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self-rehabbing a (twice) sprained ankle :(

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Old 05-15-03, 01:23 PM
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self-rehabbing a (twice) sprained ankle :(

Ok... this is annoying. I sprained my ankle for the first time 3 weeks ago. It was a mild sprain, See my reply to this thread: Bikeforums link

Then, a little over a week later, I decided that my ankle felt good enough to take my road bike out (which has Speedplay clipless pedals). The 'test ride' around the neighborhood went great -- including clipping in/out of the pedals. The 'real ride' went fine until I was stopped at a light... on a slight incline. Unfortunately, I was starting up again in too low of a gear. My right foot (bum ankle side) was still clipped in. Just couldn't get enough momentum going and, yes, I tipped over to that side and re-sprained my ankle. Figures the first time ever that I tip with the clipless is on a bad ankle day.

So... it has been 2 weeks since the re-sprain. My ankle is doing much better, but my frustration is in clipping out of the darn pedal. About a week ago, I could not clip out at all and had to remove my shoe, then take the shoe off the pedal. I've only been confident enough to ride on the trainer -- bummer when the weather has been nice lately.

Now, I can clip out, but it takes a few attempts and still hurts a bit when I do it.

The pain & stiffness is at the front of my ankle and top of my foot and only happens during certain movements. I can't point my toe as far as the 'good' foot. Pain/stiffness is also around the outside of my ankle bone (fibula?) area when I turn the foot inwards as if to stand on the outside of my foot. There's still a little swelling in that spot, too.

Any thoughts as to how long it might take to regain full movement? How long until swelling goes away? (I usually ice it after exercise.) Anyone had similar experiences?

From the beginning, I've been able to walk on it and can run if the surface is reasonably level. I've been doing stretches -- the ones that don't seem to hurt too much anyway. What else can I do to quicken the healing process? :confused:
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Old 05-15-03, 02:33 PM
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While I'm not a doctor, nor is what I say to be taken
as medical advice (hey, its lawyer talk ok? )
I'm wondering if you did more than just sprain it?
Seems 2 weeks is a bit long to still have noticable
swelling, and the pain should have eased off a bit.
I'd suggest you see a real doctor (not some internet
wannabe ) and have it checked out.
FYI it took about a week before I had full range of
motion after my little mishap with my back.

Hope you get to feelin better soon
Remember, no matter how much you want
to ride resist it until you are really healed.

Marty
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Old 05-15-03, 02:51 PM
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i 2nd that see a doc, you only get 2 ankles, and they dont let you return them.
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Old 05-15-03, 03:44 PM
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Sprained ankles can take months to heal depending on how many collateral ligaments you may have torn in the ankle. However, lotek is right, certain types of stress fractures can also present with slow healing process. Go see your doc.
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Old 05-15-03, 07:12 PM
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And stay off your bike in the meantime!!!

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Old 05-15-03, 10:24 PM
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Be a man and tough it out. Only wimps let injuries stop them from training.
No pain no gain!

Philosophies of a madman....

If you cannot use the associated areas without feeling pain then stay off of it. Any amount of pain indicates it needs more rest.

Now If I can only take my own advice.
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Old 05-16-03, 08:00 AM
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I've always heard that about ankle sprains.
what concerned me is the fact that the area that hurts
(if I read the original post correctly) is on the top of
the foot, over the bones in the arch (tarsils? Metatarsils?
gawd its been too long, or I have alttimers starting)
and not the ankle specifically (unless rotated and then
the pain is more towards the anterior aspect).

Anyhow, let us know what the doc says (and you
are gonna go see a doc, right?)

Marty
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Old 05-16-03, 09:15 AM
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Originally posted by lotek

what concerned me is the fact that the area that hurts
(if I read the original post correctly) is on the top of
the foot, over the bones in the arch (tarsils? Metatarsils?
gawd its been too long, or I have alttimers starting)
and not the ankle specifically (unless rotated and then
the pain is more towards the anterior aspect).
Ok, I meant that the pain is in the front of the ankle -- I guess that would be 'anterior' then. When I point my toe (as much as I can anyway), the muscles (?) along the top of foot feel tight -- not painful. Pain is limited to 'anterior' and outside (lateral?) of ankle. Sorry, I'm not up to speed on medical terms at all. It's hard to describe these things without pointing to my actual foot. That doesn't help you guys much, does it?

[/QUOTE]Originally posted by lotek [/B]
Anyhow, let us know what the doc says (and you
are gonna go see a doc, right?)
[/B][/QUOTE]

Yes, I called the doc this morning and have an appointment for next Thursday which was the soonest they could see me. If there's a cancellation before then, hopefully sooner. I'll report back.

(Grr... pardon the format of this post. The second quote thing didn't turn out right.)
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Old 05-16-03, 02:05 PM
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I'm recovering from a sprain right now. I'm disabled for at least the next 6 weeks, and have probably screwed any chance of another placement with the temp agency I was working with.
The doctor gave me a fairly serious ankle brace to wear, one which won't allow me to use cycling shoes. Looks like I can't get on my bike for 6 weeks....
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Old 05-16-03, 03:09 PM
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Hi there,...

