Ankle Sprains

Ankle Sprains

Post by Joe Stewa » Wed, 06 Jan 1993 00:09:31


Two questions:

   a.  How to prevent them?

   b.  What to do when you get them?

These two questions are the result of my most recent sprain.  It seems that
I sprain one or the other of my ankles every 6 months or so.  This most
recent sprain occured on Friday evening (in the cold dark, of course) as
I was cranking back to home.  A little rock or bulge in the road caused the
outer edge of my left foot to twist down and in.  I twinge just remembering
it.  This is the usual type of sprain.  Something on the inside of the foot
prevents it from landing normally and causes the outside of the foot to twist
down and in.

After the usual cursing, screaming, etc, I was able to hop/hobble the 1/2 mile
or so back to the house.  My ankle was already swelling by the time I took of
my shoe.  First thing was to take 3*200mg of ibuprofin, take a shower ('cause
I was freezing), and then I put one of those cold jelly-like bags around my
ankle.  

Since Friday night, I've taken 200 or 400mg of ibuprofin every 4 hours or so
and I've given up the jelly-like bag for a big bowl of ice and water at about
the same interval.  I try to keep my ankle/foot in the ice water for 10/15
minutes (hurts like hell to put the foot in, but that gives way to numbness in
2/3 minutes).   And I've kept the walking down to a minimum - though 4 football
games on TV was a bit much.  

Oh yes, the swelling has come down a bit and the ugly, blue bruise has begun
to show up.  I can see the blue best on the inside of the ankle, though the
discoleration has spread to the top and outside of the ankle.

So, any suggestions on treatment (ice pack, jelly wrap, ice/water, times of
freezing, ibuprofin vs asperin, elevating, wraps, etc....) and on prevention
(goofy exercises, stretches, shoes, braces, wraps, etc....) would be greatly
appreciated!

I will post the results of these questions.

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Ankle Sprains

Post by Tord G.M. Malmgr » Wed, 06 Jan 1993 05:49:04

Quote:

>Two questions:
>   a.  How to prevent them?
>   b.  What to do when you get them?

 the first thing is to put a bandage pretty tight around it to prevent
inner bleedings. Keep it on for 30 minutes, keep your foot high, and
put ice on it. Remove it to get the *** flowing again, and then put
it on again for another 30 minutes, keep your foot high and keep the
ice there. Then you tape your ankle after a very intricate schedule,
and you can start training again, not the same level, but very soft...

 How to prevent them? Run on a track or on asphalt, and not in the woods..

---------------+--------------------------------+----------------------------


---------------+--------------------------------+----------------------------
 Department of Physics, University of Stockholm -- Sweden (Northern Europe)

 
 
 

Ankle Sprains

Post by Paul Gatk » Wed, 06 Jan 1993 05:30:31


Quote:
>Two questions:
>   a.  How to prevent them?

 Don't run on areas where hidden objects could flip your foot. Your injury
in the dark cannot be avoided if you can't see where your stepping.

 I've had several ankle injuries and now take much greater precautions. Watch
out for leaves covering rocks, roots, holes. Ankle stretching helps abit but
a *** twist will still cause serious injury.

 Shoes with wider soles/heels are more stable than other types.

 Running when tired makes one more susceptible to twists.

Quote:
>   b.  What to do when you get them?
>Oh yes, the swelling has come down a bit and the ugly, blue bruise has begun
>to show up.  I can see the blue best on the inside of the ankle, though the
>discoleration has spread to the top and outside of the ankle.

 If your foot is stuck in a comfortable but unnatural position I would
recommend seeing an orthopedist. The degree of bruising makes me reminisce
about a sprain I got on a chunk of ice in the road. My ankle swelled up to
the aprox size of a small baseball or large golf ball, almost
immediately. I didn't use the ice I stepped on, but a nearby piece to ice
it up on the spot.

 After 3 days of hoping it would get better I got tired of all my friends
telling me I better go see a doctor-- so I did. (I got used to gingerly
hopping around so I entered the office with a lot of energy). The doctor
took the x-rays, told me I had no breaks, just tendon/ligament damage (the
bruising up the side of my calf), and proceeded to force my ankle back into
a normal position (instep aprox 90deg to shin). He told me to hold this    
position while he wrapped my foot in a cast. It was fairly painful but I
figured I only had to hold it for a few more moments. When he told me I
could relax, I was a bit suprised to find that I couldn't as the cast prevent-
ed me from returning to my non-painful position.

