What are the most common three ways I see runners lose all their fitness after they get an ankle sprain? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
The first thing that happens when you roll your ankle is obviously it hurts so you want to protect it. In fact, the sort of algorithm that we use to routinely treat ankle sprains what we’re taught in med school is P. R. I. C. E.
So that’s Protection, meaning don’t roll it again. Don’t make it worse. Rest it. Ice it. Use Compression to keep it from swelling and Elevate it to get the fluid out if it’s really swollen.
The first part of that, of course, is protection and what I really see is the biggest mistake is that because ankle sprains are so common, and I think they’re kind of underappreciated. So, what happens is, you’re a runner, you’re out on a trail and you roll your ankle or maybe you’re just like out for a walk, you step in a tree well on the sidewalk and you roll off the edge of a cutout on a driveway, and you roll your ankle. And because it’s just a minor thing you think you don’t worry about it too much.
What happens if you don’t act fast enough and you really kind of dismissed it as an episode initially, you get a lot of swelling. And if you don’t do something to prevent that swelling, which is the compression and elevation and some other things you can do, well, then that actually makes you take a whole lot longer before it gets better. It also many times can turn into swelling on the inside of the ankle joint and then when you’re running, you’re basically pinching the swollen tissue on the inside of the ankle, and it causes even more swelling, and it lingers and it sort of forces you to run a whole lot less. That’s the first thing. So first thing is not acting fast enough to control the swelling when you roll your ankle because you don’t take it seriously enough.
The second thing is that if you have an ankle sprain and the next day, it’s fine, but then that’s great. But if you don’t have that scenario, then you may wait too long to get the correct diagnosis, or an opinion and you might wind up with an exponential loss in fitness just because you think it’s sprained but then you’re caught in the back of your mind. You’re worried is it broken; it might have like a subtle fracture there.
I know I talk about a lot about the lateral process fractures that are tend, well, in the research study that I did where I won an award for the American College of Foot and Ankle Surgeons for that research. Well, we found out that the ankle sprains that these little subtle fractures sometimes misdiagnosed as an ankle sprain is more than 10 times more common as previously thought, almost 10% of all ankle injuries.
If you have one of those, and you treat it like an ankle sprain, well it’s a fracture, so it’s different and it can continue to hurt for a long time. So, if you think you need to get X-rays, well you should get X-rays. If you called me and I would show you how to do that over the webcam and then if you’re in California, Texas or Florida, then I would definitely order X-rays for you and we can look at them on a computer so that you could see whether or not you had a fracture and figure out if you’re moving in the right direction or can you do something more drastic.
The third thing is that you don’t rehabilitate it fully and you sprain it again and get a way worse injury later. This is unbelievably common and in the ankle sprain for runners, I teach you all about what to do initially but I also really talk about the things you need to do to make sure that your ankles are more stable because you will have inherent instability that can be lifelong if you don’t treat this appropriately.
It is easy to do. You don’t have to go to physical therapy. You can do it at home, but you’ve got to do some very specific things. But if you don’t do that, what happens is you have a little bit of, because you stretched out the ligaments and they’re a little more loose, you’re running and it’s a little more prone to rolling in the first place. So, when it does the second time or the third time, it rolls with higher force and does more tissue damage. And that can really keep you off of running a whole lot longer.
So, in short, those are the three reasons that I see runners lose their fitness unnecessarily just because of something as simple as an ankle sprain.
If you want to learn more about ankle sprains, you want to take a deep dive into this. There’s a whole talk I put together for you that you can go through. It’s the ankle sprain masterclass for runners. It’s free, you get it at www.docontherun.com/anklesprainmasterclass. So go check it out, and I’ll see you in the training.