Ankle ow woe

February 15, 2007 4:50 AM

This woman in her twenties gets her left ankle sprained every few months. It's very painful, and she does the ice-compression-elevate thing. She wants to reduce the reoccurance of this without wearing a brace forever. Do you have any advice?
posted by Arcaz Ino to health (29 comments total)

She is not exerting herself when it happens, just walking around.
posted by Arcaz Ino at 4:52 AM on February 15, 2007

Do ankle exercise, learn how to balance on a a bosu (?) balance ball or board, learn ballet, Just basically learn not to roll your ankle and be more aware of when its about to roll.
posted by stormygrey at 5:18 AM on February 15, 2007

Strengthening the ankle should help. I used to have the same problem, then I saw a physical therapist who gave me some exercises to do.

I think once she gets the basic exercises going on, and some level of strength built up, she could take up some more fun ankle-strength activity, like hiking or some kinds of dance.
posted by amtho at 5:22 AM on February 15, 2007

I used to get this loads. Try to strengthen the little stability muscles. Not sure what they're called. Exercises to help include

• Standing on one foot (once you get good at this shut your eyes)
  
• When sat down, get a tennis ball, put it under the ball of the foot and write the alphabet on the floor with the ball (good to do at the desk)
  
• Get a wobble board and follow the instructions
  

Basically though, you need to make yourself more stable on your feet. Walking on uneven surfaces more can help (on grass, through woods). I think we spend too much time walking on flat safe surfaces so when we hit anything vaguely challenging our ankles go.
posted by handee at 5:23 AM on February 15, 2007

Seconding stormygrey's recommendation - I have serious knee problems going back to when I was a kid, and the only solution to it I've found is to do certain excercises that strengthen the muscles supporting my knee, stopping the cartilage wear and dislocation.
Knowing how she should use her ankle, as well as strengthening the muscles that will aide it is basically all she can do other than bracing it.

I'd also recommend she see a physio at least once to work out a range of excercises that will best suit her problem, so as to not exacerbate her problem.

Oh, and tell her not to try skateboarding!
posted by opsin at 5:25 AM on February 15, 2007

And as handee mentions, the way we walk (shoes and flat surfaces) causes huge problems not only for our feet and legs, but our spines. The more time we spend barefoot on dodgy surfaces the better.
posted by opsin at 5:26 AM on February 15, 2007

Stand barefoot on one foot for several minutes each day. Alternate which foot.
posted by OmieWise at 5:35 AM on February 15, 2007

Standing on a VERY dense piece of foam, both feet, either foot, front or back of foot (varying as you go) is the main exercise my partner's therapist gave him for a very bad sprain he got doing step exercises at the gym. This foam is denser than any I've ever seen, and about 4" thick. So dense, it feels kind of weird.
posted by Goofyy at 5:35 AM on February 15, 2007

This was me a year and a half ago, except it was my right ankle (and fortunately, not that painful).

The advice I was given was:
-try not to wear an ankle brace--it prevents your ankle from developing the muscles and whatnot that can help you not sprain it again.

-do proprioception exercises (I was told to pretend that I was writing out the alphabet with my big toe--a slight variation of what was mentioned above). I googled for some, most of which were on the simple side (balancing on one foot in specific poses, walking barefoot one foot in front of the other, etc.) AFAIK the idea is not so much to strengthen muscles but to improve the nerves that help your body keep track of exactly where your foot is and what it's doing.

-walk barefoot as much as possible
posted by needs more cowbell at 5:43 AM on February 15, 2007

Has she had it checked out by a doctor? I have a similar problem from an over-stretched tendon in my ankle from an old injury; it "sprains" or feels like it does if I take a step wrong because of the lack of support.

Just another possibility.
posted by azriel2257 at 6:06 AM on February 15, 2007

I used to have a lot of issues with my left ankle. Yoga really helped. Lots of balancing - and a lot of stretching that helped strengthen the area. Simply balance on one leg now and again can be an enormous help - if you do it in a corner and close your eyes (as Handee recommends), you'll reduce the likelihood of falling down. Apparently closing your eyes forces your mind to concentrate more on the muscles that need to be worked.
posted by backwards guitar at 6:09 AM on February 15, 2007

azriel2257, how did you treat your overstretched tendon? Did you do something other than bracing and/or exercises?
posted by Arcaz Ino at 6:16 AM on February 15, 2007

How about better shoes with more stability?
posted by M.C. Lo-Carb! at 6:26 AM on February 15, 2007

Perhaps she needs orthotics? I've got extremely flat feet, which caused me to twist my ankles and fall over frequently as a child. A podiatrist helped me get that straightened out, and I fall over much less often now.
posted by Faint of Butt at 6:36 AM on February 15, 2007

Tai chi and related exercises.

And flat shoes.
posted by pracowity at 7:05 AM on February 15, 2007

I sprained my ankle in December, so I'm working on some of the same issues (I do not want to sprain it again!). My doctor reccomended the alphabet exercise while my ankle was healing. I also found that buying a better pair of shoes provides more lateral support, which seemed to really help my healing time. I tried on a bunch of different cross-trainers until I found a pair that provided all-around support and that didn't hurt to walk around in (K-Swiss, for me).
posted by muddgirl at 7:05 AM on February 15, 2007

i sprained my ankle a few years ago and it took FOREVER to get better cuz i kept respraining it. As Backwards Guitar said, yoga really helps. it strengthens everything basically, but its especially good for ankles. Also, and this is so important - dont tempt fate! which means for me, no ice skating! no crazy high heels!
posted by silverstatue at 8:09 AM on February 15, 2007

Back when I was a running track and cross country in high school and college this happened to me, and since I always wanted to run if I possibly could, I always came back to competition as soon as it felt remotely better. But the ankle never really had a chance to heal, so every time I rolled it even a tiny bit, I'd reactivate the injury. Finally an orthopedist ordered me to quit running, stay off of it during my normal day, and do all of my training in the pool for 10 weeks so I wouldn't put any load on the ankle at all. After that, it was actually better.

