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ankle sprain

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General fitness, health and nutrition
Published
27 January 2005
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28 January 2005
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Parker Race
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  1. My wife slipped on ice on tuesday and got her foot caught under the other
    and sprained her ankle, not just a minor twist, swelling, discoloration.

    She hasn't gone to the doctor but her coach has recommended.
    1. not wrapping it.
    2. walking on it (not using crutches)
    3. massaging it

    (This person isn't known for being conservative)
    She went swimming last night and then tried to do some aqua jogging. She
    said the swimming was OK bu aqua jogging was painful.

    What do you think of this advice?
    What is the usual recovery time for a more than minor sprain before a full
    return to running? She's still thinking she's going to be able to run
    Boston.

    TIA,
    Parker

  2. In article <[email hidden]>, [email hidden]
    says...

    Quoted message said:

    My wife slipped on ice on tuesday and got her foot caught under the other
    and sprained her ankle, not just a minor twist, swelling, discoloration.

    She hasn't gone to the doctor but her coach has recommended.
    1. not wrapping it.
    2. walking on it (not using crutches)
    3. massaging it

    (This person isn't known for being conservative)
    She went swimming last night and then tried to do some aqua jogging. She
    said the swimming was OK bu aqua jogging was painful.

    What do you think of this advice?
    What is the usual recovery time for a more than minor sprain before a full
    return to running? She's still thinking she's going to be able to run
    Boston.

    TIA,
    Parker


    There is swelling and discoloration and the advice is "walk on it". I
    would never do such a thing. The fastest healing similar case I have
    seen (and I have seen enough) is about 4-5 weeks, and that is really
    fast.

    I am no doctor and so I cannot say whether "not wrapping" and
    "massaging" helps or not but on the cases I know the doctors advised
    wrapping and had my friends use some emulsions.

    I think, even swimming may be far-fetched in her case. But she can
    certainly start swimming before she can start running after some time.

    --
    Burak
    please remove Dot NOREPLY Dot to reply

  3. These things are unpredictable- three days to three months.
    Follow the "RICE" strategy- rest, ice, compression, elevation.
    Any continuing sharp pain see an orthopedist because something
    torn or broken.

  4. Parker Race said:

    What is the usual recovery time for a more than minor sprain before a


    full

    Quoted message said:

    return to running?

    To reduce the swelling, use proteolytic enyzmes such as Wobenzym in
    high dosage.

    See one such article at -
    http://www.aurorahealthcare.org/yourhealth/healthgate/getcontent.asp?URLhealthgate=%2221432.html%22

  5. Having sprained my ankle more than once, I think I'm on solid ground in
    saying that walking on it is a bad idea. I can't imagine what good
    massaging it does, either. The medical advice I've always gotten with
    ankle sprains is to keep it wrapped, keep it warm and stay off of it.

    Parker Race said:

    My wife slipped on ice on tuesday and got her foot caught under the


    other

    Quoted message said:

    and sprained her ankle, not just a minor twist, swelling,


    discoloration.

    Quoted message said:


    She hasn't gone to the doctor but her coach has recommended.
    1. not wrapping it.
    2. walking on it (not using crutches)
    3. massaging it

    (This person isn't known for being conservative)
    She went swimming last night and then tried to do some aqua jogging.


    She

    Quoted message said:

    said the swimming was OK bu aqua jogging was painful.

    What do you think of this advice?
    What is the usual recovery time for a more than minor sprain before a


    full

    Quoted message said:

    return to running? She's still thinking she's going to be able to


    run

    Quoted message said:

    Boston.

    TIA,
    Parker

  6. hey parker,

    how old is she park? a 22 yr old heals differently than a 42 yr old.
    perscribing someone to walk free of crutches on a swollen & discolored
    ankle is not "gung ho", it's "ass hole".

    i should not be so hard, perhaps he has x-ray eyes and certainty on the
    measure of injury. absent an xray & some other testing, you're
    flying blind. could be a few weeks or months...it all "depends".
    however discoloraton (broken/bursting of blood vessels) and hints to
    the possibility of tears, etc.

    you can do some pretty nasty ankle rolls that hurt and pain for days
    that don't rise to the level of discoloration and swelling. many of us
    have done it.

    based on what you said best case scenario is lig/tendon strains or
    slight tears that will naturally heal in a couple of weeks to full
    recover (assuming she's not working against a progressive healing
    schedule).

    for some "out of the box" suggestions when i had this happen, the next
    day i went to chinatown in manhattan (you're in queens right park?)...i
    looked up an acupuncturist to expedite healing. Note working on a
    specific vertebra (L3), with the low back in extension affects the
    ankle (there's a real nexus between a joint/tendon injury, nerve
    irritation and connection with your back/spine, etc..). I spent some
    time in China and become a convert to acupressure/puncture.

    some years ago i had a major ankle roll, no swelling or discoloration,
    just piercing pain. i don't know what in the hell the guy did
    (acupuncturist)...other than fiddle w/L3 vertebra with some needles.
    The next day I was as good as new.