 Remember how I hopped into the office? Well, getting out was another story.
Ten pounds of new mass on one side of my body (happily I forget which side),
and new crutches, while cringing in pain, the other patients in various
stages of broken-ness, probably had a bit of catharsis-like glee in seeing
me, practically careen out through the waiting room. I came in through the
waiting room in aprox 15 secs; to took me aprox 3 minutes to get out!

 This is not to scare you or deter you from seeing the doctor. Your injury
is probably not as bad as this, but if you do have to go, at least you will
be a bit more mentally prepared than I was.

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Ankle Sprains

Post by Paul Gatk » Wed, 06 Jan 1993 11:59:21


Quote:
> the first thing is to put a bandage pretty tight around it to prevent
>inner bleedings. Keep it on for 30 minutes, keep your foot high, and
>put ice on it. Remove it to get the *** flowing again, and then put
>it on again for another 30 minutes, keep your foot high and keep the
>ice there. Then you tape your ankle after a very intricate schedule,
>and you can start training again, not the same level, but very soft...

 RICE: Rest Ice Compression Elevation

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Ankle Sprains

Post by Steve Conw » Thu, 07 Jan 1993 02:11:25

Quote:

> Two questions:
>    a.  How to prevent them?
>    b.  What to do when you get them?

As I've been a fairly serious orienteer for the last 17 years (since I
was 10) and I've been running hill-races for several years, I've
twisted my ankles ump*** times, and so have my running friends.  The
taping techniques (below) are those used by Scandinavian orienteers.

Initial treatment - ICE - ice, compression and elevation.  If
necessary, stick your foot in a stream or pond.  If you are at home,
apply an ice-pack.  If you don't have an ice-pack, use a pack of
frozen vegetables (peas are good), but don't eat repeatedly refrozen
food.  Bandage the ankle.  Ibuprofen seems effective, but I have only
recently started using it, and I haven't done myself much damage
recently.

Over a longer term you want to develop strength, flexibility and
protective reflexes in your ankles.

For flexibility, with bare feet, circle your toes in clockwise and
anticlockwise directions.  After doing this for several turns you can
use your hands to *gently* increase the degree of flexion.

For strength, try standing on one leg.  Once you develop enough
balance to not wobble much, try it with your eyes shut and arms
folded.  The idea is that you should be wobbling about.  This also
helps to train your muscles to act correctly to support your ankles.
You can also do this on a "wobble board" - a board raised off the
ground, that you can stand on and wobble as you try to balance.
Purpose made wobble boards are usually circular, with a hemispherical
block of wood underneath, about 5-6 inches (12-15cm) tall, but they
are easy to improvise.

Running on rough surfaces will also increase the strength and
flexibility of your ankles, but most importantly they will train your
muscles to react correctly to twisting in order to protect your
ankles.  However, you don't want to twist your ankles doing it, so take
it slowly.  Off-road shoes should not have thick wedges in the soles,
or flared midsoles.  You want your foot to be close to the ground.
Your heels must be snuggly held in the shoe for stability.  Studded
soles will help.

If you really need to protect your ankle when running you can tape it
for support.  Get wide (2in, 5cm) strapping tape.  Shave the offending
ankle a fair way up the leg.  Strapping doesn't work well on hairy
legs, and it hurts like hell getting the stuff off.  You should tape
in a stirrup under the heel, with the ends of the tape going a hands-
spread up the calf from the ankle, on both sides.  This tape should be
fairly taut.  A loop of tape around the calf will help keep the tape
in place, but don't make this too tight.  You can also put a piece of
tape over the top of the foot, behind the heel and back over the foot,
crossing itself.  This gives support if your foot is forced backwards
as you move forwards.

  Leg                           ------
 |    |                         ||||||
 | ## |                         ##  $$   Big Foot !
 ######                         |##$$|
 | ## |              and        | ## |
 | ## |                         $$ ##
 | ## |                        $/---\#
 | ## -------_                 $|leg|#
 |_##___Foot__|                $\___/#        # and $ = tape
                                $$$##

TAPE AS INFREQUENTLY AS POSSIBLE !  If you strap you ankles all the time
they won't get stronger and your muscles won't learn to react to the
signals from the nerves which monitor your ankle movements.  The only
exception to this is if you have destroyed the proprioceptive nerves
in your ankle due to repeated damage.  In this case light taping in a
stirrup will give a signal (by pulling on the skin) when your ankle is
flexed that you can learn to use instead.

