Stand on, stretch, and move a sprained ankle?

Discussion in 'Health & Fitness' started by Bottle Rocket, Jun 11, 2008.

  1. Bottle Rocket

    Bottle Rocket Hall of Fame

    Joined:
    Jan 12, 2006
    Messages:
    2,658
    Location:
    Kansas City, MO
    I just recently rolled my ankle... After getting in an argument the last time this happened with some family members that work in medical related fields about the reasons behind swelling, ice, heat, and all of that stuff, I figured I would come here for some more thoughts on the subject.

    Now, the majority of you will recommend R.I.C.E. I am looking for some more reasons behind these recommendations, as well as some sort of research somewhere that shows that these methods actually speed up or help the healing process. I have not been able to find very much.

    What I did come across was a very interesting article, I think from a skateboarding website. Obviously this guy is no doctor (might even be an absolute idiot, I don't know), but he makes a relatively convincing argument for those looking for more than the usual doctor prescribed "just lay around and do nothing" that you hear for many injuries of this type.

    Here is the article (http://flipcatch.wordpress.com/2007/08/06/ankles-tricking-sprained-foot-fix/):

    I would be very interested to hear comments from you all. After a while, I'll give some of my own ideas that will most likely be shot down by those that actually know what they are talking about.
     
    #1
  2. LuckyR

    LuckyR Legend

    Joined:
    Jun 2, 2006
    Messages:
    6,404
    Location:
    The Great NW
    Two missing pieces of info that are needed to answer your question correctly:

    1- Your age

    2- What is the actual injury to your ankle? The most common minor injury would be overstretched tendons, perhaps some ligament strain if it was really bad. However my wife had a hairline fracture of the inside of the ankle bone where the tendon attaches and she is 3-4 months into the injury and is nowhere near back to normal. You may not know the answer to this question, so you should see someone who can tell you the answer.
     
    #2
  3. Rickson

    Rickson G.O.A.T.

    Joined:
    Jun 16, 2004
    Messages:
    12,740
    Location:
    USA
    That "athlete" gives extremely bad advice and I wouldn't take his advice. Go with the traditional ice method. Your body's natural reaction is to pool blood into the injury site and that would work great several days after the injury, but it only causes pain and swelling at the beginning of an injury. You need to fight your body's natural reaction by taking down the swelling which of course means ice. Do you heal faster from icing the injured area than from never icing the injury? Of course you do because if you let nature take its course, the ankle will swell up and after several days of pain, you'll be able to walk normally again, but with ice, you take away that painful swelling and you'll heal up in a fraction of the time. Ice and heat? Absolutely not! Heat increases the swelling which of course adds to your healing time. Heat can be beneficial after the healing process has taken place, but never during. That guy in the article doesn't know what he's saying. I can't believe he's saying you should take the pain and just call yourself an athlete.
     
    #3
  4. Bottle Rocket

    Bottle Rocket Hall of Fame

    Joined:
    Jan 12, 2006
    Messages:
    2,658
    Location:
    Kansas City, MO
    Here is a post from another forum by a user name Fire Horse. He explains a lot of the things I was curious about and a lot of what Rickson has claimed without presenting anything to back up those claims. I am sort of doing public research I guess - for the greater good of the community, of course.

     
    Last edited: Jun 11, 2008
    #4
  5. Rickson

    Rickson G.O.A.T.

    Joined:
    Jun 16, 2004
    Messages:
    12,740
    Location:
    USA
    You want backup? How's this? Before I became a certified trainer, I experienced a few ankle sprains from playing basketball and in those days, I used to let "nature run its course". Average healing time, 1 week. After I became a certified trainer, I'd ice any ankle injury. Average healing time, 2 days. You do the math.
     
    #5
  6. Bottle Rocket

    Bottle Rocket Hall of Fame

    Joined:
    Jan 12, 2006
    Messages:
    2,658
    Location:
    Kansas City, MO
    Yeah... I understand and appreciate your post. I also have found similar claims from people (such as those who replied to the original article I posted) that claimed the opposite results by doing none of the things you mentioned. This is the internet, after all.