  7. [[ This message was both posted and mailed: see
    the "To," "Cc," and "Newsgroups" headers for details. ]]

    In article said:

    My wife slipped on ice on tuesday and got her foot caught under the other
    and sprained her ankle, not just a minor twist, swelling, discoloration.

    She hasn't gone to the doctor but her coach has recommended.
    1. not wrapping it.
    2. walking on it (not using crutches)
    3. massaging it

    (This person isn't known for being conservative)
    She went swimming last night and then tried to do some aqua jogging. She
    said the swimming was OK bu aqua jogging was painful.

    What do you think of this advice?
    What is the usual recovery time for a more than minor sprain before a full
    return to running? She's still thinking she's going to be able to run
    Boston.

    TIA,
    Parker

    Parker,

    As others have said, the general rule of ankle is RICE. The idea is to keep the swelling down so that the swelling won't damage uninjured tissue.

    The first 48 hours the suggestion is ice to minimize the swelling. The wrapping is also to keep the swelling down.

    Anyway here is some old folklore I've share around here before:

    Some Magic On Rehabilitating Sprained Ankles: Free The Peroneus

    I continue to maintain that the problem of the continual re-spraining of
    one's ankle is more a function of the peroneus remaining shortened by the
    original sprain and the fascia holding the muscle in that shortened state.
    Here's some magic you can work on your own ankle or you can get someone to
    help you: Free the peroneus

    Some Magic On Rehabilitating Sprained Ankles: Free The Peroneus
    by Austin Gontang,
    September 27, 2000

    Some Magic On Rehabilitating Sprained Ankles: Free The Peroneus
    c. 2000 Austin "Ozzie" Gontang, Ph.D.

    Quoted message said:

    Hi, I sprained my ankle a good four months ago and have been doing daily
    exercises to rebuild the strength, flexibility, balance etc. They've
    worked really well and now I have progressed to very gentle running. I can
    hop, skip and jump on the ankle now with no problems. However, when I've
    been sitting, or occasionally when I get out of bed, the ankle siezes up
    and is very stiff. I then have to hobble about on it gently to ease it
    back into life. I don't understand why it stiffens up when it would appear
    to be almost fully healed and rehabilitated. Any ideas/ advice ?
    Thanks, Minnie Mouse

    Minnie,

    One thing I've found over the years is that the peroneus, the muscle which
    runs down the outside of the leg - it lifts the outside of the foot - often
    gets pulled and to protect itself it tightens- i.e. shortens. After the
    healing of the ligaments around the ankle, that peroneus (longus and medius
    portion) can remain in its semi-contracted state. which means it doesn't
    fully relax when the posterior tibialis - its counterpart - lifts the inside
    of the foot up.

    So often the sprain is gone but those muscles and fascia which splinted to
    protect the pulled muscles and strained ligaments don't let go. Those
    muscles that hold on are unknown by most people. They keep thinking ankle
    and forget the ankle residue of tightness and/or clicking may be a symptom.
    Those muscles and their fascia (the thin transparent film you see between
    the skin and the meat on a chicken breast) must be worked on through
    transverse friction, deep tissue massage or fascia release. Once that muscle
    group on the outside of the leg is freed up the ankle joint is freed up and
    it's ease of movement almost feels like a miracle has happened. There's no
    clicking and the person feels immediately a fuller range of ankle motion.

    I continue to maintain that the problem of the continual re-spraining of
    one's ankle is more a function of the peroneus remaining shortened by the
    original sprain and the fascia holding the muscle in that shortened state.

    Back to my soapbox about my reason for having people train on unpaved roads,
    grassy or uncompacted dirt is to train their stirrup muscles which are
    postural muscles (peroneus and posterior Tibialis) that evert and invert the
    ankles.

    If people keep running on flat, level surfaces that are concrete or asphalt
    the level, flat surfaces create an overuse syndrome which never let the
    ankle act as the semi swivel (not anatomically correct) it is. My reason for
    having people run on grass and unpaved surfaces is to allow the ankle to do
    what it was make to do...adjust to the terrain.

