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Dr. Anderson: Sprained Ankles
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Dr. Anderson: Sprained Ankles
Dr. Eric Anderson, a charter diplomat of the American Board of Family Practice and a former
president of the New Hampshire Academy of Family Physicians, is a regular contributor to Travel
Tips 'n' Tales. He is widely traveled and published, having written a travel health column for
Travel 50 & Beyond and a weekly online column, Ask The Doctor, for The New York Times
Dr. Anderson invites you to send your questions regarding travel health issues to
How soon will I be back to normal?
Question: I sprained my ankle on a trip four weeks ago and it's still not back to
normal. When I got home, my doctor prescribed an air cast, which I wore as
recommended. Is there anything else I can do to help myself heal faster such
as strengthening exercises? How soon will I be back to normal? I'm a runner.
Answer: Ten million North Americans sprained their ankle last year. Ankles take
ages to heal and finding yourself not back to normal at four weeks is fairly
typical for ankle injuries. It is after all a weight-bearing joint.
Check for abnormalities
Assuming that your X-Rays were normal, that you didn't completely disrupt the ankle joint and
you can now, off crutches, fully weight-bear without pain, you should
continue with warm to cold soaks and a full range of motion exercises in a warm
bath. Keep doing toe raises and balance stands and
straight-ahead-activities like walking on smooth, level surfaces.
Increase activities slowly
After four weeks most physicians would increase your activities to walking, then running
lazy figures-of-eight on smooth, level surfaces. As you improve, they would
want you to exercise more, still on level ground, jogging and changing
directions in "sharp Zs" before you resumed running regularly.
How soon will that be? It varies according to your progress -- two to four more weeks
wouldn't be unusual. The delay is worthwhile: a prior ankle sprain often
leads to another within a year.
That said, I'm a little concerned about you, a runner, who from the sound of
it probably suffered some delay before being treated. Ankle injuries do best
if they are handled promptly with the classic RICE (rest, ice, compression,
elevation) and it's hard to do those things when you're far from home. Who
out there, for example, would go back to his or her hotel in Rome and skip
the rest of a visit to the Colosseum just to ask the concierge for ice? But
there's one thing travelers can do, especially those who have previously
injured an ankle: carry a 3 inch elastic compression bandage in a camera bag
or purse. Such a bandage has so many other uses from fastening the leg back
on a camera tripod to binding a suitcase with a partly broken zip. And it
goes without saying that persons with previous significant ankle sprains
should be particularly sensible when it comes to choice of shoes on
An ounce of prevention
A final consideration I would have is whether there was an explanation for
the cause of your ankle sprain. If you tripped over something or were bumped
or knocked down by another person you may have had a normal consequence: a
fall injuring the ankle. But if out of the blue, your ankle suddenly gave
way and you simply fell, that raises another question.
Sports physicians and podiatrists are interested, these days, in what they
call "biomechanical" issues. They are big on measuring length of legs and
dropping a plumb line from the hip to see if the anatomical architecture of
the ankle joint is sound. If it isn't they suggest building up the shoe to
make things normal for that person. I don't feel every person with an ankle
strain needs such assessment but a world traveler who fell inexplicably
might. As they say: an ounce of prevention...
NOTE: Lorry Patton's Travel Tips 'n' Tales would like to remind you to always consult with your
personal physician before following any medical advice and to please read the Travel Tips 'n' Tales
not necessarily the opinions of Lorry Patton or Travel Tips 'n' Tales.