Archive for December, 2011

If you have been following along, you know I am benched from running with a sprained ankle.  I can’t afford to get too lazy while I recuperate.  I have come too far to let it melt away.  The elliptical is now my litmus test of recovery.  If I get to a day after an elliptical session when my foot fails to remind me that it is sprained, then I can return to the road.  How I have missed you, cold and lonely road.  Going forward, I will use the elliptical every other day.  Today was no different. 

Looking back on my journey, the elliptical was the beginning, and now, injured, I return to it.  It seems my workouts have come full circle.  After logging over five hundred miles on the road, elliptical workouts represented constraint and boredom.  It was nowhere near as exhilarating as the cold bite of the open road.  Until my last injury, I had not touched it in a year.  Only a few weeks ago, my wife even asked if we could sell it.  I promised I would find a way to add it back into my routine.  It only took a face plant into pavement to keep that promise.  Now it offers freedom from the boredom of recovery.  It doesn’t stress my sprained ankle’s mobility since it is only a third of my stride. 

I try to keep myself entertained on the machine, but it is difficult.  I have rigged up a portable DVD player to the display.  I tend to watch TV shows since they last about 45 minutes.  It is about the right amount of time.  The show this time was Battlestar Gallactica.  I’ve seen it enough times already, though.  Are suggestions on other shows, I am open to anything? 

Looking around the room I could see the evolution of my routines.  The basement is filled with the story. First the elliptical, next on to the treadmill, and finally just my running shoes.  The least expensive and complicated is the best.  Maybe I should get an exercise bike?  How much exercise equipment do I need before my basement becomes a gym?  There isn’t space for one anyway….unless I move…NO…when would I have time to add another routine?

In addition to using the elliptical, I have decided to accept the Peacewolf Pushup Challenge.  If you follow us on Facebook, you may have seen the post about it.  The concept is to do a set of pushups and go until you can’t go anymore, and do this for thirty days.  The question is, how many more can you do on Day 1 verse Day 30?  Day 1 I started at 25.  It isn’t that impressive, but it is a start.  I don’t have a set goal of where to end up, just every day improve and see where it takes me.  By Day 30, I should be back on the road. 

Here’s to not having pain in my ankle tomorrow!

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How to Treat a Sprained Ankle

Posted: December 11, 2011 by Roberts in Injuries, Rehab
Tags: , , , ,

A sprained ankle is the most common sport injury, though not the worst.  If not treated properly, it could stall an exercise routine or sports career by several months.  Initial treatment is vital to the long term success of recovery from the sprained ankle. 

First, to review, there are simple steps that need to be taken after a sprain has occurred.  It is commonly referred to as the R-I-C-E method.  Acronyms make things so easy to remember, don’t they? 

R – Rest:

Stay off the ankle whenever possible.  At first it may seem impossible to use the ankle.  Over time, as it recovers, there is a danger of stressing the ankle before it has fully recovered.  Exercise during the first few days should be limited to swimming and cycling.  Never push yourself beyond what your ankle is capable of.

I – Ice:

Icing should be done in 15 – 20 minutes, once an hour.  Icing should be done as soon as possible after the injury.  Icing is most effective for the first 48 hours to fight swelling.  You can use a Ziploc bag of ice (with a little water), ice pack, steak or a bag of peas.  Ice needs to be applied soon and often.  Just do not ice for more than twenty minutes, as frostbite does not help the injury.

C – Compression:

Compression can be done with an Ace bandage wrap or a brace purchased from any drug store.  It should be snug, but not constraining.  Compression is important when the foot is not elevated and will have any strain placed on it.  Moreover, wear shoes, not sandals or flip flops.  The additional support can only help.  At the end of this article you will find a video demonstrating how to wrap an ankle properly after an injury.

E – Elevation:

The ankle needs to be elevated when you are not walking.  Elevation refers to a level higher than you heart.  This, in addition to the other guidelines, will reduce and minimize swelling.  A couple pillows or a folded thick blanket under the ankle should be enough elevation.  This will help in circulation of the blood through the ankle. 

Ligaments of the ankle.

Image via Wikipedia

Follow these guidelines, and the damage can be minimized.  The next step is to see your doctor or a trained professional.  The damage that has occurred can range.  There are two types of sprained ankles, inversion and eversion.  An inversion sprain is the most common and occurs when the sole of the foot is forced to face inward, thus straining the ligaments on the outside of the foot.   This type of injury represents 40% of all sports injuries and 80% of all sprains. The anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) is the most commonly injured.  The rarest ligament damage is to the posterior talofibular ligament (PTFL).  Sprains are classified under a three level graded system.

Grade I:                The ligaments of the foot have had no macroscopic tears, most likely and over stretching.  There is mild pain and tenderness.  Swelling is present and there is not loss or a very limited amount of loss of mobility.  There is stiffness and difficulty walking.

Grade II:              A partial tear has occurred in the ligaments.  Pain and tenderness is moderate.  Swelling is present and the joint is stiff.  Minor bruising is present.  The ankle is having trouble supporting weight and is painful to attempt.  The joint is instable and mobility is an issue.

Grade III:             There ligament is completely torn.  Pain is severe and tender to the touch.  The ankle cannot support weight at all.  There is gross instability of the joint and is essentially unusable.  The bruising is extensive.

Do not self-diagnose.  After a sprain, consult a doctor.  Your doctor most likely will advise you to have an x-ray to check for a break or a fracture.  What may seem to you a simple sprain may in fact turn out to be serious damage.  Injury can range from strains or tears of the aforementioned ligaments, small fractures, breaks, avulsion fractures, or even osteochondral lesions.  Due to the wide range of potential issues, consult a professional.  Once the doctor has diagnosed the issue, rehab can begin. Good luck in your recovery.  For some rehab ideas click here.