    Paved roads create an overuse syndrome because those muscles never get taken
    through a wider range of motion and therefore shorten and the fascia then
    locks them in that position.

    I think that the solution is counter intuitive. It's not the unpaved and
    uneven surfaces which are the problem. It's the paved even surfaces which
    never allow for the variability which the ankle needs to experience to
    maintain its range of motion and muscle flexibility.

    What To Do About The Tight Or Clicking Ankle

    Using A Partner

    Start about 3 inches above the ankle bone on the outside. Hold as if they
    are going to strangle the outside of your lower leg- fingers wrap around the
    lower leg thumbs pointing toward each other or one thumb rests on the other
    thumb (if more pressure is desired).

    Have them use light pressure by pushing in with thumbs as you make a small
    (emphasis on small), smooth (emphasis on smooth) circle. As you make small
    smooth circles with the foot they slowly to slide the thumbs up the peroneus
    muscle.

    The idea is that you can loosen the muscle from any adhesions and also you
    can loosen up the fascia which may be holding the peroneus from relaxing and
    going through it full range of motion.

    Stop after 3 or 4 times of small circles and they holding. Walk a few steps.
    More often than not, you'll feel less pressure around the ankle as it can
    move more freely due to the freeing of the peroneus higher up the leg.which
    takes the tightness off the ankle area.

    The peroneus and posterior tibialis are often called stirrup muscles as they
    invert and evert the foot. They are also postural muscles and therefore slow
    twitch, in that they help maintain correct posture when functioning
    properly.

    Doing The Loosening On Your Own

    To loosen the peroneus on your own, face a railing with a middle railing
    (http://www.mindfulness.com/of1.asp). Turn your body 45 degrees and place
    the peroneus side of the leg on the bar, usually the middle bar is better
    unless you're very tall. Do the same foot movement as mentioned above to
    loosen the peroneus and the fascia that may be constricting the ankle for
    its full range of motion. As you make the small circular movements slide the
    outside of the leg slowly down the railing. Start about 3 inches above the
    ankle bone and go to about the middle of the lower leg.

    If the circle made by the ankle is to big, it will be a jerky circle and
    you'll just be straining tendon since the muscles won't be letting go. So
    small circles, start penny size. The circle is not made with just the front
    of the foot. The bottom of the heel is scribing a circle also. Imagine your
    foot is the bottom of an unside down pie plate and you get the idea how both
    the front of the foot and bottom of the heel are circling. As the foot makes
    the small circles at first imagine you're screwing out the foot so there's
    more space in the ankle. When the peroneus loosens up there is a better
    range of motion in the ankle.

    Remember to do this lovingly. If you make big circles, or do it too hard or
    too fast, your body will remember the feeling when it was originally hurt,
    and tighten up even more to protect itself.

  8. Thanks for all the input, unfortunately for me an my wife it gets worse.
    She went to the doctors and got and x-ray today.
    She has an undisplaced fracture of the tibia not just a sprain.
    It was too late to see an orthopedist so she'll go tommorow.
    I'm praying she doesn't have to be in a hard cast.

  9. "> I'm praying she doesn't have to be in a hard cast.

    For your sake, me too. Like caging a wild animal, so to speak.

    -DougF

  10. yup...i suspected something like this park.....discoloration & swelling
    said it all.

    however parker. honestly...man to man, runner to runner. how do you
    feel about her coach? do you dismiss it, overlook it?...or do you
    know have to reaccess this person as a professional in their field?

    what that coach advised was so stupid....it was inexcusable and could
    have caused further and serious damange. it was a simple simon "101"
    call too.....with obvious indicators of a potentially serious injury.
    hell we called it so from on-line...that coach had much more to go with
    yet still was irresponsible...
    hope for the swiftest of possible recoveries...

  11. When I sprained my ankle last year (not very badly), my ortho told me no
    running for 6 weeks but to continue to walk as much as was comfortable (in
    fact, he said I *should* walk), and not to wrap it.
    He also referred me to p.t. as an option to help the process along, though
    it wasn't vital.
    bj

    "John B." <[email hidden]> wrote in message
    news:[email hidden]...

    Quoted message said:

    Having sprained my ankle more than once, I think I'm on solid ground in
    saying that walking on it is a bad idea. I can't imagine what good
    massaging it does, either. The medical advice I've always gotten with
    ankle sprains is to keep it wrapped, keep it warm and stay off of it.

