It's all too easy to do. You trip over a tree root, stumble on a kerb or just land awkwardly, and suddenly your ankle is screaming at you. Ankle sprains are a real nuisance for runners — and you don't even need to be out running for it to happen. After all, we all know the worst running injuries are the ones that don't even involve running, right?
An ankle sprain can be really painful and sideline you for weeks, which can be incredibly frustrating, especially if you're in the middle of a training block for a specific event.
Foot-strengthening exercises for runners best ankle supports, what should you do if you suspect you have sprained your ankle? Sports medicine physician Dr Jordan Metzl reveals all...
The 3 grades of ankle sprains
As with all sprains or tears, there are three grades of ankle sprain. Grades 1 and 2 involve varying degrees of over-stretching or partial tearing of one or more ligaments - 1 being milder than 2. A grade 3 sprain is a complete tear (or rupture) of one or more of your ligaments. Within that, there are also two different types of ankle sprain...
Common ankle sprain
After rolling or twisting your ankle, mild sprains (grade 1) cause tolerable pain, some swelling and some difficulty walking. Severe sprains (grade 3) bring on incredible pain, possible ligament rupture, swelling, bruising and total joint instability. You might even fear you have broken your ankle: in other words, yes, it's nasty.
in a pool
A high ankle sprain can also result in swelling and bruising on the top and outer side of the ankle, plus all the other symptoms you get with a common ankle sprain.
What’s going on?
We would put money on the fact that absolutely everyone twists an ankle at some point. It's simply a matter of how badly. The most common way to do it is a lateral, or inversion, sprain. This is where the foot rolls outwards, injuring the ligaments on the outer side of the ankle. The rarer medial ligament sprain is when the foot rolls inwards instead, injuring ligaments on the inner side of the ankle.
With your basic lateral sprain, the most commonly injured ligament is the talofibular, which connects the anklebone (talus) to the smaller calf bone (fibula). More severe sprains might also involve the calcaneofibular ligament, which connects the fibula to the heel (calcaneus).
A high ankle sprain is different from a common ankle sprain. It usually occurs when the foot inverts (points downwards) and twists, causing a stretch of the syndesmotic ligaments, which connect the tibia and fibula in the lower leg to the top of your foot. It’s called a high sprain because it actually happens above the ankle, in the lower leg.
The best treatment for a sprained ankle
Apply first aid
For any sprain, ice and elevation for the swelling will help (don’t ice an ankle for more than 15 minutes at a time). For anything above a grade 1 sprain, crutches and taking the weight off it completely are a good idea. As it heals, compression with an elastic bandage can also help with internal bleeding and swelling.
Employ dynamic rest
Frustrating though your injury may be, you can still stay fit with upper-body work. Depending on the severity of your sprain, you can also - with medical approval of course - try swimming or aqua jogging Health & Injuries.
Try an NSAID
As long as you have no medical conditions that contra-indicate taking it, an anti-inflammatory such as ibuprofen or aspirin can help with pain and inflammation.
Move it
For simple sprains, once the pain becomes tolerable, you can perform some basic range-of-motion exercises. But during the first week, do only the following: pull the foot upwards, then point it away. Any side-to-side or rotating movement could aggravate the injured ligaments. After a week, add in rotation. With your ankle elevated, do ankle circles in one direction, then the other. Go slow at first if the injury is still painful, but up the speed and reps as the injury heals. This will help you get back the full range of motion.
Stay flexible
Do some simple calf stretches, because these muscles tend to tighten up to inhibit ankle movement after an injury. You don’t want to best ankle supports best ankle supports.
Prevent it
Sadly, no one can totally prevent an ankle sprain, but you can do certain stretches and exercises to improve ankle stability and overall balance – which lowers your chance of injury. This is especially important if you’ve sprained your ankle before and it's likely to be a bit weaker - or prone to sprains.
One of the best ways to do this is to improve strength and flexibility in your calves, as tight soleus and gastrocnemius muscles limit ankle motion. The stretches and exercises here all target your lower leg and can be added to any workout.
Lunge (bodyweight or with dumbbells)
Stand tall with your feet hip-width apart. Brace your core and hold it that way for the entire exercise. Step forward with your right leg and slowly lower your body until your front knee is bent to at least 90 degrees and your rear knee nearly touches the floor. Pause, then push yourself to the starting position as fast as you can. Complete the prescribed number of reps, then do the same number with your left leg.
in a pool
Stand about 2ft (60cm) in front of a wall in a staggered stance, left foot in front of your right. Place your hands on the wall and lean against it. Shift your weight to your back foot until you feel a stretch in your calf. Hold for 30 seconds on each leg, then repeat twice for a total of three sets. Perform this routine daily, and up to three times a day if your muscles feel really tight.
Cross-legged calf roll
Place a foam roller under your right ankle, with your right leg straight. Cross your left leg over your right. Put your hands on the floor for support and keep your back naturally arched. Roll your body forward until the roller reaches the back of your right knee. Then roll back and forth. Repeat with the roller under your left calf. (If this is too hard, perform the movement with both legs on the roller.)
in a pool<
Jump squats
Place your fingers on the back of your head and pull your elbows back so that they’re in line with your body. Perform a body weight squat until your thighs are parallel to the floor, then explosively jump as high as you can. When you land, immediately squat and jump again. Hold dumbbells at your side to make it more challenging.