How to wrap an ankle.

Over the past couple days, I feel like I’ve been seeing runners everywhere as I drive home…not just once in a while, but EVERYWHERE!  It doesn’t matter if it is a cool day, or rainy, they’re out there.  As I drove through a downpour, three separate runners crossed the street in front of my car.  They keep finding me, and I want to join them!  If I had been on the road that day, I would have been soaked to the bone in a matter of minutes.  Strangely this appeals to me.  My wife thinks I am crazy.

After ten days of a sprained ankle, all I seem to have is jealousy and anger.  I am jealous of the other runners and angry at myself for allowing myself to get injured.  It was dumb, only a mile and half from home, and I stepped in a pot hole.  Next time, and yes there will be a next time, I will try to run earlier in the day or find a new path.  That road is riddled with pot holes, and I know it.  Since I have been road free for so long, I am feeling a little depressed.  It is hard to control my diet, I am gaining weight, I’m jealous of other runners and angry at small, pointless things.  No, I don’t need therapy.  I need to go for a run.

Today my ankle was bruise-free and no longer swollen (or at least not noticeably swollen).  It is trying to lull me into a false sense of security.  My biggest fear is hitting the road before I have healed and ruining my ability to run forever.  Since I stepped in that pot hole, many people seem to enjoy recounting stories of friends of friends who didn’t allow their ankles to heal, and now they can no longer run.  I need to run.  I NEED TO RUN!  I sound like a drug addict.

Writing the alphabet with my big toe twice a day is not enough exercise.  Not even close.  After reviewing my list of approved exercises, I decided upon the elliptical.  It is tried and true.  It gives a decent calorie burn; I just didn’t want to stress my ankle too much.

After forty-five minutes on the elliptical, I can now say it is good to at least be moving more than a slow limp down the hall.  The fifteen minutes of icing the foot was glorious.  My plan is to keep doing the elliptical until I can run again.  Once I can do that, I am restarting my twelve week program, P90X included.

Update: The next morning my ankle gave me a message written in pain, “WHAT IS WRONG WITH YOU???”  Ok, forty-five minutes may have been too long on the elliptical.

Sprained Ankle: Rehab and Exercises

Posted: December 1, 2011 by Roberts in Injuries, Rehab
Tags: , , , ,

If you are dedicated to an exercise routine or a running schedule, a sprained ankle can put not just a damper on your plans, but halt them completely.  The question is, how do you not skip a beat, but not hinder the healing process.  By now, everyone should know of the R.I.C.E. (Rest, Ice, Compression, and Elevation) method of care for the ankle.  After the swelling has gone down and the ankle’s strength is returned, what’s next?  It’s now time to move on to the rehabilitation and strengthening of the ankle.

Before trying to work out with a sprained ankle, have it checked out with a physician.  Don’t play the guessing game.  If you have a fracture and you don’t allow it to heal properly, you could permanently ruin your ankle.  Healing should always be your paramount goal.  Even if your physician confirms it is only a strain, push yourself no further than the limit your ankle can handle.  There are two kinds of exercises to discuss, rehabilitation and non-rehabilitation exercises.

Rehabilitation Exercise:

The ankle is a complicated system of bones and ligaments that provide support and balance for the body.  The first goal of rehab is to regain this function.  This is done through range of motion exercises.  These exercises should be preform three to five sets a day.

  • While your leg is stretched across a bench and your foot hanging off the edge, use your big toe as your pen, write  the entire alphabet
  • While keeping your foot flat on the ground, shift your knee side to side
  • With your leg out stretched, wrap a towel around the foot, and slowly pull each end towards you stretching the foot muscles.  Repeat twenty times.

After regaining a range of motion (after a few days of rehabilitation) it is time to regain strength.  Even though you have not used the foot for a couple days the body has already started adjusting and learning to use the strength of the other leg to compensate.  We need to fight this and not lose strength while you heal over the coming days and weeks.  These exercises should not be attempted until you are able to stand on the foot without pain.

  • Create a loop with and exercise band.  While sitting in a chair, slip your good foot through one end of the loop.  The foot of the bad ankle slips through other end of the loop.  Slowly stretch the band with your legs until you find your limit.  Repeat twenty to twenty five times three times a day.

As stated earlier, balance is a primary function of the ankle.  The final stage of rehabilitation requires retraining or reminded the muscles of the ankle how to balance.   Once the ankle has strengthened, repeat these exercises three times daily.

  • Standing with your arms out stretched, balance on the injured foot.  Hold this for 30 seconds.  Repeat while increase the time by 15 seconds each time for a total of 3 sets.
  • While standing on the injured leg, slowly crouch down by bending the knee of the injured leg.  Return to the standing position.  Repeat ten to fifteen times.

After each of the rehabilitation workouts, it is good practice to ice your ankle.

Non- Rehabilitation Exercises:

There are a few cardio exercises you can do to maintain your general health or fitness.  The rule of thumb is to make sure that if you feel any strain on you ankle, STOP.

  • Stationary Cardio Bike with the injured foot on the ground and the good foot strapped in tight
  • Stationary Cardio Bike with both feet strapped in
  • Elliptical Machine (Late in your recovery)
  • Shadow Boxing
  • Using a Heavy Boxing Bag
  • Rowing Machine
  • Deep-Water Running (may even get you closer to a new PR)

Avoid any routines that require stress on the ankle as this can prolong the healing process.  Having a sprained ankle might slow you down, but it doesn’t have to stop you.  Keep on moving!

Suggestions? rebuildingroberts@gmail.com