A Few Ankle Injury Gems

You’ve rolled your ankle! Oh no! It hurts! Should you go get it x-rayed?

My first rule of thumb about going to the ER or to get something x-rayed is: if you think that maybe you should seek help- you should. The body has its own wisdom.

Here’s a way a doctor might assess if your ankle should be x-rayed: http://www.mdcalc.com/ottawa-ankle-rules/   Some tips for reading this webpage: “Lateral view” means looking at the outside of the ankle. “Medial view” means looking at the inside of the ankle. “Posterior edge” means back edge. “Tip of medial malleolus” is the ankle bone that makes a bump on the inside of your ankle (some people have two of these, if you do, the lower one potentially an extra navicular, the higher up one is the tip of the medial malleolus).

That’s really about it.

If you think it’s ‘just’ sprained:

RICE it (rest, ice, compression, elevate), take it easy, let your pain be your guide. Note that “REST” is first- lay off it as much as you can. Each step you take *right after* you injure it is said to be roughly equivalent to an extra hour of healing time. Those 24 steps you took over to that rock to sit down? That’s another whole day of healing time added on. Expect the pain to get worse and better and worse and better and for the healing to take longer than you’d think. Yes, it’s really frustrating. No, you can’t just go trail running whenever you want and expect good, speedy healing. Yes, that applies to you even if you’re some crazy-badass and even if you’re just plain ornery. Yes, that pretty much describes all punks.

Here’s why the same ankle gets twisted over and over:

  1. It’s not because of “weak ankles”
  2. It’s because the brain doesn’t quite understand WHERE IT IS

When you twist your ankle real well, you tear these things called ‘proprioceptors’. Proprioceptors are little sensory thingies that tell your brain where your body is in space, this is how you can ‘feel’ roughly where your body parts are without looking at them. When they’re busted you tend to put your ankle down willy-nilly when you’re walking or running, and you’re less likely to compensate quite right when you step on a rock or a root or whatever… i.e. you twist that same darn ankle again.

If you don’t do some pretty specific ankle ‘rehab’, the connection between your re-growing proprioceptors and your brain never re-sync and you’re at greater risk of re-injury

Think of it like when your computer and your router aren’t ‘talking’ to each other even though they’re both on and working. So the ankle ‘rehab’ is a little like resetting the router, it re-establishes the connection between your brain and the proprioceptors. The main things here are to let your pain be your guide (don’t ‘push through it’) and to follow some kind of recommendations for ‘ankle sprain physical therapy’ (look this up online, I’m not linking to one b/c there are so many available.) The best ones might be where you stand on one foot on something sort of unsteady like a big piece of foam or a half-yoga ball. Get creative. Don’t fall over. All the tiny wobbly movements that happen when you balance helps your brain re-coordinate with the proprioceptors and reduces your risk of re-injury.

Drugs:

If you want the anti-inflammatory effects of ibuprofen (advil), you actually need to take it every 4-6 hours (or whatever the directions on the bottle say) for at least a couple of DAYS before the anti-inflammatory effect starts to happen. If you take less than the recommended dose, or you don’t take it every few hours, you’ll get the pain-relieving effect, but NOT the anti-inflammatory effect. Pain relief is nice, but the anti-inflammatory effect arguably does more to help you get better. Don’t be afraid to take advil for a few weeks to help your injury heal, when taken this way it’s really a pretty safe drug and won’t turn you into a capitalist and it isn’t a sign of physical or moral weakness (I promise). Don’t let the haters get you down; it’s ok to take drugs when you need them.

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