Sprained Ankle – Runner’s Guide to Diagnosis, Treatment & Prevention

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Sprained Ankle? Incapacitated? Here’s what you need to know.

A sprained ankle is a common ankle injury in which the overstrain occurs to one or more ligaments in the ankle. It’s also known as an ankle sprain, rolled ankle, twisted ankle, and floppy ankle.

The injury is relatively low-risk, and often times leads to the complete immobilization of the ankle. When the ligaments are sprained, blood vessels are poked/cut and they start leaking blood into the surrounding joint tissue alongside other fluids, causing swelling and inflammation.

There are 3 classifications of the injury depending on the number of damaged ligaments and overall damage of the surrounding tissue.

Sprained-Ankle-Featured

 

1st-grade: is defined as a moderate stretch and/or tear to a single or multiple ligaments without laxity (loosening) or joint instability. Estimated recovery time for 1st-grade ankle sprains is usually between 2 and 4 weeks.

 

1st grade ankle sprain

 

2nd-grade: is defined as a tear or partial tear to one or multiple ligaments with some laxity. Estimated recovery time for 2nd-grade ankle sprains is usually between 4 and 8 weeks.

 

 

3rd-grade: is defined as the most severe form of the injury because the sprain resulted in a complete tear of a single or multiple ligaments which caused severe laxity and joint instability. 3rd-grade ankle sprains can take up to 3 months to recover.

 

 

Symptoms of a Sprained Ankle

  • Pain
  • Severe discomfort
  • Swelling/inflammation
  • Throbbing warmness
  • Bruising

Since the nerves become more sensitive after the injury, pain is almost constant, more so when subsequent pressure is applied, that’s why you should never step on the affected foot after the injury, no matter the severity.

The injury also manifests itself as a warm throbbing pain and severe discomfort. Furthermore, the affected area becomes bruised with red and purple color tonalities.

Swelling usually appears immediately or may take up to 24-48 hours to develop, depending on the severity and types of damaged structures. Very mild cases may not present swelling at all, although, such cases are rare.

 

Three most common types of ankle sprains

  • Inversion (lateral) ankle sprain

Circa 70-85% of ankle sprains are inversion sprains.
The external side of the foot is affected in an inverted ankle sprain. This is the most common type of ankle sprain and affects the ligaments from the lateral outer part of the foot. Usually, the anterior talofibular ligament and calcaneofibular ligaments are affected by an inversion injury.

  • Eversion (medial) ankle sprain

An eversion sprain refers to the fact that the foot rolls inwards, affecting the inside part of the foot. Mainly, the medial and/or the deltoid ligament. The injury is less common because, anatomically speaking, an inward ankle rotation is less probable.

Ankle-Sprains-The-Runners-guide

  • High ankle sprain

A high ankle sprain involves the larger upper ligaments which connect the ankle to the tibia and fibula. A high ankle sprain usually derives from a forceful outwards overtwisting of the foot.

The injury is common and reported in sports such as football, rugby, ice hockey, roller derby, basketball, volleyball, lacrosse, softball, baseball, track, ultimate frisbee, gridiron, tennis, badminton, horse riding etc.

 

Diagnosis

Most of the times, an ankle sprain doesn’t require further investigation through imaging techniques. More severe injuries such as fractures or stress fractures require such investigations. So, to avoid unnecessary X-rays, the ankle has to be physically examined through a set of palpation tests called the Ottawa ankle rules. If one of the tests results positive, then the patient may suffer from a bone fracture which requires a different set of treatments. and investigations, including imaging techniques.

 

 

The Ottawa procedure has a very high sensitivity, moderate specificity, hence a very low rate of false negatives.

A)    If the patient can’t walk for 4 consecutive steps after the injury, then the injury is severe enough to require an X-ray or such.

If the patient manages to walk unassisted for 4 consecutive steps, then further investigation is needed through palpation to make sure there’s nothing more severe:

B)    Palpation is needed alongside the bone termination of the lateral Malleus which is the distal fibular termination. Palpate for bony tenderness on the bony part of the lateral Malleus and on the posterior bony edge for about 6 cm upwards.
If bone tenderness is identified, then an X-ray is needed.

