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Ankle sprain-pagng Dr. Roof

squid

Nov 16, 09 10:37

Post #1 of 18 (567 views)

Ankle sprain-pagng Dr. Roof	Can't Post

or any other doc, PT, etc. So I did a trail race nine days ago and sprained my ankle pretty good (finished the race, had a blast!). It swelled up and became black and blue. It's still a bit swollen and tender but greatly improved. I know it's difficult to say with certainty without seeing the ankle, but whats the rule of thumb about returning to running after a sprain? I haven't run since the race.

(This post was edited by squid on Nov 16, 09 12:28)

TriBodyboarder

Nov 16, 09 11:03

Post #2 of 18 (551 views)

Re: Ankle sprain-pagng Dr. Ruff [squid] [In reply to]	Can't Post

I think you are referring to Dr. Roof.
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Sabrekitty

Nov 16, 09 11:33

Post #3 of 18 (527 views)

Re: Ankle sprain-pagng Dr. Ruff [squid] [In reply to]	Can't Post

My PT and doc both agree to my sorrow. Average of 2 weeks no running till it heals, and if it's still swollen or warm after then no biking either.

I'm currently not allowed to bike, run or swim. All these activities were aggravating my sprain. One more week and I should be back to training, hopefully after my next apt I'll at least be able to swim or bike again.

There is no justice, there is only me. -- Death

squid

Nov 16, 09 12:27

Post #4 of 18 (498 views)

Re: Ankle sprain-pagng Dr. Ruff [TriBodyboarder] [In reply to]	Can't Post

oops. You're correct. Got my slowtwitchers mixed up

squid

Nov 16, 09 12:30

Post #5 of 18 (493 views)

Re: Ankle sprain-pagng Dr. Ruff [Sabrekitty] [In reply to]	Can't Post

I'm currently not allowed to bike, run or swim

What !!!! I really don't have much of a kick...can I still swim? :)

Sabrekitty

Nov 16, 09 12:49

Post #6 of 18 (474 views)

Re: Ankle sprain-pagng Dr. Ruff [squid] [In reply to]	Can't Post

If it doesn't return the swelling or cause pain, probably. Mine was a very bad sprain. Normal class 1 sprains, you can bike and swim to your hearts content. I went class 2 at minimum. Spin class left it hot to the touch 24hrs later and it was still swollen. Got the swelling down via expressing the lymph and kinesio taping and thought I'd try swimming. It was too painful. I have three ligaments involved, one of them being engaged in kick action. I made up for it by getting hand paddles and not kicking for my swimming, but it felt awkward.

There is no justice, there is only me. -- Death

rroof

Nov 16, 09 14:15

Post #7 of 18 (440 views)

Re: Ankle sprain-pagng Dr. Roof [squid] [In reply to]	Can't Post

It really depends on what type of "sprain" you suffered, and it would be folly to assume much more over the 'net. A typical grade I sprain won't turn all the lovely colors, so assume grade II or worse. Probably can't tell right now, but if your ankle feels "unstable" after you try to get back on it, you should be evaluated for things like ankle joint diastasis, peroneal tendon injury, etc. as these can occur with a typical innocent lateral ankle sprain. We often get X-rays on sprains not just to look for bone fractures, but things like diastasis. Ultrasound exam can rule out peroneal tendon injury, etc. (if indicated). If you have an active job, you should be in some type of splint as well to facilitate stability and proper healing and PT soon after to keep proprioceptive ability intact. good luck
____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

ktm520

Nov 16, 09 14:48

Post #8 of 18 (424 views)

Re: Ankle sprain-pagng Dr. Roof [squid] [In reply to]	Can't Post

Assuming structural stability, I go after these a little more aggressively as waiting and immobilizing is not always the best idea. I would run on it for 10-15 minutes if pain does not increase, treadmill would be a good start. You may want to try a cheap neoprene sleeve for some compression to start. If you are altering running form significantly you are not ready and, although discomfort should not be ignored some initial stiffness will need to be workout and this will take a bit to calm down. If things are going well it should get easier over the 15 minutes.

After run aggressively ice, elevate, and compress; assess for rebound swelling and symptoms and take it from there. Running often times will be o.k. and arguably beneficial for most mild to even moderate ankle sprains it is the cutting (medial/lateral effort) that will flare it up. No trails of course!

I would recommend having an ice bucket or ice pack and ace wrap on the ready and give it go, honestly there is little to harm if structures are cleared. I just had a client with grade II 10 days prior to the Milwaukee marathon and had no issues on the run despite some residual swelling. He got to me early, however, and we attacked the symptoms with early movement, e-stim, and slush bath. He ran 3 days after the sprain. Active movement is the best way to bring heat and blood flow to the area to aid in healing, reducing stiffness, and pumping edema from the area then manage any rebound inflammatory response with the usual.

Again with all the medical caveats, you have already waited too long IMO.

