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Ankle & Leg Sprain in Runners

by | September 30, 2020

What Is An Ankle or Leg Sprain?

A sprain is when the ligaments of a joint in the leg are damaged. This injury to the ligaments can result in a decreased instability which can start the process of arthritis and degeneration in the injured joint. This is different from when there is a fracture of the bone or when there is a strain of the muscle. Unfortunately, when someone initially gets injured, it is difficult to tell what type of injury that the person has. This ends up causing problems because some studies have shown that there is a decrease in physical activities and worse function that is seen up to one year after having an acute ankle sprain.

What are the symptoms of a sprain?

Pain, tenderness and swelling of the joint are the most common symptoms of a leg sprain. Bruising is possible depending on the severity as is a decrease of the range of motion and a loss of function. Pain can be present on weight bearing and walking or a person might not be able to bear weight or walk. It is extremely common to have a major amount of swelling and bruising after spraining an ankle.

Who get sprains of the Leg or Ankle?

There are couple of factors that have the tendency to predict whether or not people will get ankle sprains. These include having a history of ankle sprains, being younger in age, having greater height or weight, having self-reported instability and having impaired balance. Notice that many of the factors listed rely on having a history of ankle sprains and quite often there is no attempt at professional rehabilitation.

Another thing that has the tendency to predict having leg sprains is concussion, specifically the alterations in functional movement that can occur after having one. Incomplete rehabilitation after a concussion can allow this to happen.

When should you seek help after a sprain?

It is definitely dependent on the person but there are certain situations where you should seek help after suffering from a sprain of the leg. For issues in the knee, people that have been injured that are over the age of 55 or have tenderness only on the kneecap or cannot bend the knee more than 90° or are unable to take more than four steps should definitely seek help. For people that have injured their ankle, is a good idea to seek help if you have specific pain at the back edge of either of your ankle bones or specific tenderness on the inside or outside of the middle part of the foot or if they are unable to take more than four steps.

One situation is where you’re not sure whether or not it is a sprain/strain or a fracture. You can go to the emergency room or urgent care, if necessary. If you have a relationship with a chiropractic sports physician, an appointment can be made and x-rays can be ordered without having to possibly wait for a long period of time at the ER or urgent care.

ankle and leg sprains in runners

For those that have decided to play doctor themselves, if the injury is not feeling better within a week, it would be best to make an appointment.

will an ankle sprain heal on its own?

The pain related to a sprain is dependent on how severe the ankle sprain is. Mild ankle sprains usually feel better in a couple weeks whereas moderate sprains can take 3 to 6 weeks. Severe sprains can take several months for person to recover and probably need surgery. Notice though that in the mild and moderate cases I did not say that the person was healed.

Sprains occur when the capacity of the ligament is exceeded by the injury that was suffered. These injuries can be partial or complete. The best way to think about this is to think about the ligament as being 100 strings that are suspending some type of weight. If the weight is lifted and dropped, some of the strings may become damaged. If 10 strings break then the ligament will still work, but not quite as well as what it did before. The more strings the break, the less intact the ligament be. If all the strings are broken, then the ligament does not work at all.

If the ligament is damaged but still intact, future loads on that ligament will be distributed among fewer individual fibers. At this point, the ligament will elongate and stretch more under smaller loads and because each fiber in the ligament bears more of the load, it takes less load in order to further damage the remaining fibers. This means that anyone who has suffered a sprain injury to an area is more likely to suffer more sprains of that joint, even if the person appears to have fully recovered from the injury. This is what makes people more prone to having ankle sprains once they have suffered one as noted above.

how to treat an Ankle or leg sprain?

The most important thing to know when it comes to treating a sprain of the ankle or leg is that stretching the injured area is not a good idea. Sprain occurs from overloading the ligaments and it is easy to damage already injured tissue if trying to stretch the area.

The thing that was taught for years in first-aid was the concept of RICE: rest, ice, compression and elevation. Currently in the research there is a struggle with what is the best thing to do. I think that most would recommend icing in the area in order help to control the swelling for a day or two but this is supposed to be now up to patient preference. There are other concepts that seem to be made up in a contest for coming up with acronyms like MEAT, ARITA, MESH and METH. Look at my blog (BestToledoChiropractor.com/Blog) if you want further explanation for what these concepts mean.

Initially, most would recommend using ice in order to help to control the swelling many people have the tendency to rely on ice and compression for too long after an injury. It is well-known that movement helps to decrease swelling and increase the person’s recovery, but this does not have to be a weight-bearing type of movement.

Kinesiotaping can be one of the most effective treatments for people that have an ankle or leg sprain. Kinesio tape has the ability to decrease swelling and even drain extensive bruising. Kinesio tape can also be applied in order to support/brace the joint. Because of the ability for kinesio taping to reduce swelling, I have never recommended that someone use compression with an ACE bandage to treat a sprain. Most often after a sprain, chiropractic adjustments are not recommended for the injured area but may be appropriate in other areas depending on the circumstances. Graston Technique can be effective at treating sprains.

Now the thing to remember is that ankle or leg sprains are ligamentous injuries and they should be treated as such. Often times people are back to engaging in sport within 10 days of the injury, which is well before full recovery has occurred. Around 70% of people report additional ankle sprains within a year after the first injury and nearly 45% report incomplete recovery up to three years after an injury. Now this is not to say that somebody that has an extremely mild sprain needs to be on crutches for several weeks, but it is something to consider with somebody that has a moderate level sprain. Those that limit the offending motion for six weeks and brace the joint for 12 weeks allow time to heal and protect the area against further injury. Those that take the initial injury more seriously less likely to have pain dysfunction and further injury at the one-year mark.

Certain motions are extremely important like ankle dorsiflexion, which is raising the foot upwards. Injury and prolonged bracing can decrease the ability of the ankle to dorsiflex which can lead to multiple other problems. Proper rehabilitation (in the form of corrective exercises) of ankle or leg sprains is extremely important as well.

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