As a runner I can get away with saying this: Runners aren’t normal. Admit it because we all know it’s true. Veteran distance runners and non-runners alike would agree.
When most individuals with a swollen or painful joint would shut it down, start taking medicine and put the outcome of the injury in the hands of a doctor. Runner for some reason, be it passion or stupidity, usually try to “run through it”.
Runners with an arthritic ankle or joint effusion, in most cases, will not help the situation. Unlike a knee or shoulder, swelling in the ankle is less obvious. It will show itself as stiffness and limited range of motion.
The first step is determine the source of the swollen ankle with its pain and limited range of motion. A quick visit to a certified athletic trainer is a great start. A 3 minute exam with an ATC will help determine if the issue is within the joint, a muscle/tendon issue or a capsule/ligament problem. All 3 require different treatments and have varied outcomes.
If it’s determined it’s a joint problem, getting to an ankle doctor such as a orthopedist or podiatrist is the next step. As expected, an x-ray is in order. The biggest concern is arthritic changes or a fracture within the joint surface.
Most ankle problems for runners are related to soft-tissue issues such as tight Achilles/calves, plantar fasciitis, stiff ankle capsules and/or weak arches.
Assuming the fractures and bad arthritis is not the reason, the typical solution for a swollen ankle: Downward Dog stretches, toes exercises to strength the arch, easy & short barefoot strides on grass 2x/wk, calf & arch massages, isolated strengthening exercises for the FRONT of the shins and icing after runs. As you know, I’m not a big fan of meds….but a few Advils here and then will help.
In summary, see your friendly certified athletic trainer to rule out the bad stuff, loosen the tight things up, strengthen the muscles up and quiet down the warm stuff. It’s time for a run….
Too many of us live with daily ankle pain. Usually the factors creating ankle pain are often quite controllable and manageable with the right sports medicine advice.
Both athletes and non-athletes are susceptible to sore ankles, ankle sprains and chronic ankle pain. Controlling the pain and maintaining healthy ankles, feet, toes and calves is not difficult. I’m often asked for tips and suggestions on these body parts by individuals both young and old. Let me share with you the same tips I use on NFL players to help you live a fun and active lifestyle.
1. Strengthen your Base of Support
Strong arches and toes are key to stabilizing everything above the feet. Any base of support, be it a building or a human body is vital to both stability and function. Simple exercises such as picking up marbles with your toes, barefoot walking/running, toe towel curls and barefoot balance drills should be done on a daily Basis.
2. The Right Shoes for Sprained Ankle
Wearing the proper shoe and, more importantly, not wearing the wrong shoe is vital if you want happy “dogs”. Women’s shoes are the best things to happen to pediatrics (foot doctors) because they consistently create ankle, feet and toe pain for women. Spending a little more money on the right shoe is money well spent if an active lifestyle is a priority of you.
3. Warm-up/Cool Down for Running Ankle Pain
If there’s one thing I’ve learned about my body since I’ve turned 40 is that warming up and cooling down is important. In saying this, I realize it doesn’t require a lot of time to do so. The use of a roller, flexibility exercises, compression sleeves and ice has help me do this quickly and consistently. Too often ice is not considered an important option for chronic ankle injuries. That’s a mistake…ice therapy rocks and it should be considered to be one of your best friends!
4. Embrace your Downward Dog
This could be your most important stretch. Last week I was doing a downward dog stretch in my living room at 4:15 AM when I was startled by the sight of my dog Marshall right next to me also doing a downward dog with me!
It’s a great stretch that addresses muscle, tendons, joints and fascia from your toes through your arches, over your heels, through your calves, into the back of your knees, throughout your hamstrings, behind your hips and all though your low back…..just to name some of the locations.
5. Self Traction and Mobilizations
These require more skill or may require the assistance of a friend although they are priceless for maintaining normal ankle mechanics. With the sore ankle at approximately 90° or a “neutral position”, gently pulling on both the heel and the top of the foot together. This will create a gaping of the ankle from the lower shin. This can be accomplished with the help of an assistant or by placing the foot under a bed or couch to stabilize the foot and ankle.
Another mobilization move which is helpful to maintain the mechanics of a sprained ankle is to gently move or mobilize the lateral ankle bone both directly forward and more importantly directly backwards. This lateral ankle bone or lateral malleolus is a common source of a sore ankle. Increasing its mobility is one of my favorite tricks to decreasing pain in a chronically sore ankle.
Bonus Tip – Aggressively Directed Massage
If you really want to loosen up chronically stiff ligaments and muscle, aggressive massage should be included. Once a sore ankle, shin and arch are warmed up, apply a moderately aggressive massage with your thumbs to the locations around your ankle locations noted below.
Focus on the areas on both sides of the Achilles tendon that forms the backside of the ankle joint, the entire edge surfaces of the lateral ankle bone and the front of the ankle joint. Including the arch and the great toe is always an added bonus. After these areas have been loosened up, it’s important to get all those moving parts active and functional to both normalize range of motion and to re-program the entire leg how to move pain-free.