Sprained Ankle or Broken Ankle? What To Do When You Roll Your Ankle Running
Before going to the walk-in clinic after you roll your ankle running there is actually a decision-making process to get you back running faster after rolling your ankle. In this blog, we are going to share with you the steps you need to determine if you have a sprained ankle or broken ankle so you can get back to running and spend less time and money at the doctor’s office.
This blog discusses what an ankle sprain is, how to determine if your ankle is sprained or broken, what the signs and symptoms are of an ankle sprain, how long it takes to recover from an ankle sprain and how to recover from an ankle sprain.
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How Does An Ankle Sprain Occur?
An ankle sprain can occur when you roll your ankle. This can happen when you’re running on uneven pavement, you step on a rock, running on trails with roots and uneven ground, and even if you’re trying to avoid an animal during your run!The actual “sprain” of the ankle happens due a specific traumatic event of inverting your ankle when you roll your foot to the side, in what we call a plantar flexed position. Plantar flexion is known as the loose packed position at the ankle, meaning that this is the least stable position of the ankle. If the surrounding musculature is not strong enough to support the ankle, the ankle will roll (or invert) upon landing or turning which results in an ankle sprain.
What is an Ankle Sprain or Rolled Ankle?
A “sprain” is a stretching or tearing of ligaments in a joint. Ligaments are the soft tissue that connect bone to bone within the body. There are many, many ligaments in the foot and ankle and
there are specific ligaments that are affected when the ankle is sprained. These ligaments are commonly known as the lateral collateral ligaments and there are three of them, including the Anterior Talofibular Ligament (ATFL), the Calcaneofibular Ligament (CFL), and the Posterior Talofibular Ligament (PTFL). The ATFL is the most commonly sprained ligament when it comes to lateral ankle sprains.
There are three different grades of lateral ankle sprains.
- – A Grade 1 inversion ankle sprain is when the ligament is overstretched
- – A Grade 2 inversion ankle sprain is when there is some tearing of the ligament(s) but there is not full separation
- – A Grade 3 ankle sprain is the most severe ankle sprain where the ligament(s) completely tear and there is little to no stability at the joint anymore.
What Are The Signs and Symptoms of An Ankle Sprain?
Common signs and symptoms of an ankle sprain will include :
- – Swelling
- – Point Tenderness over the injured ligament
- – Bruising along the lateral ankle and foot
- – Feeling of instability
- – Stiffness/difficulty with range of motion
- – Inability to Weight Bear
It’s very important to recognize these signs and symptoms. MAKE SURE to get evaluated by a medical professional. These are good to know but it is important to rule out a fracture… so let’s get into how we diagnose these types of injuries and settle on the title of an ankle sprain instead of a fracture!
How Do You Determine if You Have a Broken Ankle or Sprained Ankle?
If you sprain your ankle, you’ll see some of those signs and symptoms listed above. You’ll have pain on the outside of your ankle, you’ll have some swelling that’s localized to the outside part of your ankle and it will be difficult for you to move your ankle.
NOW, if you cannot put weight on your foot or you have bony tenderness, meaning the bones on the outside of your ankle or foot are tender or painful, the biggest thing you need to do is rule out a fracture.
You’re probably wondering, how do we determine if there’s a sprain or a fracture? We utilize something called the Ottawa Ankle Rules. This simply means that if you have pain on the outside of your ankle after you roll it and you’re unable to take steps or walk on the ankle right after it occurs, we’re going to want to send you for a radiograph (an x-ray) in order to rule out a fracture.
This is to make sure that the outside bone is not broken. It is possible that upon the trauma of rolling your ankle, that the fibula can fracture. If there is bony tenderness as well as pain in the area, we would want to immediately send for an x-ray.
The first step after the x-ray is to determine if there are any fractures and be positive that it’s an ankle sprain. From here, your doctor or physical therapist will be able to do an evaluation and diagnose an ankle sprain.
At this point, you’ll want to make an appointment with your local running physical therapist to properly diagnose your specific scenario and get you going on the right treatment plan.
How Long Does It Take To Recover From a Sprained Ankle?