C)    Palpation is needed alongside the bony termination of the medial Malleus which is the distal tibial termination. Palpate for bony tenderness on the bony part of the medial Malleus and on the posterior bony edge for about 6 cm upwards.
If bone tenderness is identified, then an X-ray is needed.

D)    Palpation is needed alongside the base of the fifth Metatarsal which corresponds to the external base of the foot (pinky finger side). Palpate the area longitudinally and if bone tenderness is identified, then an X-ray is needed.

E)    Palpation is needed alongside the Navicular bone which corresponds to a small square on the internal part of the foot. Palpate the area and if bone tenderness is identified, then an X-ray is needed.

Prognosis

Most patients with grade 1 ankle sprains recover after a few weeks. Grade 2 and 3 ankle sprains need several weeks or even months for a full recovery.

The healing process is very important, as pain, instability, and re-injury after an incorrect rehabilitation are quite common. In fact, over 30% of ankle sprain patients are going to suffer another ankle sprain in their lifetimes because of incorrect healing.

 

Ankle-Sprains-The-Runners-guide-prognosis

 

Associated injuries

  • An avulsion fracture
  • Osteochondral lesions
  • Ankle Fractures

In addition to ligament damage, an ankle sprain may also be associated with damaged tendons, joint capsules, bones, cartilages, nerves, or other soft tissues. In severe ankle sprain cases, dislocations and fractures of the ankle bones are not very uncommon.

Imaging techniques

  • X-rays
  • Sonography
  • Arthrography
  • Magnetic resonance imaging

 

Causes

Aggressive, fast, twisted moments increase the chances of a misstep, which in return, can result in a twisted ankle. An ankle sprain is whenever one or more ligaments are stretched over their capabilities, damaging the ligament tissue. Injury situations for ankle sprains are one of the most diverse, as athletes can land from a few feet or just from a few inches, on soft or rough terrain etc.

Lateral sprains are the most common because of the foot’s anatomy which makes forward and backward sprains improbable, although possible.

Sports and physical activities, especially on uneven terrains, that involve side-to-side movements such as tennis, basketball, volleyball and trail running are particularly risky.

 

Ankle-Sprains-The-Runners-causes-trail-running

 

Complications

If the patient returns to activity too soon, then the ligaments are at risk of healing in a stretched position, resulting in a destabilized ankle joint. It can also lead to a chronic condition known as Chronic Ankle Instability (CAI). The condition puts the athlete at a higher risk for future ankle sprains.

 

Risk factors

  • Weak adjacent muscles

Undeveloped muscles facilitate an ankle sprain because the muscles are less capable of correcting a misstep by counterbalancing. Peroneal or fibular muscles are especially important but so are the others.

  • Weak/lax ligaments (hereditary or because of Chronic Ankle Instability)

Past surgeries, injuries, hereditary characteristics, bone-related conditions, and Chronic Ankle Instability are risk factors as such conditions may predispose the athlete to injury.

  • Inadequate joint proprioception (i.e. sense of joint position or spatial awareness)

A large portion of the ankle sprain cases is caused or partially caused by inadequate joint perception in which the patient isn’t fully aware of his ankle and foot positioning. For example, walking or jumping on rough terrain with reduced or absent visibility. Or jumping and colliding mid-air with an opponent which causes you to spin uncontrollably. Performing any sort of physical activity while not being fully aware of the foot’s position can result in an injury.

  • Slow neuron muscular response to an off-balance position

People with slow reflexes are exposed because of their inadequacy to re-balance themselves correctly and in a timely manner. Some injury situations can derive from a slow neurological response or a wrong response. Some patients end up injured because they attempt to correct a misstep with another misstep or fail to do so completely which leads to the ankle sprain.

So, before trying a new physical activity or sport, athletes should learn all the possible bail-outs and re-balancing techniques as to minimize injury probability.

  • Uneven surfaces

Irregular foot patterns are a solid cause of ankle sprains because the muscles are fatigued way faster and because the uneven surface makes the foot more susceptible to stepping errors, thus injuries.

  • Equipment/Footwear

Low-top shoes with a high base or heels, lacking cushioning or support can all play a huge risk factor.

