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


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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.


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.


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.

Helen Dixon
Helen Dixon
Trail Lover // Trail & Ultra Runner // Often found in the Mountains, Running, Hiking or Skiing // Seeking Peace, Beauty & Adventure.


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