So… you’ve been diagnosed with an ankle sprain. You’re probably, what the heck do I do now? The prognosis on how long you need to recover to get back to running is going to be variable. No two ankle sprains are the same and no two rehabilitation programs will be the same. It is going to depend on how many ligaments are involved and what grade the ankle sprain is.
Did you sprain one ligament or two? Is it a grade 1 or grade 3? It’s also going to depend on the possibility of a displaced fibula. If you’re restricted in motion at your ankle and you sprain your ankle, there is a possibility of your fibula displacing or subluxing.
Once your healthcare provider has determined exactly what is going on with your ankle sprain, you will be able to have an idea of your prognosis and get started on your rehab!
What Should I Do Right After An Ankle Sprain?
You’re right off the injury. You’ve ruled out a fracture and you’ve been diagnosed with an ankle sprain. You have some swelling, maybe it’s painful to walk and move your ankle. So, what should you do? During this initial phase, or what we’ll call the maximum protection phase, we’re going to want to follow the acronym PRICE-MEM.
This acronym stands for:
- P – Protection – In this stage we are going to want to protect the ankle from further injury. This might mean with an aircast, with crutches, or with a walking boot depending on the severity of your sprain.
- R – Rest – This doesn’t mean complete bed rest. You can do active rest. Maybe this means that after a couple days, your in the pool swimming, or you on a recline bike peddling. We just want to make sure we’re not putting too much stress on the ankle as it’s in it’s initial healing.
- I – Ice – For the first few hours after injury, icing for 20 minutes on and off will help decrease the inflammation!
- C – Compression – Utilizing compression sleeves and braces or an ace bandage wrapped around the ankle in a spica will help decrease the swelling and stabilize the ankle joint.
- E – Elevation – This does not mean just throwing your leg up on a chair next to you at work. For the elevation to really assist in the healing process, your ankle will need to be above heart level!
- M – Manual Therapy – This is specifically to help decrease swelling and increase a little bit of mobility. Manual Therapy will be performed by your physical therapist.
- E – Early Motion – Gentle ankle motion during this phase of healing with help in decreasing ankle stiffness following the injury.
- M – Medication – Non-Steroidal Anti-Inflammatories will be beneficial during this time! They will help to decrease the swelling and inflammation in the ankle. Be careful and make sure you don’t have any contraindications to taking NSAIDS and that you take them appropriately (don’t take too many, follow proper dosages!)
We also want to recognize that during this time, we don’t want to shut down the entire leg! We want to stay conscious of the other muscles within our body and our lower limbs. Runners will want to engage and strengthen those all-important running specific hip muscles because they will be important in preventing an ankle sprain in the future and are important in improving your running form.
During this initial phase, you may not be able to do a whole lot in terms of exercises for the ankle, but you can do a lot of hip and knee exercises during this phase. Remember, this phase is going to be variable depending on the runner and the type of ankle sprain you’ve suffered. Some individuals will last in this phase for 1 to 3 days or up to a week, maybe even 10 days! It’s going to be dependent upon you getting a proper diagnosis and prognosis!
If you are struggling with reoccurring ankle sprains and you want to get your ankles stronger so you don’t have to worry about rolling your ankle on your next run, that is exactly what we help runners do in our Healthy Runner Coaching Program.
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Dr. Duane Scotti, DPT, PhD, OCS is a running physical therapist, run coach, host of the Healthy Runner podcast, and founding owner of Spark Healthy Runner and has been a leader in the rehab and running community for over 19 years. He is passionate about helping runners feel strong and confident so they can stay healthy and become a lifelong injury free runner! Dr. Duane truly believes that anyone can run and that all runners should be treated differently as athletes. He is on a mission to change the traditional thinking that running causes “overuse injuries” and you must “take a break” in order to get better. Through run specific training (exercises and running progression) you can build your body to be a strong, resilient runner and stay active, stay healthy, and just keep running!
Duane received his Bachelor of Health Science degree and Master of Physical Therapy degree from Quinnipiac University in 2001 and 2003. He then went on to receive a clinical Doctor of Physical Therapy and a Ph.D. in Physical Therapy from Nova Southeastern University in 2017. Duane is a board-certified Orthopaedic Clinical Specialist, RRCA Certified Running Coach, Certified Mulligan Practitioner, certified in dry needling and has advanced training in spinal manipulation and rehabilitation for runners.
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