Proper equipment is needed for dynamic activities –  such as:

Low heel-to-toe drop shoes (minimalistic or barefoot shoes)

Super high-top sneakers (ankle reinforcement)

Grippy/adherent sneaker soles (for ground traction)

 

Ankle-Sprains-The-Runners-guide-proper-shoes

  • Age

The vast majority of reported ankle strains come from teenagers and young adults aged 10 to 19, mostly because of their high level of activity and relative inexperience. Another consistent group in reporting ankle sprains are older people because of age-related health factors. Nonetheless, virtually everyone is exposed to this type of accidental injury.

 

First aid

R.I.C.E. (Rest Ice Compression Elevation)

First and foremost, the injured ankle should be protected/immobilized to avoid further complications.

  • Rest is both needed in the long and short term. The first thing the patient should do after the injury occurred is to cease all physical activity and to immobilize the ankle until further notice. An injury such as an ankle sprain can require anywhere from several weeks to several months, and proper rehabilitation is needed for a more efficient healing process.
  • Ice to reduce the swelling and tissue inflammation. A nice bucket of iced water or some ice cubes wrapped in a towel are going to relieve some of the most unpleasant symptoms. Some mobility may be regained immediately because of the liquid drainage. Pain is reduced because the nerve endings are numbed and relieved from the internal fluid pressure. Apply 15-20 minutes once every 30 minutes or so. Avoid direct ice-to-skin contact, rather veil the ice into a towel or dip your feet in iced water.

 

  • Compress the area lightly with a compression wrap or similar orthopedic device to redistribute some of the pressure towards other parts of the foot. It keeps the swelling down and allows the ligaments to heal better. Careful not suppressing blood flow!
  • Elevate the leg to further decrease the swelling and inflammation. Find a comfortable position and height, don’t go over a 45-degrees.

 

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Taping

Reinforcing the ankle with medicinal tapes, casts, or other sports devices is extremely important and beneficiary towards a proper healing process. Ask your doctor about the different methods of taping and see what’s best for you.

 

Over-the-counter medicine for symptom relief

Glucosamine and nonsteroidal anti-inflammatory drugs (NSAIDs) of the propionic acid class:

  • Ibuprofen aka. Brufen, Advil, Motrin, and Nurofen etc.

Eat a fiber-rich meal beforehand because Ibuprofen can cause, in very rare cases, gastrointestinal bleeding. Carefully read the package insert. Avoid if you suffer from asthma, heart, kidney, and liver problems!

  • Naproxen aka. Aleve, Anaprox, Flanax, Naprelan, Naprosyn etc.

On the other hand, Naproxen can increase the risk of stomach ulcers which is why it’s often taken with a proton-pump inhibitor (a medication that reduces stomach acid production). Carefully read the package insert and avoid if you have gastric or duodenal ulcer.

 

 

  • Methyl salicylate-based analgesic heat rub gels

Methyl salicylate aka. oil of wintergreen or wintergreen oil is an organic ester, naturally produced by many species of plants, particularly wintergreens. It is also synthetically produced and can be found in different brands such as Ben-gay, Tiger Balm, Heat Rub, IcyHot, Deep Heat, Flexpower, RUB A535 etc.

 

 

Rehabilitation

Rehabilitation consists of reducing the amount of edema fluid within the tissue while regaining strength and mobility. R.I.C.E. should be immediately implemented as fast as possible after the injury occurred, regardless of the severity. Complete immobilization of the leg is needed in the first week of the injury. The ankle has to be protected to avoid further complications.

After a minimum of 1 week, gradual stress can be applied to the ankle with the help of different mechanisms and medical devices to help stimulate correct ligament repairment. Physical therapy is needed to restore both strength and flexibility.

 

Ankle-Sprains-The-Runners-guide-rehabilitation

 

Ankle immobilization

Immediately after the injury, a short period of immobilization is needed. A bellow-knee tubular cast is the most common medical device but it’s proven to be inferior to an Aircast, for example. Seek medical advice to what’s the best medical device for you and your situation. Seek an orthopedist doctor for a better opinion on the matter.

After this short period of complete immobilization, the ankle has to undertake gradual strength and flexibility training regiments. These exercise regiments are usually performed 3 times a day for 20 minutes, each. They’ll help in restoring range of motion, muscle fiber activation, overall strength, and normal sensorimotor control.