Although I'm a newbie to cycling, I know a thing or two about sports injury...as I'm a chiropractic orthopedist, a chiropractor specializing on orthopedic injuries.

From what I gather from reading your previous posts, you've originally sustained a "mild" inversion sprain. This is to say, that the various supporting ligaments on your ankle was "sprained mildly" when your foot "inverted" while stepping off of the step while carrying a box. This leads to microscopic tearing of the ligament, in your case, the medial talocalcaneal ligament (on the lateral or 'outside" portion of the ankle). Now, when one hears the term "microscopic tearing" one may think of a partial tear, but in this case it may be minor.

In either case, "mild" swelling shortly after the actual incident of "sprain" will lead to a inflammatory process which may take anywhere from 20 minutes to 40 minutes, depending on how seriously it was sprained. With this type of injury, the simple diminishment of the perceived "pain" or even the swelling in not the actual indication of the healing process that is being undergone by the ankle. Here are some tips for the future...

1) first goal is to reduce the swelling. This is important since it will help the ankle initial heaing "in the correct manner". Persistance of swelling will lead to greater build up of scar tissues in the ankle, leading to poor and improper healing and more unstable ankle, which will be more prone to the same injuries in the future. One should elevate, ice it, and apply compression (ace bandage). If the swelling is more "noticable" one should seek professional help to rule out any further injuries or even fractures. If the swelling and pain is considerale enough where weight-bearing standing posture if slight to moderately difficult to maintain, even attempt at walking, one should seek immediate professional care!

2) limit the time of standing or walking. Stay off of your feet and keep icing it and elevate it. When sleeping, apply compresion via the use of ace bandages.

3) Receiving physical therapy, including interferential electrical stimulation, will speed up the healing process and reduce the amount of scar tissue formation. This will lead to greater stability and stronger ankle and ligamentous structures.

4) Stay off of the bike for at least two weeks! After several days or couple of treatments follow the doctor's advise and start off with mild stretches and walking exercises, never on a bike initially!! The simple act of pedaling, especially while standing on the pedal and leaning forward, will stretch out the ligament that was initially injured and re-traumatize it!!! Use your head and sensed and get back gradually.

5) retraining....one may need to "work out" the legs and thighs to re-strengthen the muscles to help support the ankle when getting back to riding. This may take going to the gym and using specific exercises and machine to work the muscle groups.

6) when not sure, always seek professional medical help!!

Gotta go...have patient's waiting...

Dr. Christopher
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Old 05-16-03, 03:20 PM
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One more thing to those who've injured their ankle before....

USE SUPPORTIVE ANKLE BRACE OR SPORTS TAPE FOR SUPPORT!

USe of a simple sports tape to support the injured ankle will prevent further injuries during the post injury self-rehab. Ask your local sports injury specialist to show you how to "tape" your ankle.

Hope this helps...

Dr. Christopher
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Old 05-17-03, 08:13 AM
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OK, Dr.Chris, I have a specific question for you:
Will my ankle brace give me adequate protection for clipping and unclipping from my Look cleats? Also, I have 2 braces right now: a lace-up one, and another plastic one. Will I be able to cycle without the plastic one, without risk of reinjury? That thing is too big to put into a shoe, and i'm sure it will hit the chain.
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Old 05-22-03, 05:59 PM
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Update...

I saw the doctor today. X-rays showed that nothing is broken, thank goodness. Doc classified it as a Grade 1 to 1 1/2 ankle sprain and gave me a velcro type brace (Rocketsoc) to wear during the day for the next couple of weeks. Kinda sucks -- it doesn't fit into most of my shoes, but could be a LOT worse.

I also have a list of exercises (with instructions/diagrams) to do every day to increase range of motion and strengthen it.

I can run (on flat surfaces) and bike as long as it feels ok to do so and I must wear the brace. That pretty much means that I'll be swapping my Speedplay X2s for platform pedals for awhile. (can't fit my braced foot into the road shoes -- I already tried!)

Does anybody know if Zefal Mini Toe Clips are still available? I have some on my MTB ( love em!) which I could relocate, but I wouldn't mind having a second set for the other bike.
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Old 05-23-03, 07:16 AM
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One more thing... the ankle-specific exercises are excellent. I'll be a good girl and keep them up twice a day so that I can ride sooner.

Not riding just plain sucks, especially with the weather being so ideal lately. Well... it won't be long until I'll be back out there! (Maybe I'm just in a good mood because it's Friday.)
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Old 05-23-03, 07:31 AM
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Originally posted by OctoberBlue
Does anybody know if Zefal Mini Toe Clips are still available?
Check Bike Nashbar. I was flipping through their catalog and saw some Nashbar brand mini toe clips for under $10.00

Zack
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