I hope this helps some of you with ankle problems.

Steve.

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Ankle Sprains

Post by Thomas Pa » Thu, 07 Jan 1993 01:51:22

In my experience, most doctors and most runners don't take severe ankle sprains
seriously enough.  With most sprains, you partially tear ligaments.  If you go
back to walking on it too soon, and even worse running on it, the ligament heals
back longer than it was.  This means the joint is looser, and more prone to
rolling over in the future.  Severe sprains take six weeks to heal.  Running on
them before that dooms you to more sprains in the future.  The best treatment
is to put the ankle in a cast with the foot held in a position such that the
ligament heals back the right length.  However, most doctors take the attitude
of no break, no cast.

I had a series of sprains which were taken too lightly.  Then I had a major one
that completely severed the ligament on the outside of the ankle.  I was given
the choice of surgery or physical therapy.  I chose to avoid the knife.  That
ankle is now fine for running.  It is stable front to back but completely floppy
side to side.  It rolls over easily, but since the ligament is gone, there is
no pain; I just fall.  Sometimes I fall down just talking to someone; I shift
my weight, the ankle rolls over, and down I go.  If I wanted to continue playing
basketball, I would have had to have the surgery, but running is enough for me
at this point in my life.

So, try to talk the doctor into casting a sprained ankle.  If you can't, follow
the R.I.C.E religiosly and use your crutches; no weight at all on it for a couple
weeks at least.  And then, don't try to go back to running on it for 6 weeks.
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Ankle Sprains

Post by Mike Dotse » Thu, 07 Jan 1993 03:23:34

   A simple but effective exercise for the ankles will help in greatly
reducing your chances of ankle sprains. The exercise:

   Stand with feet in normal standing position. Place a hand on a wall
   or a railing for a little balance. Now, 'roll' your feet around on
   their 'outer edges'. Repeat 50 times.
   ('Rolling on the outer edges' means to tilt your feet as far outward
   and inward (supination and pronation) as possible but inbetween
   rock forward on your the balls of your feet and back on your heels.)
   The major benefit is the stretching and strengthening on the muscles and
   tendons which keep your foot stable as you run.

  If I am fairly consistent with this exercise, instead of rolling my ankle
and spraining it when I run, if I hit an uneven surface, my foot will roll
out, but since it is stretched it can go farther and since it is strengthened
it can pull back up easier, and I hardly ever sprain an ankle any more.

Mike Dotseth      "WOW FUN WOW"
     /_           "They call me Lucky. The harder I work, the luckier I get!"
      |              - Kenton Finanger (Luther College Cross Country Coach)
     / >          "There is no finish line...................................

 
 
 

Ankle Sprains

Post by Susan Hou » Thu, 07 Jan 1993 08:13:46

I posted a few months ago with a queury about pain in my inside heel.
Based on the replies that I got, I think the problem was an inflammation
of the tissue that connects the heel to the toes.  I was finally able
to cure the problem with new (& well-cushioned) shoes, two weeks of
rest (some walking, no running), ice after each walk & initially after
each run when I started back, starting back slowly, ibuprofin.

Then, before Christmas, I was running on a level road & suddenly felt
a very sharp pain in my ankle, on the outside just below & slightly to
the back of the boney part.  The ankle never twisted at all; the pain
just started on one perfectly mild-mannered down step.
Further running was out of the question--I could walk but only
gingerly.  As soon as I cooled down, the ankle stiffened but never
swelled.  I tried to run once after 2 weeks & made matters worse--
now almost 3 weeks later, I definately get the impression that running
is not a good idea.

The first question is what the devil I managed to do to myself.

The second question is whether there could be a dietary deficiency
or other problem that is causing my ligaments to be injury-prone (I also
injured something in the back of my hand late last Fall, an injury that was
attributed to too much computer work).  I don't eat red meat & eat chicken
no more than 2-3 times a week; I don't drink much milk but eat lots of
cheese; I don't eat eggs at all; I usually take some sort of vitamin with
iron as otherwise I tend towards mild anemia.

Thanks in advance to anyone who can help,