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“My ankle’s sprained, but I want to run” | The Fight Physio Blog

“I’ve sprained my ankle but I want to run.” – Lily Sullivan

26 Aug 2020

Lily Sullivan is a physiotherapist working at Physio-Logic. She enjoys hip hop dancing and playing the saxophone. Her experience working at Physio-Logic including coming into contact with combat athletes, strongman athletes, as well as everyday folk who simply enjoy running. Her commentary comes from her experiences working with her clients.

   Ankle sprains are one of the most common injuries recorded. An ankle sprain generally alludes to a strong pull/tear on a ligament within the ankle. In particular, there is a ligament called the ATFL (anteriortalofibular ligament), which is the most commonly sprained ligament of the ankle. If you’re reading this, and you’re wondering how long it will take to be able to return to running, it firstly depends on what ligament you have injured and to what extent. It is strongly recommended to see a physiotherapist if you have an ankle injury, so that a full initial assessment can be completed to rule out any other potential pathology/injury.

   There are three grades of an ATFL ankle sprain:

  • Grade 1:a mild sprain(stretching of ligament or small tear) with a little pain/discomfort, perhaps some swelling, stiffness
  • Grade 2: a moderate sprain (incomplete ligament tear) with a lot of pain, notable swelling, some bruising, stiffness
  • Grade 3: a severe sprain with very little to no pain (ligament is ruptured), notable swelling and bruising

   In all three grades, people may find it especially hard to walk in the first 3-5 days after injury. It is strongly recommended to not return to running during this time; in fact, it will probably be too painful anyway. This is the acute stage of healing. It is important to elevate the foot during this stage to help reduce any swelling and to let your body run its course to start to heal what has been injured. During this time, physiotherapy exercises often consist of gentle movements of the ankle in non-weight bearing to help maintain the ankle’s strength and movement, and to promote circulation within the area.

“Balance re-training is often over-looked”

   After this initial phase of healing, pain may start to reduce and you may feel you can move your ankle more as the inflammation begins to settle. This is a crucial stage to start re-introducing strength and balance training of the ankle after your injury. Ligaments are vital structures for balance, so when they are injured, it is important to re-train balance to prevent the injury from happening again. Balance re-training is often over-looked, which is how some people often get recurrent ankle sprains. Physiotherapists can help guide your rehabilitation post-injury to ensure your training is progressed appropriately. Physiotherapists will also address why you potentially sprained your ankle in the first place – more often than not, there is likely to have been a muscle imbalance that was not able to adequately support your recovery when you lost your balance. This can also be due to misalignment of your ankle structures, either before the sprain, or sustained after.

   As you gradually increase your strength, ankle stability and improve your balance, when appropriate, you will be able to start returning to running. It is very important to note that this should be a graduated process, as your muscles have to re-build endurance, strength and perhaps power, as they have not been utilised in this way for some time. For Grade 1 ankle sprains, you may be able to start re-training for running within a couple of weeks. For Grade 2 ankle sprains, this could take 1-3 months. For Grade 3 ankle sprains, this could take 4-6 months on average. If you’re wanting to return to sport, then rehab will also consist of more dynamic and plyometric activity to ensure that you can return to your sport safely.

   Finally, if you have/had an ankle injury, there are 3 take-home messages to remember:

  • Strengthening and balance re-training are both equally important
  • Respect the body’s healing process and pace yourself
  • Stay consistent with your rehab

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