First Aid for Fighters: Not So Stupid Ankle Injury

by Meredith & Doc Dill

Thumbs and shoulder being healed, it was time for leg and feet injuries. I hurt my ankle during a footwork drill. This was before I wore shoes to class regularly and my foot just rolled to the side and my leg stayed upright. I fell down instantly because I knew it was bad. I started swelling up right away and I had to take the rest of the class off and ice it. I iced it all night and it hurt so very very bad. I limped to work the next day with an ankle brace and iced it every hour for twenty minutes and wrapped it in between. It hurt. At first I didn't tell anyone about it aside from those in the class where I had hurt it, and wore a brace and shoes to classes and iced it afterwards. The icing got easier in the weeks that followed and as it felt better I iced it less. General consensus was that it was fractured. I took six weeks off from grappling class, wore shoes to every class, with an ankle brace (which I still sometimes do) and if live grappling ever occured in regular classes during that time, I took care to warn my partners off of ankle locks.

Dr Dill says:

Ankle injuries are very common in most sports. Sounds to me like you handled the “First Aid” part pretty well. Rest Ice Compression and Elevation or RICE is the mantra given to most musculoskeletal injuries. Now here’s the troubling part, many ankle “sprains” on further examination, namely radiographs, or x-rays in the parlance, are shown to be ankle fractures. So much so that emergency medicine, especially “sports” medicine, say to assume all ankle sprains are fractures unless proven otherwise. Most sprains feel much better for walking around in 3 to 5 days. Longer than that and I would suspect a break. By the way there is no difference between a “fractured” bone and a “broken” one.

Anyway recovery and rehab is about the same for sprains as non-displaced fractures. Initial healing takes about 2 weeks then gentle stretching or range of motion begins. Strengthening and kinesthetic rehab starts next and progresses for 4-8 weeks.

The retraining of joint position sense (kinesthetic training) is the key to preventing serial or recurrent sprains. This can be done in literally dozens of ways. Make sure to walk on different slopes and surfaces. Pay attention to your foot, don’t wear an ipod. Do heel and toe raises. Also raise up on the inside and then the outside border of your foot. Get to the point that you can walk around on the borders of your feet. BUT Pay ATTENTION to avoid respraining your ankle.

Ankle supports are good if you use good ones. Like the Aircast, or Sweedo lace up ankle brace. The elastic ones are useless, except to keep compression on if they have a tendency to swell. If you are having trouble go see a physical therapist for advice and or a treatment program. They are truly the experts at rehabbing injuries. Take good care of those feet. They are the foundation of your body. Ignore them and the rest crumbles.

Dr D

In case you missed it earlier, Doc Dill isn't actually a doctor. Take his advice for what it's worth, but consider talking to someone with the appropriate credentials.