    Another great link:

    http://orthopedics.about.com/cs/sprainsstrains/a/anklesprain.htm
     
    #6
  7. Rickson

    Rickson G.O.A.T.

    Joined:
    Jun 16, 2004
    Messages:
    12,740
    Location:
    USA
    So what is your take on the matter, rocket? Do you believe in icing or do you believe in tough love like that skater dude?
     
    #7
  8. Julieta

    Julieta Guest

    I used to do this all of the time. I believe in icing. Also in ASO ankle braces. The other thing you can do is strengthen the sides of your legs which will help stablize you if you start to go down again. Stand on one leg, get a Bosu etc. But the first thing you should do is get an ASO.
     
    #8
  9. Punisha

    Punisha Professional

    Joined:
    Dec 22, 2005
    Messages:
    823
    RICE for me ... im gonna trust the combined knowledge of our medical professionals... also i concur with the basketball injuries... rice lowers the healing time by alot!
     
    #9
  10. Kevo

    Kevo Hall of Fame

    Joined:
    Feb 3, 2005
    Messages:
    4,157
    I can only offer my personal experience. I've only had one major ankle roll in my life, but it was painful, and it was from a skateboard accident. Go figure...

    Anyway, it was one of those popping sound type rolls and it was the first time ever I've had the kind of pain that prevents use of any kind. I ended up hobbling around for a few minutes and manipulating the ankle by hand to try and determine how bad it was. After I decided that it wasn't broken or totally borked I decided to test it out. Within about 10 minutes I was riding my board home very gingerly. As soon as I got home I iced it for a good while and then I walked on it around the house and stretched it out as best I could.

    The worst part of the whole thing was waking up after my first night of sleep. It was much worse in the morning. I stretched it out as best I could, iced it a bit more and made sure I walked on it several times an hour. The next day it was much improved, and I continued to stretch it and walk on it. I played tennis on it, lightly, after 4 days, and it was probably 95% after a week. It wasn't 100% for a couple of weeks maybe, but I think if I would have kept up with the stretches it wouldn't have taken so long.

    I definitely think the don't use it advice is totally bogus. My mom just finished her second knee replacement, and they had her up standing on it the first day and walking on it the next. She does exercises for several hours a day to make sure it stays mobile.

    I think the main thing is to make certain that the damage isn't so extensive that you might need special care from a doctor. Other than that, use it but don't overdo it. Definitely don't totally ignore the pain.
     
    #10
  11. Rickson

    Rickson G.O.A.T.

    Joined:
    Jun 16, 2004
    Messages:
    12,740
    Location:
    USA
    Kev, you would have healed much faster if you didn't stretch the injured ankle. Ice is to prevent swelling and rest is for recovery. Stretching an injury prolongs healing time although it's a good thing after you've completely healed. That means you can stretch after a week, not during the healing phase.
     
    #11
  12. BullDogTennis

    BullDogTennis Hall of Fame

    Joined:
    Apr 26, 2008
    Messages:
    2,216
    Location:
    Big Orange Nation
    whatever you do just start SLOW. you dont want to take a chance of hurting in more in the long run. its better to stay off it as much as possible for a week or so, then be off it for months.
     
    #12
  13. Bottle Rocket

    Bottle Rocket Hall of Fame

    Joined:
    Jan 12, 2006
    Messages:
    2,658
    Location:
    Kansas City, MO
    Yeah, I'll agree with that.

    Stretching an injury as soon as it happens doesn't sound real smart to me... Especially when it is a tearing of muscles and/or ligaments. Sort of counterproductive, isn't it?
     