Walking should be reintroduced gradually, only after completing a couple of training days to ensure ankle readiness. Discomfort is acceptable but never pain. In the beginning, walking should be heavily assisted. In the final period of rehabilitation, when the ankle is asymptomatic, it’s advised to wear snug high-top sneakers and to tape the ankle with a wide, nonelastic adhesive tape. Don’t suppress blood flow. The patient should return to sports only after the ankle has been healed completely.

 

Ankle-Sprains-The-Runners-guide-ankle-brace

  • After 3 days

Massage

Light massage can be performed with caution after 3 days, and if a hard cast wasn’t needed. Gently massage the calf, shin muscles, as well as the foot itself. Apply gradual pressure to stimulate blood flow and increase the pressure only if the body allows you to do so, let pain be your guide. Start from the uninjured parts of the leg and slowly work your way to the affected parts.

  • After 7 days

Cross friction

Deeper tissue massage can be applied after 7 days on the ligaments if pain allows it. This will help in preventing scar tissue formation.

Don’t use oils or other lubricants because they’ll limit your sensibility over your ligaments and will reduce massage movement control.

This massage is performed directly on the ligament in its stretched position. Gently stretch the desired ligament and apply deep pressure with one of your fingers. Apply as much pressure as you can within the limits of pain. Massage the tendon in every direction, but avoid massaging along its length. Some pain and discomfort are acceptable when massaging, but never unbearable or acute pain.

Massage once every other day for 5-10 minutes, and make sure you know the anatomy of the foot. If you don’t feel up to the task, maybe it’s better to seek a massage professional.

If swelling increases or if pain is worse the next day, then refrain from massage until the acute stage has passed.

Ankle mobilization through joint manipulation

Joint manipulation refers to passive movements of the skeletal joint. Meaning, you or somebody else is moving the foot.
The procedures involve specific movements that seek to reduce musculoskeletal pain, shorten the recovery time, increase passive range of motion, stimulate the central nervous system in re-establish ing key pathways and functions. The therapy is performed by trained chiropractors, osteopathic physicians, occupational therapists, physiotherapists, and osteopaths.

 

Ankle-Sprains-The-Runners-guide-r-i-c-e-therapy

 

Ankle exercises

To both aid in recovery and avoid re-injury, different sets of strength and flexibility exercises are needed. The basic guideline is to work the ankle muscles from every angle, with gradual weight, and to the fullest extent of motion without causing pain.

Range of motion exercises

Execute a complete cycle of the following exercises for a couple of times a day, up to 5 times a day. These are quite easy to do in front of the TV or PC.

1. Free-weight ankle rotating

Proceed to move your ankle in every direction while keeping your leg extended in front of you. In the beginning, it’s advised you do the rotation without weights as to not overstrain the healing ankle. Gently rotate the ankle in every direction while avoiding pain.

2. Alphabet writing

While sitting on a chair, write the alphabet with your pointed toe on the ground. Write the whole alphabet for 3 times with each toe. It will cover virtually every motion. Remember to move the ankle to its full motion extent without causing pain.

3. Side-to-side knee jerks

Sit on a chair, firmly plant your foot on the ground while forming a 90-degree angle and move your knee side-to-side while keeping the base of your foot firmly planted on the pavement. This is to stimulate the upper part of the ankle. As always, avoid pain.

4. Towel curls

While sitting up, place a towel on the floor and place your foot on the center of the unraveled towel or piece of fabric. Proceed to curl the towel with your toes towards the inside of the foot, try to grab/grip the towel like you would with your hand. Repeat for a couple of times. Go easy on the contraction the first times to avoid pain.

Ankle-Sprains-The-Runners-guide-exercises

 

Stretch exercises

Perform these stretching exercises a couple of times a day to aid the healing process. It’s recommended that you do a full stretching cycle 3 times a day, in the morning, afternoon, and evening. Try to stretch the ankle in every direction. Discomfort is acceptable but never pain, always stretch with gradual force.

1. Towel stretch

Sit on the ground with your feet extended in front of you. Place a rolled towel under the ball of your foot and gently pull with both hands towards you. Start gently and increase the tension while avoiding pain. Hold for 15-30 seconds. Alternate and repeat for 2 to 4 times for each foot.

