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Ankle injuries: The lowdown for runners

By on Sep 19, 2013
Injured ankle - image

Another RunningInjury recovery guide. We take you through the basics of ankle injuries, before examining how you can speed your rehabilitation.

As a runner, you’ll notice the signs if you experience an ankle injury. First, you’ll probably feel pain. In many instances, that will be quite severe. Second, you’ll most likely experience swelling – for example in front of your Achilles tendon – as well as bruising. Third, the ankle may becomes progressively more uncomfortable as you point your toes, or turn them in, out or upwards.

But the extent to which you experience these symptoms depends on the severity of the injury. As we set out below, that can vary quite significantly across runners.

What causes ankle injuries?

In most cases, ankle pain during physical exertion is caused by a sprain – a stretching or tearing of ligaments. Sometimes, it is related to other injuries, such as Achilles tendinitis.

The standard ankle sprain is an inversion sprain (or lateral ligament sprain). This is where the ankle turns over such that the sole of the foot faces inwards, damaging the ligaments on the outside of the ankle.

While an eversion ankle sprain is less common, it sometimes occurs, particularly with a fracture. This is where the ankle rolls in the other direction, such that the sole of the foot faces in an outward direction, resulting in damage to the ligaments on the inside of the ankle.

The damage sustained in a sprained ankle is typically to the anterior talofibular ligament, which connects the ankle bone (the talus) with the smaller of the two bones in the lower leg (the fibula). In severe cases, the sprain might also damage the calcaneofibular ligament, connecting the heel bone to the fibula nearer the heel.

Ankle sprains are typically placed in one of three categories. A Grade I ankle sprain is where there is stretching of the ligament, accompanied by pain and swelling. Running, let alone jogging, may be impossible.

In the case of a Grade II ankle sprain, the injury is more severe, with partial tearing of the ligament. This is typically accompanied by greater swelling and bruising (reflecting bleeding under the skin) and walking is painful.

Finally, for a Grade III ankle sprain, a complete tear of the ligament is experienced. This will be painful, with walking a challenge, and you are likely to feel quite unstable.

How can I speed my recovery from ankle injury?

Take a look at our dedicated ankle injury recovery store for the full RUNNING INJURY range of rehabilitation products. In addition, the following recovery methods may be of use.

1. Rest. A first step is to rest the injury to reduce pain and prevent further damage. But partial weight bearing is thought to speed recovery and is usually recommended as soon as pain will allow. It may also be possible to follow a reduced training programme, though running on an inflamed or infected joint may lead to longer-term damage.

2. Ice or cold therapy. This can ease the pain, reduce swelling and limit bleeding (as well as stimulate blood flow when applied at a later stage). The standard approach is to apply the cold therapy treatment for 15 minutes as soon as possible after the injury takes place and then repeat every couple of hours.

3. Compression. This approach helps to reduce both bleeding and swelling. Both bandaging and ankle supports can work well, providing support and compression to the injured ankle.

…bandaging and ankle supports can work well, providing support and compression to the injured ankle…

4. Elevation. The final part of the so-called ‘RICE’ approach (Rest, Ice, Compression, Elevation) involves the use of gravity to reduce bleeding and swelling. This allows fluids to flow away from where the injury is located.

Following the initial painful stage, there are other treatments that can help the ankle return to normal as soon as possible.

5. Stretching. As the videos below demonstrate, a couple of stretching exercises are thought to be particularly effective. Ankle circles can aid ankle movement and, when performed with the leg elevated, can also reduce swelling.

Gentle stretches of the calf muscles can also support ankle movement. This is important as, following a sprained ankle, the calf muscles commonly tighten to protect the joint.

6. Medical treatment. While it does not usually come to this, there can in some instances be a need for medical treatment, including potentially anti-inflammatory drugs and antibiotics. But, in cases of overuse injuries, the approaches above (often as part of a programme of physio treatment) are often enough to resolve the symptoms and lead to a full recovery.

When will I recover from ankle injury?

How long you take to recover from ankle sprains can vary widely. But, with a little work and an active approach to rehabilitation, full recovery is common within three months and in some cases takes as little as a week.
More information about ankle injuries

There has been extensive research in this area. One particularly useful paper by Osborne and Rizzo summarises the current literature regarding common ankle sprain prevention strategies and provides a review of appropriate treatment schemes.


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