this session, your next step is to do a few walk/jog sessions. Walk for 5-10 minutes to warm up, and then introduce some 15-30 second slow jogging bursts into your walking. You’re aiming to regain your normal running stride length without sharp pain. If you feel uncomfortable at normal stride length but can continue running without pain, shorten your stride and slow down. Run the figure 8 at a slow pace, and then speed up, as you get better at doing this.

Physical therapists recommend that you wear your ankle brace during these early sessions because this is the time when you’ll be the most susceptible to re-injuring your ankle. The tendons and nerves around the ankle are disturbed and your reaction time is reduced.

Watch for a recurrence of swelling—this is a sure sign that the injury will need more time to heal. It’s better to delay your progression from partial weight bearing to full weight bearing, to walking, to drills, and finally to jogging, than to hurry it, and risk re-injuring the ankle. That said, it is normal to experience some discomfort and mild pain when rehabilitating the ankle. If it is not sore the next day, but just stiff, you’re healing normally.

Finally, use your common sense when getting back in to your standard training routine. It will be normal to experience a mild aching feeling, and the ankle will be stiffer than normal. Both symptoms will disappear completely within a few days or weeks. If the soreness does not ease up, return to your doctor for a re-evaluation.


Return from Ankle Sprain Treatment to Running Injuries

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