Ankle brace

In article said:

Hi trail runners. I could use some advice re: ankle braces. I've
sprained both ankles so many times now that I need some ankle support.
Any advice? I run on moderate to very technical trails. I've excercised
faithfully - both strength and balance but with only limited success.
Any help?
Thanks
Phil

Phil,

From a previous post:

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.

In health and on the run,
Ozzie Gontang
Director, San Diego Marathon Clinic, est. 1975
Maintainer - rec.running FAQ
http://www.faqs.org/faqs/running-faq/
Mindful Running:
http://www.mindfulness.com/mr.asp

phil said:

Hi trail runners. I could use some advice re: ankle braces. I've
sprained both ankles so many times now that I need some ankle support.
Any advice? I run on moderate to very technical trails. I've excercised
faithfully - both strength and balance but with only limited success.
Any help?
Thanks
Phil

Just a thought. Have you allowed it to thoroughly heal before running
technical trails again? Yea, I know the implications, but thought I'd
ask anyway 😉 This is where my field season breaks have provided me
time to completely heal in the past. I still limit the number of uneven
footing runs to 1 per wk - builds strength without overdoing it. My PT
had given me some proprioception drills for achilles that work for
strengthening feet / ankle.

I usually just tape my ankles if running on rougher terrain (or pitted
snow) than normal. I use Johnson & Johnson Coach (iirc) tape - thin so
you don't feel it. I usually start with an optional circular wrap (holds
better than just taping to skin) around the ankle - about 3-4 inches
from floor - that acts as anchor for vertical strips. Then wrap about 3
strips from one side of ankle, under the heel, then up the other side -
somewhat like a stirrup, but under heel. Then finish off with another
wrap over the top to hold ends in place. This keeps the ankle from
moving side to side but still gives you the forward/backward flex. Wraps
should be firm to hold things, but not too tight so it doesn't cut off
circulation as feet / ankle swell.

Some of the people in my cross-training class wear ankle braces, but
I'm not sure what kind they use. They do look horribly uncomfortable
relative to taping.

Hope this helps.

Dot

--
"You try to slow down and enjoy it. You try to look at the scenery. But
your brain can kind of go blank. All you want to do is tell your feet to
keep working."
-Cedar Petrosius, women's winner 2004 Matanuska Peak Challenge (14mi,
9000ft up and down)

"Dot" <dot.h@#duh?att.net> wrote in message
news:[email hidden]...

Quoted message said:

phil said:

Hi trail runners. I could use some advice re: ankle braces. I've
sprained both ankles so many times now that I need some ankle
support. Any advice? I run on moderate to very technical trails.
I've excercised faithfully - both strength and balance but with only
limited success.

Unless you stopped running for 10 years on trails and did some extensive
strengthening exercises those muscles and tendons are stretched and
toast. Those plasic looking braces I guess work but I understand so damn
uncomfortable they drive you nuts at every step.

Quoted message said:

Just a thought. Have you allowed it to thoroughly heal before running
technical trails again? Yea, I know the implications, but thought I'd
ask anyway 😉 This is where my field season breaks have provided me
time to completely heal in the past. I still limit the number of
uneven footing runs to 1 per wk - builds strength without overdoing
it. My PT had given me some proprioception drills for achilles that
work for strengthening feet / ankle.

I usually just tape my ankles if running on rougher terrain (or pitted
snow) than normal. I use Johnson & Johnson Coach (iirc) tape - thin so
you don't feel it. I usually start with an optional circular wrap
(holds better than just taping to skin) around the ankle - about 3-4
inches from floor - that acts as anchor for vertical strips. Then wrap
about 3 strips from one side of ankle, under the heel, then up the
other side - somewhat like a stirrup, but under heel. Then finish off
with another wrap over the top to hold ends in place. This keeps the
ankle from moving side to side but still gives you the
forward/backward flex. Wraps should be firm to hold things, but not
too tight so it doesn't cut off circulation as feet / ankle swell.

Phil, as Dot suggests below - tape your ankles. My only addition to what
Dot says above is to alternate vertical stirrup strip, with horizontal
strip and a slight overlap with each, i.e. two or three of each. It's an
interlocking effect that I find holds even better especially if you dip
your feet in water or a heavy sweater. The secret of taping is to do it
and not know you have taped. It should not feel restrictive as you stand
or run on level ground. In fact you should hardly know the tape is
there. It's when you ankle turns a few degrees that you feel the
stirrups hold you from going over. It will take a run or two to learn to
trust it. FWIW, the easier the trail the more likely I'm to tape. It's
the easy trail that you are most likely to drop your guard. I'm not
suggesting you don't tape on rugged trails but most of the time you are
more alert.

If you want some greater detail drop me a line.

-DougF

Pansy

"Miss Anne Thrope" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Pansy

Hermaphrodite!

-DF

phil said:

Hi trail runners. I could use some advice re: ankle braces. I've
sprained both ankles so many times now that I need some ankle support.
Any advice? I run on moderate to very technical trails. I've excercised
faithfully - both strength and balance but with only limited success.
Any help?
Thanks
Phil

Hi, Phil.

I'm straying outside my expertise, but I gotta contribute my skepticism
that braces don't much help. I've read a few scattered reports here and
there that the ankle and knee braces that get handed out at ER's and
Ortho office galore do not make any difference. And when you think
about the tremendous amounts of force involved at the moment that your
ankle does or doesn't twist -- your entire body weight multiplied by the
acceleration/deceleration forces of landing and pushing off as you run
-- I just don't logically see how a bit of plastic with a bit of
stiffness makes a big difference in whether an ankle or knee holds or
caves at that moment of possible injury. Again, I don't pretend to know
the medical literature on this extensively. The stuff I've seen is
probably anectodal and random. But it fills me with skepticism.

Them's my two cents.
-- Josh Steinberg MD, Syracuse