Coming Back After Injury

Linli_Anne

I suffered a very bad sprain to my right ankle on July 26th. I was told no weight bearing for a week, and off I went on crutches with a tensor.

During my follow up appointment I was cleared to start weight bearing, and that I could ease back into my running, perhaps trying to use an ankle brace/support for the first few runs.

So, I'm feeling really good, no more swelling or bruising, and each day my ABC exercises are getting better and better with less 'stickiness' during my rotations.

I had registered for a 14KM trail run this Saturday before I was injured. I don't plan on running it and risking re-injury, however I am in need of some advice on the best way to build back up my mileage safely as I have a Trail 1/2 in 6 weeks, and a 6 hour trail run (5KM loop, as many times as you can in the time frame you registered for) in October.

Also, does anyone have experience using any kind of ankle brace/support during runs. What is your opinion on them?

JTick

I am coming back (pretty much fully recovered) from a minor tendon tear and tendonitis in my ankle. Were you prescribed PT at all? That was the best thing ever for me - and I was able to keep my activity up without risking reinjury.

I didn't see anything in your post about cross training, so FWIW biking helped me immensely. I only lost a little conditioning in the 3 months I was down, and it's helped to continue to build my fitness now that I'm running again. My legs feel stronger than they did before I hurt myself.

As far as braces, that's probably going to be a question for a doctor or PT. It depends on your injury, and there are several types of braces available. I was told not to wear one at all...they wanted my body to do the work to heal instead of relying on a brace.

ETA: I just saw where your doc said maybe try a brace. Could you call and see what kind they'd recommend? I wouldn't think you'd have to make another appointment for something like that. There are some that wrap around, there are some that lace, and some are stiffer than others.

GiddyupTim

I am going to tell you to go back and talk to your doctor....however, having said that:
I might advise against the brace. You want to restrengthen your ankle and wearing a brace might work against that.
Keep doing your ABC exercises diligently. Those help improve any mobility that you have lost during healing. But, more importantly, they help you to regenerate the nerve fibers torn and injured when you injured your ankle. Some PTs and doctors think that the reason an ankle feels "weak" for a long time after a sprain or strain is because the nerves you use for proprioception has been torn and have not completely regenerated yet. Since you cannot "feel" where your foot is you may be more likely to reinjure it. Those exercises may reduce the time that your proprioception is impaired.
Also, just for FYI, I once heard the orthopedic surgeon for the New York City Ballet Company speak and he said that he had started having dancers with ankle problems do a couple of exercises. Ballet dancers sprain their ankles a lot -- and very seriously -- because they are up on toe so often.
Anyway, the exercises were: Take a canvas bag with handles on it (the kind you might take to the grocery store) and put weight in it (start with five pounds and work up to 15 pounds or more). Lay on your side on, say, a couch and hang your ankle over the arm at the edge of the couch. Point your toe and hang the bag over the foot. Then lift. Do sets of 10-12 reps. When 12 gets too easy, go up in weight a bit. (You can use cans of soup, or whatever, for weights in the bag.)
That was it. But you can do it with your foot dorsiflexed too, if you would like, though it is probably not necessary.
He said it was highly effective in strengthening ankles so that those dancers never sprained again. (Of course, ballet dancers for the New York City Ballet are extremely dedicated athletes -- not your average joes -- so you can assume they are EXTREMELY diligent about exercises.)
Good luck,

PS Found this listing of exercises for ankle strengthening.http://www.aofas.org/footcaremd/how-to/foot-injury/pages/how-to-ankle-sprain-strengthening-exercises.aspx
They appear to follow kind of the same principles as the ones I mentioned above, but without the weights.

CarsonRuns

I'll address the running aspect here.

When coming back from injury, it's best not to think it terms of mileage, but it minutes.

Starting out, you'll want to run fewer days than you were before. If you were at 5, run 3. If you were at 6, run 4. If you were at 4, run 2.

