How to Beat an Ankle Sprain

Just when I had finally started to feel fit and injury-free, I turned my left ankle on a trail run.

I think I sprained a ligament or two last Sunday, but I have not yet seen a medical doctor or physical therapist for a professional diagnosis.

Of course, I feel anxious to return to running. At the same time, I am afraid of facing another ankle injury that forces me out of competitive running for more than a year. My anxiety and fear have driven me to exercise caution over the past week and to incessantly research how to treat ankle sprains.

Among my findings is that ankle sprains are incredibly common and possibly even the most common injury of athletes. More than 20,000 ankle sprains occur each day in the United States.

I also learned a series of new strengthening exercises aimed at healing and preventing further injury to the ankle and non-running workouts for maintaining fitness.

The best initial treatments for an ankle sprain are the four methods, which are often collectively referred to as RICE: rest, ice, compression and elevation. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are also often prescribed to patients with this injury. Some, however, question the effectiveness of doing so. Running Physio summarizes why there is division among professionals on whether NSAIDs are useful for treating ankle sprains in the following quote. “There has been some suggestion that they may delay healing but if they allow early movement and reduce pain they can have a beneficial effect on recovery,” says the Web site.

Stretching, Strengthening and Conditioning

Actively separating your toes for five seconds, writing out the alphabet with your toes and stationary cycling for 15 minutes a day are recommended for runners early on in an ankle injury, according to Competitor.com. These exercises are all done seated, because, at this phase of the sprain, weight-bearing is too painful to do. Read more tips on how to treat ankle pain in this article from Competitor.com.

Once weight-bearing is tolerable, rehabilitation professionals often suggest performing exercises that restore proprioception, which is the body’s ability to know where it is in space. This may be attributable to researchers having found that distortions of the ankle can lead to disturbances in this sense.

A commonly prescribed series of exercises for restoring proprioception is balancing on one leg with eyes closed, then progressing to balancing on one leg on a pillow and ultimately balancing on one leg on a less stable structure, such as a wobble balance board or rockboard. Physical rehabilitation experts recommend that balance is maintained for as long as possible on each surface and that several reps of this exercise be performed a few days a week.

The strengthening programs for patients with ankle injuries often include the basic squat and the more challenging single-leg squat or dip. Physiotherapist Tom Goom demonstrates several variations of the single-leg squat in this video. He says this move is good for runners, because it activates the glutes, ensures the ankle joint is "loose and mobile"  and strengthens the quads. 

To prevent additional ankle injuries, a Running Times article suggested performing several exercises that strengthen the tendons and muscles in your ankles, feet and lower legs. These include "[stretching] your ankles regularly by rotating your foot several times in each direction" and "[pointing] your toes downward as far as possible for 10 seconds, followed by pointing your toes upward for 10 seconds".

When it comes to purely maintaining fitness without exacerbating ankle pain, some sports medicine experts suggest circuit training, which involves performing a series of strengthening exercises with brief rests in between each one. I like this program, because it targets the upper body, lower body and core.  Lat pulldowns, stability ball push-ups, leg extensions and bicycle crunches are some of the exercises that it includes.

Cycling and swimming are also helpful for maintaining cardiovascular fitness. For some with ankle injuries, performing these exercises can be almost as painful as running, so exercise caution (Yes, pun intended).

I hope this post helps injured runners heal!