  12. In article <[email hidden]>,

    Ozzie Gontang said:

    One thing I've found over the years is that the peroneus, the muscle which
    runs down the outside of the leg - it lifts the outside of the foot - often
    gets pulled and to protect itself it tightens- i.e. shortens. After the
    healing of the ligaments around the ankle, that peroneus (longus and medius
    portion) can remain in its semi-contracted state. which means it doesn't
    fully relax when the posterior tibialis - its counterpart - lifts the inside
    of the foot up.

    Ozzie, maybe I'm reading this wrong and I certainly don't have any
    medical training...

    When I've sprained my ankle - which has been fairly frequently since my
    adolesent days, some 35 years ago - I always land such that the ankle
    rolls outward. I sprained it so badly a couple summers ago when I
    stepped half-on, half-off some pavement that the swelling and bruising
    extended from midfoot to the outside, lower portion of my calf. After a
    week without much improvement in pain, I went to the doc - xrays
    revealed no breaks. Just a really bad sprain.

    In your description above, it sounds as though a shortened peroneus
    would prevent such outward rolling as I experience. I've always thought
    that the outer ligaments and whatnot in there were stretched from
    repeated sprains and that's why I seem to be susceptible to them.
    --
    "Sure we'll have fascism in America, but it'll come disguised
    as 100% Americanism." -- Huey P. Long

  13. When the peroneus contracts to protect itself, the fascia around the
    peroneus shortens. If you take a sleeve of a jacket as the fascia and
    you tighten it by twisting it with your other hand, the arm in the
    sleeve is constricted from moving as freely as when the sleeve wasn't
    being twisted.

    A medical term for this fascial shortenings and causing a limitation of
    the muscle under the shortened fascia to move through its full range of
    motion are called adhesions. You can do surgery or you can get someone
    to do rolfing or fascial release to allow the muscles to once again
    move through its full range and therefore take the strain off the
    tendons which can but aren'st suppose to stretch. Remember that's the
    work of the muscles to contract and relax.

    That is also why I continually tell people to roll their quads to
    release the fascia and the shortened but strong muscles of the quad. I
    want strong elongated muscles that can move through their full range of
    motion so that the tendons do not have to take the tension.

    In health and on the run,

    Ozzie Gontang
    [email hidden]
    Maintainer - rec.running FAQ
    http://www.faqs.org/faqs/by-newsgroup/rec/rec.running.html
    Director, San Diego Marathon Clinic, est. 1975

    Mindful Running http://www.mindfulness.com/mr.asp

    In article <[email hidden]>,

    DadatHome said:

    In article <[email hidden]>,

    Ozzie Gontang said:

    One thing I've found over the years is that the peroneus, the muscle which
    runs down the outside of the leg - it lifts the outside of the foot - often
    gets pulled and to protect itself it tightens- i.e. shortens. After the
    healing of the ligaments around the ankle, that peroneus (longus and medius
    portion) can remain in its semi-contracted state. which means it doesn't
    fully relax when the posterior tibialis - its counterpart - lifts the inside
    of the foot up.

    Ozzie, maybe I'm reading this wrong and I certainly don't have any
    medical training...

    When I've sprained my ankle - which has been fairly frequently since my
    adolesent days, some 35 years ago - I always land such that the ankle
    rolls outward. I sprained it so badly a couple summers ago when I
    stepped half-on, half-off some pavement that the swelling and bruising
    extended from midfoot to the outside, lower portion of my calf. After a
    week without much improvement in pain, I went to the doc - xrays
    revealed no breaks. Just a really bad sprain.

    In your description above, it sounds as though a shortened peroneus
    would prevent such outward rolling as I experience. I've always thought
    that the outer ligaments and whatnot in there were stretched from
    repeated sprains and that's why I seem to be susceptible to them.

  14. Quoted message said:

    I'm praying she doesn't have to be in a hard cast.

    You can still hump her free leg.

  15. Quoted message said:

    however parker. honestly...man to man, runner to runner. how do you
    feel about her coach? do you dismiss it, overlook it?...or do you
    know have to reaccess this person as a professional in their field?

    what that coach advised was so stupid....it was inexcusable and could
    have caused further and serious damange. it was a simple simon "101"
    call too.....with obvious indicators of a potentially serious injury.
    hell we called it so from on-line...that coach had much more to go with
    yet still was irresponsible...

    Um, he's her coach. But everything else you said was accurate.

  16. Quoted message said:

    When I've sprained my ankle - which has been fairly frequently since my
    adolesent days, some 35 years ago

    That's "days" not years.