Start with a 10 minute run and see how it feels. Do this on your running days for a week. If you can get through this with no pain, go up to 15 minutes the second week. If you get through that with no pain, move up to 20 minutes for a week. Still okay, go to 25 minutes for a week. If you are still feeling fine, move up to 30 minutes for a week. In most cases you'll be right around 3 miles at that point. Now you can start gradually adding mileage back in, but don't go to quickly. You can also add the additional days back in, but don't do both at once. Don't jump to 5 miles on each run and add an additional day in. That's a little too aggressive. Also, if at ANY time, you experience pain in that ankle, STOP. Get some ice on it, take some NSAIDS and rest it. Obviously if it continues to hurt, go back to your doctor.

Linli_Anne

Thanks for all the great replies, and exercises.

After talking to a PT friend, he also advised against the brace as he thought it would hinder proper healing and strength.

I did try a run last night, and I felt no pain, weakness, numbness etc. during or immediately following the run. My ankle was a bit stiff feeling this morning, but after doing my ABCs that stiffness went away, and so I think I need to be very diligent about doing some stretching after my runs for that ankle.

I'll rest the next couple of days, and hopefully can do another little run sometime on Saturday.

HappyRunner34

I'll address the running aspect here.

When coming back from injury, it's best not to think it terms of mileage, but it minutes.

Starting out, you'll want to run fewer days than you were before. If you were at 5, run 3. If you were at 6, run 4. If you were at 4, run 2.

Start with a 10 minute run and see how it feels. Do this on your running days for a week. If you can get through this with no pain, go up to 15 minutes the second week. If you get through that with no pain, move up to 20 minutes for a week. Still okay, go to 25 minutes for a week. If you are still feeling fine, move up to 30 minutes for a week. In most cases you'll be right around 3 miles at that point. Now you can start gradually adding mileage back in, but don't go to quickly. You can also add the additional days back in, but don't do both at once. Don't jump to 5 miles on each run and add an additional day in. That's a little too aggressive. Also, if at ANY time, you experience pain in that ankle, STOP. Get some ice on it, take some NSAIDS and rest it. Obviously if it continues to hurt, go back to your doctor.

So agree with this. I've been off for almost 6 weeks and likely will be another few months before my injury is healed and I know I will have to start from scratch. But my focus will be to come back fully, not to rush and risk re-injury. This is taking long enough!! Great advice Carson.

lporter229

I'll address the running aspect here.

When coming back from injury, it's best not to think it terms of mileage, but it minutes.

Starting out, you'll want to run fewer days than you were before. If you were at 5, run 3. If you were at 6, run 4. If you were at 4, run 2.

Start with a 10 minute run and see how it feels. Do this on your running days for a week. If you can get through this with no pain, go up to 15 minutes the second week. If you get through that with no pain, move up to 20 minutes for a week. Still okay, go to 25 minutes for a week. If you are still feeling fine, move up to 30 minutes for a week. In most cases you'll be right around 3 miles at that point. Now you can start gradually adding mileage back in, but don't go to quickly. You can also add the additional days back in, but don't do both at once. Don't jump to 5 miles on each run and add an additional day in. That's a little too aggressive. Also, if at ANY time, you experience pain in that ankle, STOP. Get some ice on it, take some NSAIDS and rest it. Obviously if it continues to hurt, go back to your doctor.

I had a foot injury in March and was out of running for a month. This is exactly how I eased back into it. I started by running 8-10 minutes and increased it by 2 minutes every third day (resting the two days between). Once I reached 20 minutes, I started doing run/ walk intervals for 30-40 minutes. From there I just started running 3-4 miles at a time, adding 1 mile to one weekend run each week, my "long run". I was back up to the 30 MPW range by mid July.

HappyRunner34

What was the injury?

lporter229

Are you asking about my injury? Assuming you were, initially it was thought to be a stress fracture of my metatarsal, but the MRI did not confirm it. Instead it showed that I had severe bone edema to the metatarsal, as well as a bipartal sesamoid bone (which may or may not have been due to fracture...some people are born that way. They only did an MRI on one foot, so it is impossible to tell). At any rate, I was told to wear a boot for 4 weeks and stay off of my foot as much as possible. I took to bike riding in the meantime.