Rolled or Sprained Ankle?

There is a phrase in the therapy world that says, “once a rolled ankle, always a rolled ankle!” Sounds pretty miserable, right? But, as much as I don’t want to admit it there is some gentle truth to the saying.

In the late Spring of 2020, smack dab in the middle of a public health crisis caused by Covid, I renewed my love for running. I was running and walking daily just to get away from the news and the sadness the world seemed to be experiencing.  On one particularly beautiful Saturday, I had almost finished my longest run in a year. I looked down at my phone to smile at my recorded distance when all of the sudden, I was on the ground! Not only did I literally swear to never look at my phone again while running, I also swore at the pain I was feeling in my right ankle. As any experienced and optimistic runner would do, I stood up and told myself, “I’ll be fine. It’s just a little ankle roll. I’ll run it off.” Wrong. I limped the last of my run back to the starting point and looked down at my ankle. This was no rolled ankle, it was sprained, swollen, and painful. I was so frustrated!

Physical Therapy Can Help.

Thankfully, I knew just where to go. My own clinic! I consulted with Eileen Vogt, P.T. and she was able to determine the stage of my sprained ankle. Common sprains with little pain or swelling or usually considered a stage one. Ankle sprains with increasing pain, specifically pain when walking, generally speaking, are stage two. I was not so fortunate to experience either of those stages! My ankle sprain was a stage three! I was in extreme pain, had a goose egg on my outer ankle, and walking on it just seemed like a bad idea.

I did all the practical interventions that could be done for the first several weeks, including resting, using crutches as needed, ace-wrapping the ankle to compress it, taking the non-steroidal anti-inflammatory drugs (NSAIDs) recommended by my doctor, and tried to be patient. But, alas, I am a runner. Patience is not a virtue for runners.

Eileen explained the healing process and what to expect, including the expectation that during the first several weeks after this type of sprain, “less is more.” What I heard, however, was “You can run in three (3) weeks, max four (4).” Clearly, I needed hearing aids. After the third weeks of patiently doing NOTHING, I went to Eileen and asked if I could run. Believe it or not, but I was actually taken aback when she told me “No!”  She then asked if I could do one simple thing. She asked if I could raise up onto my tippy toes using my right leg only. I couldn’t even get my heel off the ground without pain and weakness. Eileen gently said, you cannot run because you are still too inflamed. Of course, my 25-year-old brain stuck in a 44-year-old body truly believed I would be able to run again at 3.5 weeks!

After four (4) weeks, my ankle swelling finally subsided and I was able to raise up onto my heel 50 percent of full motion. Eileen, as an experienced and talented physical therapist, continued to say, “less is more.” I was able to progress to gentle, eccentric strengthening exercises for several weeks, and then moved on to harder strengthening exercises. Over time, which means roughly six to eight (6-8) weeks from my injury, I was able to perform activities that challenged my balance and proprioception (knowing where your leg is in space) skills. By week 12, I was back to running and walking again. Perfect timing, right…in the midst of the real summertime heat.

Once a Rolled Ankle, Always a Rolled Ankle.

As I started running again, I had great faith that I was fully restored and would be back to running and walking distances that thrilled me. I signed up for a trail race and started running on the road. With confidence building, I began running gentle trails and GUESS WHAT HAPPENED? Yep. It happened again. I was near the end of a short trail run and put my right foot down on the teeniest, tiniest rock you have ever seen, and my ankle rolled. Not only did I pick up that rock and throw it as hard I could, I started crying. I cried because I didn’t understand. I had done the work! I was strong! I was young…’ish! “Why had this happened again!”

Confused and frustrated, I went back to my caring but honest physical therapist, Eileen, who dropped the bomb… “once a rolled ankle, always a rolled ankle.” She sat me down and explained how despite my hard work and improved strength, the tendons deep in my ankle had been overstretched when I rolled my ankle the first time. These tendons, once stretched, could get stronger but they may never hold the joint in place quite as strongly as they did prior to being stretched.

Eileen suggested one small thing that has made a difference, well two, but hear me out. First, she suggested I purchase (and actually use) an ankle brace with supports on the sides of the ankles. She also suggested I keep up the strengthening exercises despite feeling strong.

With Eileen’s advice in hand, I purchased several ankle braces and found the one that worked best for me. I have kept up my exercises and know which ones are the most important to continue. I may not be able to safely run without an ankle support again, but at least I am doing what keeps me healthy, running, and outdoors having fun!

My story is not unlike many people’s story out there. Chronic ankle instability is frustrating. You literally don’t trust your ankle on uneven surfaces, you walk a little more cautiously, and your fear of falling due to a rolled ankle increases. Eileen, the star physical therapist of this story, didn’t just recommend helpful ankle exercises and the most appropriate ankle brace, she also provided me with education. She explained the stages of my ankle sprain, when to push and when not to push the recovery, and how to recover well using strengthening exercises and the proper brace for further risk of ankle rolls.

Trio Rehab’s talented occupational therapists are here to help!

Physical therapy can work for severe ankle sprains and instability. Remember, you have the power to control your recovery with the help of a trained physical therapist. That means, you must stay informed so ask questions, request as much education as you need, and work together with your therapist to maximize your recovery and continue safety with your activity of choice!

If you or someone you care for is experiencing severe rolled or sprained ankle, don’t wait. Give us a call today to make an appointment to see Eileen Vogt, P.T, or any of our talented and highly trained physical therapists.

Jennica Colvin, Owner & Occupational Therapist
Trio Rehabilitation & Wellness Solutions
Boerne, Texas