The moral of the story is, make sure the affected ankle is actually healed before you return to normal activity and lay off of it as much as you possibly can while recovering from the sprain. It might feel 'better' after a week, but that doesn't mean that all the damage has been repaired.
posted by dseaton at 8:16 AM on February 15, 2007

If she is very flexible or limber in general, and particularly if she is tall and slender, she might want to mention the ankle and her flexiblity to her health care provider.
posted by jamjam at 9:01 AM on February 15, 2007

You wanna know what worked for me (male)? SCAR TISSUE. As a kid and a teen, I was constantly spraining my ankle. I finally tore some ligaments while in college and ended up in a cast. For about a year I had extremely poor range of motion, but eventually it worked itself out and haven't sprained that ankle since. About ten years later I tore ligaments in the other ankle. Same treatment- cast and all that. It responded the same way- took a long time to get range of motion back, but both ankles are bulletproof now.

Looking at dseaton's response, there may be something to that; when I tore up my ankles good, the scar tissue forced me to take a good long time to rehab them.
posted by Doohickie at 9:02 AM on February 15, 2007

This isn't normal, and she shouldn't be trying a DIY approach to it. She should be seeing a physical therapist, getting professional advice and following it to the letter.
posted by nanojath at 9:37 AM on February 15, 2007

I sprained my ankle no less than 12 times when I was younger. I swear... I'd look at something funny and my ankle would sprain. It was ridiculous. My ankles are very thin, I can wrap my fingers around and the tip of my thumb will touch the tip of my third finger. They snap like twigs.

What ended up helping me was yoga & strength training. (And giving up on learning how to ski.) But especially yoga. I used to go 3-5 times a week. I don't go now, but from that training my ankles are still stronger than what they were before. I went 12 years with no sprained ankles until last April when I did something stupid & had a nice broken foot/ankle sprain combination. I TOTALLY earned that injury, though... it wasn't just because I walked crooked or something.
posted by miss lynnster at 10:34 AM on February 15, 2007

Ankles are slow to recover (as dseaton said) and never heal as fast as one would like. If you really want to get better, you'll have to committ to limiting social activity for about a month. Give the ankle time to heal.

Nanojath is also right - see a physical therapist - if money/insurance is aproblem, then make sure you get a really good one, and go once and ask for exercises you can do on your own. They may even be able to hook you up with ankle strengthening devices.

Why should you believe me? Because I've sprained each ankle 3-4 times, and never properly rehabbed. What happened? I injured it again and needed surgery. The operation was in October and I am still going to rehab. You don't want this to happen.
posted by taliaferro at 11:45 AM on February 15, 2007

PS - good luck!
posted by taliaferro at 11:46 AM on February 15, 2007

Arcaz Ino; I use a lot of sprained ankle exercises (the kind they give you on a photocopied sheet at the doctor's office), like writing the alphabet using your foot, but I still use an ACE bandage on occasion when it starts acting up, or very stiff boots. I also keep an air-cast handy in case it gets really bad. You can probably find diagrams of those basic exercises online.
posted by azriel2257 at 12:49 PM on February 15, 2007

Mostly repeating what others have said:

-See a doctor
-Stop wearing ankle braces
-Do ankle rehabilitation exercises to strengthen the ankle when the immediate trauma has subsided. Specifically the elastic band exercises are what I use to rehab strained ankles. You can get the elastic band/tubing from a pharmacy, or it will be given to you by the physical therapist your doctor sends you to.
-Stop wearing high heels?
-The best way to use ice to fight the ankle swelling immediately after the injury is to fill a bucket with icewater, and a little salt and immerse your whole foot and ankle for 15 min or so.
posted by Manjusri at 1:08 PM on February 15, 2007

Another tip, don't favor the ankle while injured too much. It's a fine line between returning to activity too quickly, and too late. Basically you want to start using it while it still gives you some discomfort/tenderness/stiffness, but not when it is causes severe pain or swelling.
posted by Manjusri at 1:12 PM on February 15, 2007

She needs to go see a podiatrist. This isn't a strength issue, it's a gait issue (spraining it while just walking? yeah, something is wrong with the way her legs and ankles work). Exercises and stuff aren't necessarily going to fix this and, since she doesn't know what's actually wrong yet, they could be counter productive if she does the wrong ones.

I used to do the same thing and orthotics literally changed my life. No more injuries, I'm more mobile, exercise more and am free of pain. Pain I didn't even realise was there I'd got so used to living with it. Shoves these things in my shoes and I'm normal again.

Continual sprained ankles during normal movement are a classic symptom and the answer is a total no-brainer. A podiatrist is the appropriate person to talk to and they *will* be able to help your friend in some way.
posted by shelleycat at 1:21 PM on February 15, 2007

I should mention a podiatrist may give her exercises to do and will advise her on how to build the muscles back up again. But they'll do it in the context of how she walks and aimed at correcting her gait issues. This is why she needs to see a podiatrist rather than just a physiotherapist.
posted by shelleycat at 1:23 PM on February 15, 2007