  17. <[email hidden]> wrote in message
    news:[email hidden]...

    Quoted message said:


    what that coach advised was so stupid....it was inexcusable and could
    have caused further and serious damange. it was a simple simon "101"

    And I will disagree with you but that's not infrequent. Once it has been
    determined that the sprain is in fact a minor sprain(x-ray) it is not as
    bizarre nor unreccomended as you think. Notice the caveat a minor sprain
    which still means lots of swelling and delightful collors.

    Twas many years ago but three weeks before( my last long run) doing my
    first Escarpment Trail Race, I sprained my ankle. Yup, puffed the size
    of a basketball. Off to ER, pictures taken, recommendation RICE. For
    two days I sit on my back porch, foot up, lamenting my foot, not going
    to work and general all around pissy attitude. I call my RD friend to
    say that I won't be able to run the race and give my slot to someone
    else. The conversation ensues and tells me that many people for these
    type of sprains go out and walk run on them and they heal just fine and
    in many cases faster.

    Afeter the call I went out and walked a mile or so. It felt squishy at
    first but actually felt a little better after it "warmed" up. After my
    walk I iced it and wrapped it. I did that for a few days and then added
    in some slow running. It didn't feel any different running on it than
    walking on it. The swelling went down each day, the colors as you might
    expect were black and blue. By race day I was 95% recovered. I taped my
    ankle since the race is made up of rocks and roots and I know the ankle
    tendons were still weak, and ran the race. No post race repercusions
    other than one ired

    I know anecdotal but I'm suggesting that sitting back and playing the
    woe is me and doing nothing for weeks on end, is safe conservative lore.
    It definitely prevents the opportunity for reinjury so the injured
    person must be careful to run on safe level surfaces. So you can do what
    you want with this lore but with some sprains RRICE also works.

    So maybe the question you should have asked before you pointed the
    irresponsible finger at the coach - " is there and history of running
    with a sprain vs. recovery?" In Parkers brides case, The X-rays showed
    something much worse and now will have to live with a compulsive runner
    that can't run. No Parker, I'm not coming to dinner to save your sole.
    🙂

    Topics such as this are similar to running shoes. You will get some
    Podiatrists that suggest your feet will turn to squash if you don't run
    in highly supported running shoes while others will say the closer you
    get to barefoot the better. As with sprains so goes shoes.

    -DougF

  18. <[email hidden]> wrote in message
    news:[email hidden]...

    Quoted message said:

    yup...i suspected something like this park.....discoloration & swelling
    said it all.

    That's not necessarily an indicator, my sister sprained her ankle very badly
    skating once and it looked much worst than my wife's foot, she didn't have
    any broken bones, I was surprised that she broke something.

    Quoted message said:


    however parker. honestly...man to man, runner to runner. how do you
    feel about her coach? do you dismiss it, overlook it?...or do you
    know have to reaccess this person as a professional in their field?

    what that coach advised was so stupid....it was inexcusable and could
    have caused further and serious damange. it was a simple simon "101"
    call too.....with obvious indicators of a potentially serious injury.
    hell we called it so from on-line...that coach had much more to go with
    yet still was irresponsible...

    He probably shouldn't have made the recommendation not knowing if there was
    a break involved and like I said he's not exactly the conservative type.
    He does know how to get people to reach running goals though, my wife didn't
    take his advice anyway as far as the massage anyway.

    Quoted message said:

    hope for the swiftest of possible recoveries...

  19. "Doug Freese" <[email hidden]> wrote in message
    news:[email hidden]...

    Quoted message said:


    <[email hidden]> wrote in message
    news:[email hidden]...


    No Parker, I'm not coming to dinner to save your sole.

    Quoted message said:

    🙂

    My plan for the weekend is XC skiing on Saturday, Sunday, there'a a morning
    race at SUNY Albany and an afternoon indoor track there also, I ought to be
    able to keep out of the house most of the weekend.

  20. Oh Doug. C'mon......it's not that complicated and actually very
    simple. The coach gave decisive detrimental instruction based entirely
    on assumption(s). That's a series of errors Doug, not just one. In
    RL people get fired and sued for similar action on a daily basis Doug.
    It's called negligence.

    This wasn't "hairline" judgement stuff...this was simple simon "101"
    caliber stuff. In the absense of information and knowledge
    (certainty), you proceed with caution and prudence and advise
    accordingly.....especially when you're in the business of working with
    humans and their physiology / body / mind, etc.

    Your stories Doug mean nothing in this matter. Defend the
    instrutctions of the Coach.

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