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How To Recover From a Sprained Ankle While Trail Running

We love to read and share trail running and adventure inspiration. But unfortunately, the reality is that there are times where you need to be reminded that reality is not always clear skies, leaping between boulders and spending hours on the trails. When you can’t get out for your fix of nature, it can be hard on your body and mind. I’ve had three BAD ankle sprains, two in the last year, which required me to practice positive thinking and focus on exercises other than running to maintain my fitness and sanity during the recovery period.

I hope this reality fix keeps you in good company if you’re also dealing with an injury or period where you’re unable to get out running, until the time that you can return to those trails. I’ve also shared, based on my ankle-spraining experience, how to recover from a sprained ankle.

A Sprained Ankle in the Wilderness

One minute you’re running along a beautiful trail, glancing up at the views, watching your steps as well as you can, and the next minute you’ve hit the ground with your foot twisted in or out underneath you. Bummer.

volcanic 50 Mt St. Helens
Scenes from the Volcanic 50

The last two sprains have been in pretty remote locations. The last time I sprained an ankle, I was halfway into a 50km ultramarathon around the volcano Mt St Helens, miles from a road.

I had successfully navigated boulder fields, canyons – some VERY gnarly terrain, but for whatever reason, I slipped on some sand and fell down.

Once I had recovered from the shock of not only the injury but that the two runners right behind me didn’t stop to see or ask if I was ok (everyone out for themselves, right?), I had to find a way off the mountain, which involved 4+ hours of hobbling back over canyons, climbing the sides and crawling over boulders, all the while with a useless, floppy foot and being periodically chased by bees. This was much harder than running an ultra, and thankfully I ended up being joined by a couple of mountain rescuers who helped me find the way off the mountain.

While I was incredibly annoyed at the injury (my second in six months – but thankfully not the same ankle), I was most upset by the way so many fellow runners had just ignored me while I sat on the side of the trail in pain. Unfortunately, it seems that you get assholes everywhere, even in our beautiful sport of trail running!

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First Aid – Dr. Google – a Help or a Hindrance?

As a trail runner, I often ‘roll’ my ankle, but only so far as it happens occasionally, I curse, and then keep running and have a slightly sore lower leg (usually above the outside ankle bone) while the stretched ligaments recover.

How to recover from a sprained ankle 3 trail and kale

This is different. This was a full-on sprain. Huge ankle, puffy foot, and bruises all the way from 10cm above my outside ankle bone to the top of my toes, inside and outside my ankle – in every color, from red and purple to green and yellow. I could not put any weight on it without excruciating pain.

Dr Google reminded me to ice, compress and elevate it. The first two are always a pleasure to do and help with the swelling, but getting your foot above your heart is very uncomfortable and makes working a challenge. So I resorted to working at home so I wasn’t walking very far, and periodically using a footstool to help stop the swelling worsening.

As someone with an interest (but no expertise) in managing sports injuries, I’m pretty comfortable looking up my symptoms online to determine if I should see an expert.

Dr Google and past experience told me I very most likely had a sprained ankle, but that the bone could be fractured due to the rolling action meaning the ligament pulls off a sliver of bone from your ankle. This was possible, as my ankle bone itself was sore to touch. However, the treatment was most likely the same.

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Three Steps to Recover From a Sprained Ankle (first couple of weeks)

  • ice, compress and elevate to reduce swelling
  • take anti-inflammatories if needed. I don’t like to take any pills, but I did have ibuprofen before bed, to help me sleep through the pain
  • rest and avoid using the ankle as much as possible

Essential items for recovery (reusable for future injuries ;-)):

How to recover from a sprained ankle 4 trail and kale

The best thing I did after the sprain on Mt St Helens was to get the ankle straight into a bucket of ice-cold water as soon as we got back to our hotel. My foot started ballooning as soon as the shoe came off (and I’d had the shoe on for HOURS after the sprain, due to the epic evacuation hobble I had to undertake). We emptied the hotel room bin, which was fortunately large enough, and Alastair kindly filled it up with ice and water. This really helped with the initial swelling, as the icy water covered my whole foot.