    #13
  14. Kevo

    Kevo Hall of Fame

    Joined:
    Feb 3, 2005
    Messages:
    4,157
    I tried the rest and don't use it thing on a more minor ankle injury before. It was over a month before I could fully flex the ankle in all directions without mild pain. I got that injury playing tennis. It was what I would consider a minor sprain. I had some trouble walking on it after it happened, but nothing like the skateboard accident. This injury had only minor swelling.

    With the major sprain I literally couldn't put my foot on the ground immediately after it happened. It was quite scary. When I say stretch it, I didn't stretch it like I would normally. I just didn't want it too stiffen up and be painful for such a long period of time. I would just move it until it hurt and then back off. I was walking on it regularly the next day and played some light tennis on it within a week. This was a huge improvement over my previous experience with an ankle injury.

    The day it happened my wife was talking about getting me crutches. I thought I would be off the courts for weeks. The fact that I was able to walk on it and that it was less painful to keep walking on it gave me hope for a quick recovery.

    Maybe I am totally off base, but I think resting it completely would have kept me off it for a much longer time.

    And, I want to stress that I am only speaking from personal experience and nothing more. I have only basic first aid training and I am not a doctor. If I had medical insurance, the first thing I would have done would have been a trip to the doctor.
     
    #14
  15. Rickson

    Rickson G.O.A.T.

    Joined:
    Jun 16, 2004
    Messages:
    12,740
    Location:
    USA
    You mentioned that it swelled up more in the morning. That's why you ice and rest because you keep the swelling down. If it happens again, and I hope it doesn't, ice constantly without stretching. I guarantee you'll be back on your feet faster. The last ankle injury I had took me just over a day to heal. I was icing the whole time. I walked fine the next day and without any pain at all in 2 days.
     
    #15
  16. Fee

    Fee Legend

    Joined:
    Feb 19, 2004
    Messages:
    7,308
    Location:
    In front of my computer, obviously
    I studied sports medicine for two years. Ankle injuries and shin splints were probably the most common problems we dealt with (community college football team, and every other sport). Of course we had modalities to help heal injuries, but the one thing that we stuck to with or without the modalities was ICE ICE ICE. For at least the first 48 hours, longer if there was still swelling. When the swelling went down significantly, we moved to ice/heat, but never in the extremes described in the first post. It was usualy ice or ice bucket for about 20 minutes, 5 minutes at room temperature, then 20 minutes of heat (whirlpool or heating pad).

    Mobility was also part of the healing, but again usually not for the first 48 hours. The tendons, ligaments, and muscles involved in sprains and strains need time to recover and rest (and release a spasm) before they can be asked to do their old job again. No, you don't want to wait too long, but you don't want to push it either. We would usually check mobility with simple point/flex/make a circle movements, with the leg extended out in a sitting position, or up in a prone position. The athletes would be encouraged to do those same movements on their own as often as possible, but never to the point of pushing it.

    There are other ankle exercises you can do during the healing process that help without hindering (sit in a chair with your foot flat and bunch a towel with your toes, then push the towel back out unbunched, pick a pencil up with your toes, foot circles, stuff like that). Weight bearing should be the last step after all of the non-weight bearing activities become easier, the pain is mostly gone, and the swelling is reduced.

    Sorry I cannot give you any links to this info, and it might be completely outdated by now, but it was what I was taught when I studied to be an athletic trainer (but that was a while ago, I gave up and got a degree in Poli Sci instead). :)
     
    #16
  17. Kevo

    Kevo Hall of Fame

    Joined:
    Feb 3, 2005
    Messages:
    4,157
    Fee, you make a lot of sense. I would be curious to see any kind of clinical studies of injuries that compare healing with no movement of the joint during initial recovery versus movement and limited exercise of the joint during initial recovery.

    Like I mentioned earlier, after a knee replacement they try to get you walking shortly after surgery, and they do push you a little. Without the use of pain killers getting out of bed after the first day would probably not happen. Also there is significant swelling during this as well. I know it's not apples to apples, but I think the movement and exercise limited as it is really makes a big difference.
     
    #17

Share This Page