2. Calf stretch

Two stretching components:

a) Gastrocnemius stretch

Face a wall at eye level and put your hands on it. Stand shoulder-width apart. Make one step backward with the foot you want to stretch and keep it straight. Lean towards the wall until you feel a stretch in the calf muscle. Hold the stretch for 30 seconds and alternate.

b) Soleus stretch

This stretch is similar to the Gastrocnemius but you’ll have to keep both legs bent. Place the leg you want to stretch a step back and lean against the wall while maintaining full foot contact with the ground.

Another variation of this stretch includes putting the forefoot against the wall while the heel rests on the ground. You’ll then lightly push the foot against the wall.

 

Ankle-Sprains-The-Runners-calf-stretch

 

Balance (proprioception) exercises

Balance exercises consist in holding a certain position and recruiting different fibers to maintain equilibrium.

1. One-foot stands

This exercise has variations which increase the difficulty. Firstly, stand on the injured foot with your eyes open and arms stretched at the sides. Try to maintain the position for a minute or so. After you’ve mastered it, try the same exercise with your arms crossed at your chest. The next variation involves holding your hands to the sides but closing your eyes. The final variation consists in holding your eyes closed with your arms crossed at your chest. This final variation may prove a little bit tricky but will fully stimulate your ankle in maintaining stability.

Other exercises include the use of specially designed boards, pillows, and such uneven surfaces that can be ordered online or bought at sports shops. Studies have shown that these types of exercises aid tremendously in the healing process.

2. One-leg squats

Start off by doing some regular two-leg squats to get a feel of your ankle under some dynamic pressure. If everything goes well, then proceed to attempt assisted and unassisted single-leg squats. These are super important as they also work your upper leg which might have lost some muscle mass during the initial recuperation phase when immobilized.

3. Balance Board Ball Toss

Keeping your balance on a wobble board, balance board, or Bosu Ball can be of great benefit. Strengthens muscles and improves muscle fiber activation, giving you an all-around better coordination.

Start by stepping on and off for a few seconds to get the feel of it.
Try performing a few half-squats while maintaining balance.
Progress to much more complex variations: while stabilizing yourself, try to gradually involve your upper body by catching and tossing a small medicine ball with a partner, for example, or similar.

 

Theraband-Balance-Board-best-balance-boards

 

Strength exercises

Exercises for strength can be performed safely only when your ankle can support your whole body weight without pain. These exercises incorporate the four movements of the foot: inversion, eversion, plantar flexion, and dorsiflexion. Perform approximately 3 sets of 8 to 15 repetitions for each movement.

1. Lateral isometric resistance

Sit on the floor with your leg extended close to a wall or immovable object. Proceed to push the foot outwards against the wall and hold for about 6 seconds. Repeat for 8 to 12 times without causing pain.

The next level would involve an elastic band or similar. You’ll have to extend both feet in front of you and create a leverage with one foot and pull to the outside with the other. Increase tensile resistance as you progress. Avoid pain.

2. Front isometric resistance

This can also be done with ankle weights!

Sit on a chair. Place the weight of the healthy foot on top of the injured foot. While the heel of the injured foot remains in contact with the pavement, push up for 8 to 12 repetitions. If it’s too easy, try to push the healthy foot down for increased resistance in order to perform 8 tp 12 repetitions. Hold each rep for 6 seconds. Stop in the presence of pain.

3. Toe raises

Find a small step or elevated ledge, and proceed to do the so-called calf raises. This exercises will help both strengthen and stretch the calf muscles. Contract the muscles on the repetition as well as on the negative, avoid pain, and stretch everything in the final positions.

4. Step-ups and step-downs

Find a small step and proceed to regularly step up and down with the injured foot. In the beginning, be careful to step lightly. Focus on contracting the muscles in a slow, controlled manner. Do this for a couple of dozen repetitions.

5. Heel and toe walks

While avoiding pain, walk on your toes for about 30 seconds. Rest, switch, and walk on your heels for about 30 seconds. Practice a few times a day, focus on the muscle contraction, balance, and stretch.

 

Ankle-Sprains-The-Runners-guide-toe-walk

 

Harder exercises for the final rehabilitation phase

Before resuming your usual training regiments and sports activity, you’ll have to prepare and test your body. The following exercises must be performed only after the ankle is almost completely healed. This means that the heel is asymptomatic and can support the bodyweight without a problem. Walking at any pace shouldn’t be a problem. Only at this final stage should the following be attempted by the patient.

