Running

Not a doctor or a physio but here's what happened to me last year.

I had a quite severe sprain (and avulsion fracture of the medial malleolus - basically the ligament on the inside of the ankle was stretched and rather than snapping/tearing itself it pulled away a small chunk of bone).

I did it playing 5-a-side football (no-one near me, no-one kicked me, just tried to change direction quickly and it went ping). Foot seemed to slip forward and I heard a click. It hurt a bit and I was limping for 5 minutes afterwards so I took my turn in goal. 5 minutes later it felt ok so continued to play another 40 minutes on it eventually returning to normal and running on it and shooting hard. Adrenaline is great but it wears off, on the way to the pub after a shower I was limping a bit, after 4 hours in the pub I was limping much more and faced with a mile and a bit walk home (with a train in the middle) I opted for an Uber.

Next morning I couldn't put any weight on it at all, my wife dropped me at nearby minor injuries at QMH and I was seen, x-rayed and given crutches and referrals to the fracture clinic and physiotherapy all within 45 minutes. Classic sprained ankle bruise lines along the side of the foot and very swollen.

Needed crutches for 2 days as I really couldn't put weight on it but after those two days I was able to get by without them but with a limp.

Got a physio appointment a couple of weeks later and I was given a bunch of exercises to strengthen the ankle:-

• Calf raises (both ankles, with support of a chair available if required) with a pencil on the floor half way under the arch and the idea is to put the foot down without rolling inwards by avoiding touching the pen
  
• Sit in a chair, feet shoulder width apart, green physio band around the top half of the dodgy foot and, holding on to the other end, pull it round the opposite knee. Then flex the ankle outwards making sure not to twist the leg, only the ankle.
  
• One legged dips, chair for support, stand on one leg, bend knee to dip down (keeping back vertical)
  
• Stand on one leg on a bosu ball (bought a cheap one from eBay) and balance
  Build up to 30 (or 30s) of each, 3 or 4 times a week, starting off gently (really couldn't do more than a few of each at first before fatigue).
  
  

Icing for 15 minutes at a time (ice in a plastic bag and then wrapped inside a tea-towel and tied around my ankle. Raised up. Keep doing this once or twice a day for weeks and weeks. Avoid getting the ankle too warm (I like a nice hot bath but kept my foot out as much as I could).

Next phyiso appt (2 weeks later) was re-assessed and hadn't progressed enough so continued on that regime. I couldn't do enough of all of those exercises without discomfort or fatigue.

Phyiso appt 2 weeks after that and I could. This time I had the following exercises added:-

• Lunges onto a bosu ball (knee level with toes at end of lunge)
  
• Squats (both legs) on a bosu ball (standing on the domed side, nearby chair for support if required)
  
• The "star" - stand on the bad ankle and touch the toes of the other foot as far away as possible in the 4 compass points, i.e. far in-front of you, far to one side, far back and then as far as possible to the side of the dodgy ankle (good ankle passing behind bad ankle)
  
  

At first I was very wobbly on these as I didn't have much side-to-side support from the muscles/ligaments in the ankle. Again build to 30/30s.

Fracture clinic consultant wasn't interested in me. Physio was going well and a boot would have only been a pain in the arse.

Another two appointments (4 weeks) and I got the final set of exercises (on top of everything so far):-

• Single leg squats on a bosu ball (standing on the domed side, nearby chair for support if required) - don't forget to do the other side
  
• Bouncing on the ball of the foot (start with both feet) - build to 30s again
  
• Once you can bounce on the ball of the feet for 30s (both feet) then do it on a single foot (this is the one which was uncomfortable quickly)
  
• Extend the "star" to 8 compass points (i.e. including NE,SE,SW,NW).
  
  

The bosu ball really helped and the "star" was the key exercise according to my physio. That and actually doing the physio rather than staring at the list of exercises and not doing them. Also do the balance/squat/dip exercises (even the others) on the good ankle too, helps you understand how it should feel and give you an idea of where your fatigue level is.

After all of that I was told to do Couch to 5K from the beginning. Not for fitness (I'd been continuing to swim and cycle) but to progressively build up the load on the ankle as it wasn't used to the pounding action of running nor the side-to-side stresses of small adjustments when running. Injury was 1st August, C25KW1D1 was 9th December and I was doing a gentle 5K (39 minute parkrun with my 10yo daughter) by 18th January.

(Also was cycling gently a few weeks after and doing a spin class a month after the injury but this could have been even easier, I just waited for the first physio appt to give the ok. Was back swimming from just 4 days after doing it although I mostly use a pull buoy now as I'm lazy.)

P.S. Good luck and GWS.