Sprained Ankle

Excerpted from: How To Run For Your Life. Pain Free With No Compensations.

Sprained Ankle1

Mild second-degree sprain, (lateral sprain).

There are two forms of sprained ankle―medial or lateral. Runners most often laterally sprain an ankle by going over on the outside of the foot. Athletes who constantly and explosively change direction, such as basketball or football players, tend to suffer medial ankle sprains. A sprain is an overstretched joint ligament (which may or may not be torn) caused by trauma where the joint is forced beyond its normal or functional range of motion. The damage can vary from minor to severe, including rupture and avulsion which require rehab ranging from simple to complex. Many of the fore-mentioned foot conditions can lead to a sprained ankle, especially flat foot, high arch and weak ankles. A sprained ankle is painful; it swells up, bruises and requires rest, ice and immobilization to enhance recovery. Small tears of soft tissues will generally “knit” back together in a higgledy-piggledy knot-like adhesion (see athlete’s ankle), while larger or complete tears may require surgery. Avulsions where the ligament has ripped off a bit of the bone attachment site may require full immobilization and casting.

Related Story:

I’ve sprained my right ankle many times over the years. Once an ankle has been sprained, it’s prone to being a weak link at a later date as has happened in my case. I’ve never sprained my left ankle. I wear glasses for distance vision but often like to run without them. Years ago, living close to an uninhabited estuary in south Texas, I ran with my dogs regularly after work. One such evening my right foot landed on half a house brick, sight unseen, and I was quickly bowled over the outside edge of my foot (lateral ankle sprain). My dogs circled back and licked the tears from my eyes as I groaned piteously on the ground. Eventually I stood and hobbled slowly home with the dogs in attendance.

The next morning I had my foot X-rayed and the doctor said my ankle joint had survived the trauma even though the ligaments were inflamed and swollen, but the fifth metatarsal had been avulsed (tendon attachment to the bone of the little toe at the side of the foot). He gave me two options: to be immobilized in a cast for six weeks, or wear an open sandal and be careful not to irritate the outside of my foot when walking as normally as possible.

I’d planned to be snowboarding on Mt. Hood, Oregon in three weeks’ time. If my foot was in a cast, I couldn’t fit into snowboard boots and my leg muscles would begin to atrophy. I chose the other option and walked carefully in an open sandal. All went well with the healing process and eventually I could fit into my boots and snowboard as planned.


  • Rest, ice, compress and elevation (RICE) to reduce swelling.
  • Immobilization creates muscle atrophy, so after the sprain is fully healed, focus on strengthening all the surrounding muscles and ensure full and normal range of motion.

Corrective Exercises:

  • After the sprain has settled down, strengthen peroneous longus and tibialis posterior to assist with arch support and ankle stability.
  • Ankle ROM’s.

Strengthening exercises shown in the “Happy Feet” Stack Blocks section.

If you want to read more about typical runner’s injuries, and correct rehab, how to find root causes and how to rectify the issues with specific of exercises, stretches and strengthening with lots of photos, click on the cover page