Ankle sprains are a common occurrence among runners. Especially, trail runners. I recently sprained my ankle for the second time in ten years, not a bad record considering how much I run. I have lose tendons in my ankles anyway, so I can turn an ankle and not cause any damage 90% of the time. Two weeks ago, I was running down a mountain and another runner was coming up. I stepped up onto the slope of the mountain to avoid the runner and when I came down on my left foot it rolled over.
Pain shot up my leg and I heard it tear and said some choice words. I limped along for a bit, but was able to slowly run down the last little bit. I stopped at the first gas station, picked up ice and iburprophen. The swelling isn’t totally gone, but I think I’ll be back out on the mountain in another week.
True to form, I researched how to rehabilitate a sprained ankle and how long it takes to heal. During the acute phase injury to 3-4 days taking iburprophen, icing 4-5 times a day for 15 minutes each time, compression and bracing when you are walking on it.
There are three grades of ankle sprains. Grade one isn’t too bad maybe a minor tear and over stretching. It can cause some pain when walking and some swelling. This takes a week or two to get back to your activities. Grade two is a minor-moderate tear and over stretching. It causes swelling, bruising, pain, and imbalance. It takes 3-4 weeks before you’re back to your activities. Grade three is severe or complete tear of the tendons, which may make surgery necessary. You’ll definitely need crutches to get around. Recovery time on this one is going to be six to eight weeks at a minimum.
Rehabilitating any injury requires strengthening the muscles and tendons that were injured and then the surrounding and supporting ones, balance and proprioception and maintaining mobility. Physical therapy/rehab exercises should begin as soon as you can do them without zero to minimum pain (2 or lower on a 1-10 scale). Exercises should continue for three to four months.
Start mobility exercises about 4-10 days after. Move the foot forward and back, start ankle rolls and writing the ABC’s with your big toe, heel on the floor. You also want to stretch your Achilles and calf muscles. For strengthening, use an exercise band. Wrap it around your forefoot and pull it to the outside, inside and away from you. You can also do this against a wall. Calf raises are also good.
For the balance piece, start slow and work your way up: standing on one leg on the floor, then with your arms out and bent over, and finally using a balance board. To reestablish the brain body communication (proprioception) write the ABC’s with your whole foot while balancing on one leg.
Be patient in your recovery. Once you roll an ankle it is easier to do it again in the future, which is why continuing the exercises for three to four months is so important. When you do return to running, tape your ankle (youtube) each time you run for a week or two. You’ll have to reduce your miles and build them up to reduce the risk of overloading the healing tissues.
You can cross train doing things that don’t cause any pain. Getting out there as soon as possible is important, but keep in mind, going out too soon poses a high risk for re-injury and starting from square one or causing more damage.