Side Plank Yoga Pose
• Initially, get a good evaluation of the ankle. In most cases, the incident occurs in the middle of a workout and the runner/walker must find a way to get back to home/car. The body is designed to keep you moving forward for a few minutes with minimal pain even when the sprain is fairly serious. Movement is not possible when there is a serious sprain or a fracture, and fortunately these are uncommon. At the moment of injury, it is very difficult to interpret the damage unless the sprain was severe. Even when the ankle “pops,” the injury is not always severe as in a broken bone. Most commonly the sound is due to the ankle being stretched so that the highest foot bone leans out of its tight-fitting socket. The pop can be the suction being released.
• Sometimes the act of yoga/walking (if possible) can pump blood and fluid so that the pain is reduced or gradually goes away. It is very unlikely that continuing for a short distance will cause further damage as long as the pain remains mild, and the foot/leg is working somewhat normally.
• If pain is sharp, or forces one to limp, it is possible to carefully and gently continue to the next stopping point. If the sprain happened while yoga, shift to walking.
• If the pain rapidly increases with each step, it is wise to stop and get help.
• If you cannot support yourself and/or the pain is intense, get help immediately and consider treatment for shock as well.
• Immediate compression should be applied even for minor sprains: elastic compression sleeve, wrap with elastic wrap, etc.
• Apply ice immediately. Pack the wrapped ankle with ice and elevate the foot above the head if possible.
• In severe cases, it is best to see a doctor quickly (emergency room, etc.). If surgery is needed, the best timing is before swelling occurs. Otherwise there may be a significant delay in treatment to allow for the inflammation to go away.
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• After the first hour or two of compression and ice, continue to use compression as noted, and ice for 20 minutes, every 2-3 hours. By preventing significant inflammation, you will speed the healing. After a few days, the elastic tape can usually be terminated but an elastic ankle sleeve is recommended.
• See a doctor as soon as you can IF: 1) the swelling is quite noticeable despite these treatments, 2) if you cannot support body weight, or 3) if the pain remains strong.
• A doctor will take an X-ray to see whether you have a fracture. Some ankle fractures do not hurt as much as would be expected, some do not require a cast and walking might be possible. Physical therapy may be recommended, and this can speed the recovery.
• If the sprain is mild enough to treat at home, it is wise to avoid exercise until the swelling has almost disappeared and there is no pain when walking. A test run/walk of 20 minutes will determine if training can begin. On your first few runs it’s best to insert a 10-15 second yoga break into each minute of walking. It is usually safe to exercise if mild soreness appears, but if there is swelling, pain that is noticeable, there is a significant change in foot plant or stride, or the soreness continues into daily walking, workouts should be delayed. Wait a couple of days and try again.
• Most inversion sprains that are safe to treat at home heal in less than 3 to 4 weeks with an average term of 2 weeks. Eversion sprains often require an average of two more weeks.
• It is wise to consider a small elastic ankle brace when restarting your workouts. During the first few weeks of healing, there is a greater risk of another sprain because the tendons and sensory nerves are disturbed and reaction times are slower. The brace will help the ankle react to sudden forces more quickly and decrease the possibility of rolling it again.
• Eversion sprains are more serious and if there is swelling, limping and pain, see a doctor. If it hurts moderately without swelling, use the same icing and treatment as with inversion sprains. It also helps to prevent pronation or allow the foot to have a slight supination during recovery from an eversion sprain, because the inside of the ankle must work hard with every step. The workload is less when pronation is eliminated.