Throughout the lockdown I have started to run a lot more. A few years ago, I used to run 3 to 4 times a week and enjoyed it so much; I found my love for it again during this lockdown. After a few weeks of building up some endurance and speed, I really wanted to test myself with a 5km time trial. I began my warm-up, a slow paced jog, just to get my legs in motion. Running along an uneven (but familiar) path, ahead of me I noticed a dog walker, so I moved to one side to give the 2m of distance – and disaster (maybe an exaggeration) struck!!
Unknowingly and completely unprepared, I stepped partly onto a brick and sprained my ankle. At this point I did say a few superlatives and just thought to myself, ‘For god’s (original word may not have been god!) sake, just when I am getting started again, what am I going to go now?!’ Angrily and drowning in self-pity, I limped home, slammed a few doors and then sat with a bag of frozen peas on my ankle. Previously, whenever I had an ankle sprain, I would spend the next few weeks, just doing nothing, icing as and when I felt like it and hoping that by magic I could run. I’d even go and try and run it off – ridiculous!
This time though, I thought what would I tell the people who I treat? How would I get them to handle things at home? I, surprisingly, began to follow my own advice!
I’m not going to go into details of what ligaments, tendons etc were strained and how severe, as I want to go through what I did at home to help myself – there are a few links below that have far more detail if you are interested.
I’ve been using the POLICE principle when thinking about injuries. It is similar to the RICE/PRICE principle but with a few tweaks. POLICE stands for:
Protection
Optimal Loading
Ice
Compression
Elevation
I Protected my ankle – basically made sure that I did not put it under any more strain that may cause damage. What I did differently this time though, I continued to move it within my pain. Limiting movement completely is thought to be damaging to body tissues (Bleakley, Glasgow and MacAuley, 2011). This is where the Optimal Loading came in. As I mention, rather than just keep it completely still, I started with some simple movements of the ankle. Just sitting on the sofa watching Hey Duggee with my little girl, doing non-weightbearing movements. That was literally the morning after injuring my ankle.
Over the next few days/weeks I increased the movement types, and also started to include a resistance band to load my ankle tendons/ligaments. The whole point of all this is to allow the range of motion of my ankle to remain/increase, and to start building strength early on in the healing process. Inactivity results in loss of strength and range of movement.
I did also use Ice, Compression and Elevation regularly. In the first week, I would strap a bag of frozen peas to my ankle for 15 mins, and then repeat that a couple of times a day. The idea is to help create an environment to heal the damaged tissue.
Another approach that I took on this occasion was to include some balance work. Simply, every time I boiled the kettle, I would stand on the leg that was injured (when there was enough strength) and just balance. To increase the difficulty and benefit, I then would stand in front of a wall and throw a tennis ball against it and catch it. This really helped me to gain a better sense of balance again. A combination of balance, proprioception, strengthening, stretching and range of motion is thought to be the best way to recover from ankle sprains.
Doing a combination of all of the above has helped me to recover better and quicker than I have before, and I am now back to the beginnings of running again. The main reason I have written this is because it can seem like the end of the world for runners, or anyone when they injure themselves, but there are things that you can do to help yourself and feel like you are making progress. If you are injured, or have been before and want some advice on ways to help yourself and ways that I can help, get in touch!
*Note – I haven’t put specific exercises, repetitions, time scales etc as these depend on the individual and severity of the injury – it’s best to discuss these on an individual basis.
Useful Links and References:
https://www.health.harvard.edu/pain/recovering_from_an_ankle_sprain
https://www.physio-pedia.com/POLICE_Principle
https://www.healthline.com/health/how-to-heal-a-sprained-ankle-fast#exercises
Bleakley, C., Glasgow, P. and MacAuley, D., 2011. PRICE needs updating, should we call the POLICE?. British Journal of Sports Medicine, 46(4), pp.220-221.