Expect to keep icing, compressing, elevating and resting the ankle regularly for a couple of weeks after the injury, until the pain and swelling have gone down and the bruising is gone.

Rehabilitating My Sprained Ankle (after pain, swelling and bruising had subsided)

After two weeks, once the sprained ankle became less painful, the next step was to ensure that it is suitably rehabilitated and that I don’t re-injure it and delay the recovery process.

How to recover from a sprained ankle 5 trail and kale

I didn’t visit a doctor because I was pretty sure I knew what was wrong. Of course, if the pain had stayed bad or the swelling/bruising hadn’t improved, I would have definitely sought expert advice, and I’m not recommending other people necessarily do what I did, this is just my experience.

To rehab my ankle injury, I focused on:

  • heat treatment to increase blood flow and assist the healing process
  • massage and arnica
  • stretching and rehab exercises (Our Bosu Balance Trainer was a huge help)
  • cross-training
  • wearing comfortable shoes – always – Recover Sandals are a great way to rest your feet. Wiivv do some amazing custom sandals that you can get fitted for using their app, from the comfort of your home. Here’s our review of them: Wiivv Custom Fit Sandals Review – Everything You Need To Know!

I also continued to avoid walking for a total of 4 weeks after the injury, as I found that the ankle would swell up in the afternoon if I’d been walking during the day. I also tried to work at home where I could have it up on a footstool, for the same reason. I’m fortunate that my job allows me to do this – although the flip-side was that I often have to travel by air, which has the opposite effect due to the swelling resulting from flying and not being able to elevate the leg for several hours during the flight.

Heat Treatment For My Sprained Ankle

I swear by the gel packs, which you can slip into their felt elasticated Velcro sleeve, to wrap around your sore body part! It wraps nicely around your ankle, and I have managed to get a heat pack around my lower back using the same method.

Massage

I gently massaged arnica into my ankle and lower leg every evening, and sometimes during the day. I get cold feet so the massage felt good as it warmed up my ankle area, and I swear arnica helps with the pain and inflammation.

Stretching and flexing

My left ankle has never been right since another bad sprain 10 years ago. It is pretty inflexible (for example, I can’t get my knee very far over my toes with my foot flat on the floor).

This is mainly because I didn’t do the right (any) rehabilitation and the physio I have seen since explained there’s a lot of built up scar tissue in there and as it had been there so long it was pretty permanent at this stage. So for subsequent injuries, I’ve been really disciplined with stretching and flexing my foot, to keep it moving and build up range of motion. I do a few different exercises, the easiest one to remember to do is tracing the alphabet with my toes, which I can do when sat at a desk.

broken arrow skyrace

Cross training

It is, of course, frustrating not being able to run. I was just starting to improve on my speed when I sprained my ankle. However, looking on the positive side, I spent more time on the exercise bike, and walking up steep inclines on the treadmill, with a view to being a stronger uphill hiker when I recovered.

Acceptance…

I know that I always take around 25% longer to heal than I expect. If general guidance is that an injury takes 4 weeks to recover, it will take me 5 weeks. I deal with it and accept that fact, even if I get frustrated if I can’t run.

I also accept that I will get frustrated… which makes me feel less frustrated! I actually enjoyed having the time on the treadmill, I was able to listen to music and watch videos on my phone that I wouldn’t have time to do if I’d been out running. Plus, I picked up some personal bests on my local uphill running route, on my first trail run since injury – and I was taking it easy!! Silver linings.

