Ultrarunning: Some Sprained Ankle Guidelines for the Ultrarunner

March 20, 2012

This article is part of Endurance Planet’s ultrarunning article series. If you have questions, comments or feedback about “Some Sprained Ankle Guidelines for the Ultrarunner”, please leave it below in the comments section…

An ultrarunner’s ankles are probably going to be another frequent site of injuries. It is somewhat inevitable given the mileage you’ll be building up during training and the formidable distance you’ll need to conquer on race day itself.

One way to look at injuries like sprained ankles is through the kinetic chain concept. This idea postulates that our bodies are a linked sequence of bones, muscles, and joints through which force travels through (this is of course a very basic and oversimplified explanation of the term). As long as every link on that chain is in good condition, your performance won’t be troubled. Your ankles then are obviously an important part of that chain. Hopefully if you take good care of them, they won’t become the weakest link that forces you to not complete an ultra.

Sprained ankles

What ultrarunner hasn’t sprained his ankles to some degree of severity at some point in his practice of this sport? The typical case is that your ankle twists such that the sole of the foot turns inward. This overstretches or tears the outward-facing ligaments, particularly the ones called talofibular ligaments. Twisting an ankle in the opposite direction also happens too but this is much rarer.

As you can easily figure out, the situation that commonly brings about this type of injury is running on rough terrain. Although that directly points to trail ultras, remember that your feet can just as easily fall and get caught in a road pothole. Previous ankle injuries from another sport, activity, or accident may also weaken the bones, ligaments, tendons and other tissues that comprise this joint and make it more susceptible to sprains.

Grades of severity

Pain and other factors such as stability are good enough initial guidelines for gauging the severity of your ankle sprain. In a Grade 1 or mild sprain, the ligaments are likely just overstretched with possibly some minor tearing. The pain is mild and the joint is still fairly stable. There could be some swelling around the ankle bone. Usually it’s still possible to walk this one off.

Grade 2 or a moderate sprain involves more ligament tearing. The pain can be moderate to severe and there will be some unnatural looseness in the ankle joint. Some bruising, swelling, and stiffness are going to be evident. More often than not, you may have to call it a day when the sprain is at this level to avoid making it worse.

Grade 3 is the worst case where the ligament is completely torn off. The pain will be very severe and the joint absolutely unstable. There’s going to be a lot bruising and swelling on this one.

Remember that these grades are simply a quick way for you to estimate the damage right after the injury occurs. You still need to get your ankle examined by a medical professional even if you feel it’s just a mild sprain, just to be on the safe side.

Treatment and prevention

You’re probably already aware of the R.I.C.E method (Rest-Ice-Compression-Elevation). You can use any or all combinations of this approach. Ice is going to be particularly necessary the first 36 hours to contain the swelling. Don’t hesitate to take some appropriate anti-inflammatory medication if there’s really a lot of pain.

Consider bringing along some spare compression tape, elastic ankle brace, or any other type of manufactured or improvised device for keeping your ankle stable. In mild cases, this can be an immediate remedy that may even let you finish the race.

The preventive approach is to strengthen your calves and improve your balance. Your calf muscles are a major part of the process of shifting weight from heel to toe. One suggested exercise is to attempt balancing on one foot with the other leg bent back. You can close your eyes to train yourself to stabilize your ankles for balance by ‘feel’ alone. Of course it would also help to train specifically on rough terrain and if you happen to be unfamiliar with running on trails, you might want to take it slow in the beginning.


Do you have questions about sprained ankles, or what you’ve read so far? Do you have any ultrarunning pointers of your own to add? Please leave your feedback, comments and questions below, and we promise we’ll respond.

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