Cheers!

tigerchik

Nov 16, 09 15:47

Post #9 of 18 (405 views)

Re: Ankle sprain-pagng Dr. Roof [squid] [In reply to]	Can't Post

Best wishes for quick healing,

tc
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mmm, pi!

squid

Nov 16, 09 16:55

Post #10 of 18 (376 views)

Re: Ankle sprain-pagng Dr. Roof [rroof] [In reply to]	Can't Post

Thanks everyone for the advice and well-wishes. Since the injury, I've biked and swam (even some kick drills)without pain. I even did a little warm up jog yesterday to see how it felt- some mild pain. I decided not to risk aggravating it and went for ride instead. I think I'll stay off of it until this weekend and then re-evaluate. I guess no trails for awhile. Again, thanks!

bhauser

Nov 16, 09 17:40

Post #11 of 18 (349 views)

Re: Ankle sprain-pagng Dr. Roof [squid] [In reply to]	Can't Post

My PSA - Here's what NOT to do ;-)

Did this mid-April this year. Got ice on it right away, so the swelling didn't get too bad, so when I got home, I jumped on the mtb to test it out. Had a 6hr mtb race I was really wanting to do the next day and thought that riding wouldn't bother it too bad. Nevermind the 3.5 hr drive to and from the race. Of course it rained over an inch just before the race started. Due to all the mud (never seen mud stick like that stuff!), I made it about 3 miles into an 11 mile loop before my RD wrapped around my cassette. It was a nice 8 mile walk through all the mud to finish my 1 lap. Amazingly, it wasn't that painful while I was walking, and I even passed several people who had functional bikes! However, in the end, the kickball game against the Finance dept wasn't worth it as I couldn't run for pretty much all of summer. I STILL have some swelling in that ankle. STUPID!!

squid

Nov 17, 09 7:19

Post #12 of 18 (282 views)

Re: Ankle sprain-pagng Dr. Roof [bhauser] [In reply to]	Can't Post

Oh god!! that pic is painful to even look at! My ankle has vastly improved over even yesterday- pain and swelling are just about gone and range of motion greatly improved. I bought some ankle braces that work well in my trail shoes. I'll be wearing them on my next trail rum- which won't be anytime soon.

Ron in AZ

Nov 17, 09 7:29

Post #13 of 18 (275 views)

Re: Ankle sprain-pagng Dr. Roof [rroof] [In reply to]	Can't Post

Jumping in on the ankle injuries and the wonderful world of folks with educated opinions!! (actually being serious here) --

OK...peroneal tendon runs down the outside of the ankle....I'm being tremendously bothered by tendon (??) that runs down the inside side of the ankle...curves around the back of the ankle bone (kind of an upside down questiomark shape) -- thought original symptoms maybe achilles...but I can follow the tendon up the lower leg -- crunchy at times...swollen at times...??? -- swelling appears to be in the soft spot behind ankle in front of achilles???

Just trying to figure out what I've done!! ..went from 20 miles a week of easy running...now down to 1 painful short run a week...????

Thanks!
-Ron
I have deceptive speed...I'm slower than I look.

rroof

Nov 17, 09 9:06

Post #14 of 18 (254 views)

Re: Ankle sprain-pagng Dr. Roof [Ron in AZ] [In reply to]	Can't Post

So, are you saying you are having pain along the peroneal tendon or posterior tibial tendon? Different mechanisms of injury to those with VERY different long term sequelae as well.
____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

Ron in AZ

Nov 17, 09 9:43

Post #15 of 18 (234 views)

Re: Ankle sprain-pagng Dr. Roof [rroof] [In reply to]	Can't Post

sorry for confusion --- pain is NOT along outside of foot (peroneal tendon) -- pain is along inside side of ankle (inside/rear) -- tendon curves around ankle bone and runs up center/side of leg...from about center of ankle/ankle bone to about 3-4+ inches above the ankle..

??
I have deceptive speed...I'm slower than I look.

rroof

Nov 17, 09 9:58

Post #16 of 18 (232 views)

Re: Ankle sprain-pagng Dr. Roof [Ron in AZ] [In reply to]	Can't Post

That is the PT tendon, a more ominous long term actor. Google around for PT tendonopathy. Have been in worn out shoes? Increased running volume/speed work or trying the "new" barefoot/minimalist approach?
____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

Ron in AZ

Nov 17, 09 13:22

Post #17 of 18 (209 views)

Re: Ankle sprain-pagng Dr. Roof [rroof] [In reply to]	Can't Post

increasing volume and speed...pretty consistant in the 20 mile/week range...but long run went up to 10 miles from about 6 (over several weeks)...and dropped by about 10-15 sec/mile...

Thanks for the info -- I'll google and read.

-Ron
I have deceptive speed...I'm slower than I look.

Ron in AZ

Nov 18, 09 6:55

Post #18 of 18 (170 views)

Re: Ankle sprain-pagng Dr. Roof [rroof] [In reply to]	Can't Post

Doc -- thanks for the info -- sent ya a PM with a question.

Thanks again!
-Ron
I have deceptive speed...I'm slower than I look.