Progressive endurance exercises

After a comprehensive warm-up, try to light jog for a couple of minutes and see how it goes. Rope jumping is also a great alternative.

A very important rule of thumb is to add no more than 10% in distance every running session after resuming jogging. So, if it’s your first time running after an ankle sprain, run no more than a couple of minutes. Next time you run, add 10% in distance from last time. This progressive loading phase will let your body adapt so you won’t suffer from complications.

Maybe it’s advised to start with low-impact endurance activities, just to stay safe, but you’ll have to speak with your doctor and assess your situation, it may or not be necessary.

Plyometric exercises for agility

Plyometrics exercises such as squat jumps, rope skipping, and similar high-impact activities should not be implemented until the ankle has regained full function.

Progressive load principle should be implemented here, as well. Start plyometrics with low-impact activities and progress to the more harder ones. Stop immediately if you feel pain and reassess your ankle condition because there’s little room for error when performing high-impact exercises after an injury, so be cautious and pace yourself.

Cross hopping

A great exercise for both ankle stability, overall leg strength, and coordination is cross hopping, more specifically, multi-directional single leg jumps. Start by drawing a cross on the floor. Start from a corner and test the stability of your ankle by jumping a couple of times and holding the position for a couple of seconds. Advance to quick jumps and mix things up both side-to-side and diagonally.

 

Ankle-Sprains-The-Runners-guide-cross-hopping

 

Diet and lifestyle

As in most injury cases, there are some things you can do to help speed up your recovery time. Added together, they’ll prove a tangible factor towards a better recovery.

A plant-based diet will help fuel your body with the nutrients it needs for a faster, better recovery. You’ll need a lot of Calcium, Vitamin D, proper sleep, and hydration. Alongside a reduction of harmful vices such as smoking, drinking etc.

A plant-based diet is the most healthy and efficient diet. You should focus on dark, leafy greens, fruits, legumes, nuts, seeds such as Broccoli, Brussels sprouts, collards, mustard greens, chickpeas, spinach, tofu, fortified foods etc. You should also monitor your micro and macro nutrients to see if you’re meeting your needs. B12 is especially important on both a vegan and non-vegan diet, so monitor your intake and eat B12-fortified foods.

 

  • Calcium

Men and premenopausal women should consume at least 1000 mg of calcium. Postmenopausal women should consume 1200 mg of calcium. Don’t take more than 2000mg of calcium a day, in total.

  • Vitamin D

Men and women should consume between 600 and 800 international units (IU) of vitamin D per day. Don’t take more than 800 IU of vitamin D a day as high doses can be toxic, especially after long periods of time.

  • B12 in micrograms (μg)

Age                            RDA (μg)
0-6 months……………….0.4
7-12 months……………..0.5
1-3 years…………………..0.9
4-8 years…………………..1.2
9-13 years…………………1.8
14+ years………………….2.4
pregnant women………2.6
lactating women……….2.8

  • Sunlight and water

Get at least 1 hour of sunlight, every day. Continue maintaining a physically active lifestyle to encourage calcium synthesis in the body. For proper hydration, remember the 8×8 rule: drink 8 servings of 8 ounces of water a day (a total of 2L of water a day).

 

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Alternative drug treatments

  • Growth Hormone (GH)

Growth hormone, also known as somatotropin or as human growth hormone, is a peptide hormone that stimulates tissue growth, cell reproduction and regeneration in humans and other animals. Studies with lab rats have shown that GH can significantly aid in reconstruction and tensile strengthening of bones, tendons, and ligaments. Ask your doctor about GH therapy and consider running a short cycle while and after recuperation.

  • S.A.R.M.

Selective androgen receptor modulators (SARMs) are a novel class of androgen receptor ligands. (The terminology is currently used for similar molecules targeting the estrogen receptor, such as tamoxifen.) SARMs are intended to replicate androgenic drugs like anabolic steroids but with a more targeted action with fewer side effects. Ask your doctor about these as they may benefit your recuperation.

For men with normal levels of testosterone and testicular function but in need of a therapy for bone related issues such as osteopenia or osteoporosis, SARMs is a better alternative to most steroids or hormone replacement therapies: in this case, SARMs molecules are effectively targeting bone and muscle tissue but with less influence on the testes or prostate.

