Dear James,
A few weeks ago, I sprained my right ankle while scrambling down a cliff path to the beach. I think the main factor was that I was carrying a backpack which, though not heavy, moved my center of balance in an unfamiliar way. Also, my sandals were very worn at the outer edges of the heels. I have been elevating and doing the rehab exercises you recommended as well as applying this thing to my calves and I got a pair of cute new sandals! They have a slight heel and I have noticed that walking in them is much more comfortable than in flat shoes. What can you tell me about ankle injuries and rehab?
Sincerely,
Lynn
My Dear Lady,
Initially after Injury
Sleep on a couch with your injured foot raised on the back.
Ice it.
Use kickboxing ankle braces for compression when active and swollen.
Brace both ankles, even the uninjured one as you will unconsciously shift stress to it.
Do not just rest it. The sooner you can get blood pumping through the quicker healing can begin.
A good blood flow exercise while still swollen is to lay on your back and do bicycle motions, leg presses, scissors, and side leg laterals while lying on your side.
The right ankle has less blood flow and will heal more slowly than the left.
When Mobility Returns, Swelling is Minimal and Pain Subsides
-Practice doing the activity that you were doing when it was injured slowly, studying your mechanics and attempting to do more while flat footed and with less ballistic motion.
-Stand on the other foot and roll the ankle around the joint, reversing directions slowly, and make this part of your every day injury prevention. In general, injury recovery exercises should be maintained as preventive measures.
-Massage will help break up adhesions, in which injured tissue clings to muscle and skin and will promote blood flow.
-A BAPS board is a great ankle development tool.
-Once ankle and knee injuries start, reduce running, jumping, lunging and “scrambling” activity and focus more on walking.
-It will take your ankle 10 months to fully recover.
-Continue to brace both ankles in the future during any activity that previously resulted in injury.
-Sandals are cute.
-Heels do help. I switched from flat-bottomed sneakers and boxing boots while stick-fighting and boxing as of 2001, to military “jump” parade boots as the leather upper braced the ankle and the slightly elevated heel permitted a pre-chambered acceleration, like a sprinter’s starting block, and reduced the stress of ballistic activity.
-Warning, on uneven terrain, a heel poses some danger if the upper of the footwear does not extend 2 inched or more above the ankle. The sandals with a ½ inch heel will be an improvement on flat surfaces, but not for scrambling. For scrambling moccasins or bare feet with ankle braces are ideal. Heels higher than ½ inch are dangerous.
-Boots and high-top sneakers that have uppers that stop at or below the ankle increase torque and injury. If hiking and the boots does not lace higher than the ankle, it is safest to lace it low and leave the part of the upper around the ankle unlaced. This is how I wear my Keene’s. You will still roll your ankle but the misstep will not have as much leverage on your tendons.
-For the above reason, the sandals, on the flat, are probably better than sneakers and other ankle high shoes that lace further up. Note that in early MMA it was found that simple wrestling shoes left a man open to ankle locks.
-The worst footwear for the ankle is a hard boot with a higher than ½ inch heel that laces right at the ankle.
-Finally, doing toe-heel alternating raises and making the tendons stronger will help them from being involved in future ligament injuries and will help the cause of blood flow. Ligaments never heal to 100%. You will get 80% at most back. But you can strengthen its attachment area and muscle base and learn how to be more careful.
When, five years ago, I sprained my ankle walking down the stairs to get some water for coffee, I gave up on my ankles. Then, I discovered that ankle sprains did not stop me from fighting or training. I get multiple sprains a year. Embracing my biomechanical state as fate seems to have relaxed me. Relaxation prevents injury. This is a reminder, that when you roll your ankle, go with it, do not fight it. Fighting it stiffens the joint and makes damage more severe and more general.
Good Luck, Lynn!
James, August 24, 2021, Kamas, Utah