When you return to the trails, they’ll be even more awesome

The old saying ‘absence makes the heart grow fonder’ has truth to it. Of course, it was intended to refer to missing people, not parks, forests, dirt roads or mountains, but it definitely applies to places and experiences. When you can get back out running, even if it is 10 minutes on the pavement and slower than you thought you’d ever run, it will feel great. Don’t rush back, come back slowly and stronger.

sunski sunglasses for running 3-min

More reading…

If you’re getting back to running after a sprain, why not treat yourself to some new gear, as a reward for your patience?! We had fun putting together a Trail Runners Gift Guide for your perusal. Also, if you like to read, check out our book lists.

8 COMMENTS

  1. Dear Helen,
    Thank you for your article. Hope you are doing fine. By the description and photo it seems that we had similar sprain. I’m now in 5th week recovery. I do exercises, swimming in sea and now I started using bike. I think the recovery is going fine, swimming and exercise in sea are very helpful and I hope to slowly start running soon. 🙂 Did you damage or tear your ligaments with this sprain? If so, is that the problem for future trail running?
    Kind regards,
    Luka

    • Hi Luka, sorry to hear about your ankle, but it sounds like the rehab is going well, I think swimming is the best thing for it!

      I believe a sprained ankle is, by definition, a stretch or tear of ligaments in the ankle area. I have had a worse sprain before, on my other leg, which had torn ligaments and never healed quite right because I did not do the rehab work at the time, so it is not very flexible. Having said this, I have no problems running trails on it… and the other one (in the story above) is fully back to normal 🙂

      I hope you can get back to running again soon! Thanks for reading!

  2. Thanks for a positive story about a dark time! I’m in week 2 of ‘rehab’ with a similar-looking brown-blue-red-yellow-green-blobby foot, thankfully now starting to deflate. This is encouraging to read and helps with the frustration.

    • Hi Ben, sorry to hear about your blotchy ankle! Glad you found the post encouraging, a sprained ankle is certainly a good test of patience. Heal well (keep that foot elevated)!

  3. Hi Helen. Very educating text which I read all of. I sprained my ankel very badly two days ago and am now blue from my toes to mid-calf. I hump around on crutches and elevate and ice regularly. I have been working all year to prepare for a 5-mountain trail-run which is in a little over 5 weeks from now. What are the odds I’ll be able to compete? In your opinion? Ut shouldn’t take more than 6 hours…
    Sincerely, a heartbroken Hanne

    • Hi Hanne – oh noo, I’m so sorry to hear about your sprain 🙁
      It sounds bad, did you visit a doctor? If I was in your position I’d probably get it checked out, and keep with the rest, icing and elevation to keep swelling down. I reckon there’s a chance you could be ready for your race, and would suggest avoiding the temptation to ‘try’ to run on it before the 5 weeks, and keep it rested for as long as possible. It sounds like you’ve done lots of training over the past year so 5 weeks off training shouldn’t be too much of an issue. I really feel for you, and hope the recovery progresses well. Let me know if you end up racing!

  4. Just got back from my first physical therapy visit, this morning. My ankle looked almost identical to your pictures. Major bruising, swollen, etc. I actually did go into a doctor (my insurance accommodated this — this time, at least) and was told there was no break, but that this was a significant sprain.

    It’s been 4 months since my own Pull Yourself Off the Mountain incident and I’m coming along. Still some swelling, but I’ve been working hard on strengthening and range of motion. I can only run about 3 miles so far (which, as a distance runner, makes me a little insane.)

    I just wanted to drop in and let you know I get it. It’s tough. But good on you for working hard on your recovery! Have a great day.

    • Hi Nathan – thanks for reading and for the comment, and great to hear you’re coming along. I think when all the acute pain and swelling is gone, the strengthening and range of motion is so important for getting back running again without feeling like you have a brick at the end of your leg! I hope 3 miles turns into many more miles for you, very soon!

      P.s. Love the comics on your site 🙂

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Helen Dixon
Helen Dixonhttps://www.trailandkale.com
Hi, I’m Helen. I write for Trail & Kale about trail running, outdoor adventures and mindful living. There’s no Planet B.

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