For women, SARMs molecules are a better alternative to standard steroids and growth factors, as SARMs successfully repairs bone and muscle tissue without undesirable side-effects such as virilization (development of male characteristics), increased cholesterol, liver dysfunction etc.

  • TB-500

TB-500 is a synthetic peptide molecule consisting of a fraction of the protein thymosin beta-4 which consists of 43 amino acids and is encoded by the gene TMSB4X. The protein is present in almost all human and animal cells. It’s produced in higher concentration wherever tissue has been damaged and contains potent anti-inflammatory agents. It can be injected anywhere because of its very low molecular weight which doesn’t bind to the extracellular matrix.

The substance regulates Actin, the cell-building protein. Studies have shown large repairing benefits after a heart attack by reactivating cardiac progenitor cells to restore damaged heart tissue.

  • Corticosteroids

Corticosteroids are a class of steroid hormones that are constructed in the adrenal cortex of vertebrates. They’re usually made in the lab, artificially. Ask your doctor about corticosteroids as they need to be prescribed. Injections should be administered around the affected area and never in Achilles tendon.

 

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Surgery

With severe ankle sprains, surgery may be needed for a proper and faster healing. Athletes who want to speed things up may want to consider this alternative.

 

Prevention

There are some foot drills you can do to strengthen your ankles. Try them only after complete recuperation! This means that your ankle should be as good as new before doing these drills. Doing otherwise may be contra productive.

1. Walking using the sides of your feet

Just walk regularly using the sides of your feet as much as possible. Use both the inner and outer sides.

Stand with your feet at around shoulder width. Then, equally place the weight of your body on the sides of your feet and proceed to walk around for a couple of dozen steps. Alternate sides: at a much closer width, while naturally letting your knees cave in, switch to the inner sides and proceed to walk for another couple of dozen steps.

Do them without shoes, on a carpet or similar soft, adherent surface.

2. Balancing using the top of your feet from a kneeling position

 

Ankle-Sprains-The-Runners-guide-seiza

 

Seiza: This drill consists of maintaining balance using the top of your feet from a kneeled or ‘seiza’ position. It’s a great stretch drill that will strengthen the top part of the feet.

  • Start off by kneeling, but instead of supporting your weight with your toes, place your feet flat on the ground.
  • Proceed to lean back so your knees elevate. Balance yourself across the top of your feet. Hold it for half a minute.

A word of caution: most people have to work their way up to accomplish this drill as it’s quite hard. You may need to partially support your weight by using your hands or by placing towels between your feet and bottom.

 

Conclusion

The first thing to do after spraining an ankle is to follow the R.I.C.E. rule (Protect, Rest, Ice, Compression, Elevation). Protect and immobilize the leg, apply ice, light pressure, and elevate the leg. Seek professional medical advice and/or acquire pain and symptom relievers. Design a comprehensive rehabilitation program with your doctor, change your diet/lifestyle, and have patience!

 

Ankle-Sprains-The-Runners-guide-re-injury

 

Re-injury is very common due to insufficient or incorrect rehabilitation, so don’t overlook it, better safe than sorry. Train after rehabilitation and make sure you’re completely healed and prepared before returning to physical activity and sports.

Sources

  1. OrthoInfo, Sprained Ankle, American Academy of Orthopaedic Surgions,
  2. Loudon JK | Reiman MP | Sylvain J., The efficacy of manual joint mobilisation/manipulation in treatment of lateral ankle sprains: a systematic review, US National Library of Medicine,
  3. Healthwise Staff, Sprained Ankle: Rehabilitation Exercises, Online Health and Wellness Database,
  4. Elizabeth Quinn, Ankle Sprain Rehab Exercises To Get You On Your Feet Quickly, Online Health and Wellness Database,
  5. Logan Christopher, 2 Drills To Injury Proof Your Ankles, Sports Conditioning Online Database,
  6. Sports Injury Clinic, Ankle Sprain Exercises, Online Database of Sports Injuries,
  7. John Miller, Sprained Ankle, Physio Works Online Medical Databse,
  8. WebMD, Sprained Ankle: What kind of rehabilitation program should you follow?, Healthwise Medical Topics,
  9. FootCareMD, Ankle Sprain, American Orthopaedic Foot & Ankle Society,
  10. EM CapeTown, The Ottawa Ankle and Foot Rule, Capetown Emergency Medicine and Information,