How to Run with Sprained Ankle

Ankle sprains are one of the most common musculoskeletal injuries, and are caused by a sudden over-stretching and tearing in the ankle ligaments, usually when we twist or ‘go over’ on an ankle. A ligament tear can be partial or complete, and this dictates the level of the injury and how long it will take to mend. An ankle sprain is more likely if you have previously sprained your ankle, as this will lengthen and weaken the ligament and leave your ankle joint with less stability than before, predisposing you to further injuries.

How will I know if I have sprained my ankle ligament?

You will probably be aware of twisting your ankle during a run, but you could incur a small strain without realizing it and just feel some tenderness later on. Your ankle may become swollen and reddened, could be tender to the touch, and the ankle joint will feel unsupportive or wobbly.

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A partial tear means that the ligament is still attached across the ankle joint and continues to provide some stability; a complete tear through a ligament will provide no stability for the ankle joint. Although the amount of pain may not directly relate to the ligament damage, a complete ligament tear will generally be more painful when the foot is moved than a partial tear. If you have a bad ankle sprain, you may need an X-ray to evaluate the damage as ligaments attached to bone sometimes pull a piece of bone away as they tear.

What causes it?

An ankle sprain is usually caused by sudden movements, changes in direction or uneven ground tipping the foot over. A previous sprain may weaken the ankle joint so that it is less supported than normal, and this may cause further ankle sprains.

Can I continue to run?

This will depend on the severity of the sprain – a small sprain may be fine during short runs, as long as the ankle joint isn’t tested by uneven road surfaces and you have plenty of ankle support. However, the last thing you want to do is turn a small sprain into a bigger injury by going over on your ankle whilst the ligaments are weak, so the best advice is to rest it until it is mended.

How can I treat it?

Ankle sprains should be iced and rested, and keeping the foot up can help to reduce inflammation and swelling. An elastic bandage can also help to reduce inflammation through compression around the injured area. Depending on the severity of the sprain, you may need to stay off your feet for a day or two. If your sprain is any worse than this, an X-ray, crutches, a plaster cast or surgery may be required.

Remember that ligaments support joints, and if your ankle ligament has been partially torn, it will be unable to provide full support for your ankle joint. For a few days after a sprain, consider wearing a support bandage around the ankle, avoid high impact activities such as running, and be careful of uneven terrain. Wearing a pair of hiking boots or trainers with ankle support may be helpful until the ligament mends.

How long will it take to mend?

This will depend upon whether you suffer a partial or complete tear of the ankle ligament. Partial tears may take from a few days to weeks to heal, but for complete tears requiring plaster casts, you’d better hang up your running shoes for a while…

Prevention is better than cure

Although wearing ankle supports such as a neoprene bandage can help to stabilize the ankle joint, the best thing to do is strengthen the muscles and ligaments around the ankle as follows:

• Although running off-road on uneven ground can cause a twisted ankle if you don’t watch where your feet are going, uneven terrain will help to strengthen the ankle joint. Every time the muscles and ligaments in the foot are ‘tested’ on uneven ground, this works and strengthens the parts of the foot that are responsible for preventing an ankle sprain.
• Invest in a wobble board! Balance training has increased in popularity over the last few years. It is a functional exercise where the muscles, tendons and ligaments are exercised in the same way that they function on a daily basis, making them better at ‘doing their job’. Balance training is also great for strengthening core muscles (abdominal and lower back muscles) and stabilizing muscles which are often weak and contribute to poor running form and injuries.