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Injuries Chronic & Acute

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Old 08-14-2008, 12:19 AM   #1
Bryan Blake
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Neverending ankle sprain

One year ago I ran my first ultra trail race, a 50-miler around Mont Blanc. Given the nature of the terrain - very rocky, single track trails and uneven footing throughout - I ended up rolling my right foot rather severely twice over the race.

For a few weeks after that, the tendons of both feet were quite inflamed, which is not unheard of for a long trail race. The docs just said to hit the Motrin and stay off it. Done.

Once the tendon pain subsided, I started noticing that the upper ankle of my right foot was hurting more and more - but only following a workout or athletic event involving sharp cuts or quick bursts of speed off of the ankles (mainly rugby, but also the occasional WOD). It reminds me of a constant, nagging sprain. Again, performance is not affected, but the pain afterwards has increased to the point of not being able to walk on it or apply any pressure. This only lasts for a few hours, though, and then is fine the next day and the next workout.

I was told it may be a high ankle sprain or high sprain, but the nature of the initial injury was that the foot rolled inwards. The doctors again just tell me it's inflammation and to rest it, which I feel I've done adequately, but it just will not go away.

Does anyone have any experience or knowledge of this sort of thing? I'm at a loss for remedies here: stretching, wrapping and icing don't seem to have any affect.

Thanks for any help.
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Old 08-15-2008, 06:29 AM   #2
Michael Peachey
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Location: Adelaide  SA
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Re: Neverending ankle sprain

Hi there...

Upper right ankle sort of doesn't give enough info! Are we talking just below / in front of the lateral malleolus (the knobbly bit on the outside of the ankle), the front of the ankle (the first part of the 'hinge'), or a little bit higher?

A better description would help differentiate between the ATFL (anterior talo-fibula ligament - the usual culprit in lateral ankle sprains), anterior capsule (often chronic impingement occurs following recurrent sprains), or the inferior tib-fib joint (fibrous ligaments that basically hold the two bones together, and prevent them from making a wish!). They'll all have similar but different management! Could even be another cause!

In the mean time - every time you stir it up, follow the advice that has been given to you, and treat it like a brand new injury... rest, ice, compression, elevation!
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Old 08-15-2008, 09:00 AM   #3
Christian Lemburg
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Re: Neverending ankle sprain

Dear Bryan,

I know this one very well from cross-country running.

Massage the muscles stabilizing the ankle (especially tibialis anterior and posterior, and peroneus longus and brevis - I would guess your problem is in the tibialis posterior) to eliminate any trigger points caused by the sprain. This will prevent chronic problems with your ankle, and give you full ROM again. The Peronĉi longus and brevis extend the foot upon the leg, in conjunction with the Tibialis posterior, antagonizing the Tibialis anterior and Peronĉus tertius, which are flexors of the foot.

For prevention, balancing exercises are the way to go.

My favorites:

- star reaching: stand on one leg, reach out with other leg in all directions (star pattern), as far as you can go, ideally in different heights

- vacuum cleaner: stand on one leg, pretend the other foot is a vacuum cleaner and "clean" the floor around you (just not touching the floor)

- incorporate running in a criss-cross pattern in your running workouts (like interval training)

Good luck, and fast recovery,


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Old 08-19-2008, 09:46 AM   #4
Benjamin Husted
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Location: Marblehead  MA
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Re: Neverending ankle sprain

1. Doing the letters of the alphabet front and backwards with each foot has kept my ankles nice and healthy. I'll usually do it twice each side. One direction first then the other right after.

2. You can also use resistance bands to do 4 direction exercises. (Tie the band around a post of some kind, then do the exercises either sitting or standing on one leg.)

Good luck.
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