Three weeks ago today, I twisted my ankle while running fast down hill on a trail near home. My ankle was mostly fine, though I suffered a similar injury in 1990 while running/racing downstairs and turned my ankle at the bottom of the steps. At that time I did not go to the doctor or get an X-Ray. But, it was mostly better after a couple weeks (just in time so that I was barely limping in my wedding ceremony). And I wasn’t running as regularly back then. I have known from decades of running (both in shoes and barefoot) that this injury had left my right ankle weaker than normal, which probably contributed to this re-injury.
I was also shooting video of my feet on my last run – where I twisted the ankle and broke my metatarsal), but unfortunately, just before I turned the ankle, I had changed angle of the camera to view the trail ahead ;-(
A sadly magical shot missed by that much!
Post Injury, No Haste
After this recent injury, I walked very gently 1.5 miles home. The pain was extremely similar to the injury in 1990 (a nasty twist of the ankle while wearing shoes 24 years ago). Swelling about the same, but bruising was a bit more, probably due to the 1.5 mile walk home before resting, elevating, cooling the foot down (not with ice, better to use frozen peas or berries – ice is too extremely cold, and the cubes don’t conform as well with the shape of the foot), and compressing (R.I.C.E. – Rest, Ice, Compression, Elevation and/or Exercise – see Gallery below for examples). Keep in mind that the “Ice” and “Compression” should be for relatively short periods. Rest and Elevation can be for much longer periods – about as much as practical. Exercise of the injured area should wait until initial healing is mostly finished – otherwise, you’re just going to re-injure, again, and again, and again. In the meantime, exercise other (un-injured) areas of the body by tensing, relaxing, and stretching, and relaxing, and of course more relaxing.
Documentation of the Injury
I happened to be shooting video of my feet on my last run – where I twisted the ankle and broke my metatarsal), but unfortunately, just before I turned the ankle, I had changed angle of the camera to view the trail ahead ;-(
A sadly magical shot missed by that much!
This time, after a few days, I called my doctor, and got an X-Ray of my right foot. The doctor didn’t seem to think the ankle needed an X-Ray (no tenderness), and I agreed, it’s probably tendon or ligament damage that needs to heal there (and build strength after healing).
My fifth metatarsal was cracked, not displaced. There was a small heel spur, and a little bit of arthritis in the 1st metatarsal. At almost 59 years old, no surprises on the heel spur and arthritis.
It’s been three weeks, I’m walking 1 mile, 1 or 2 times most days with Psycho Herman. A few days ago, Herman and I walked at least 2 miles. Some days, when my muscles are more tired and sore, I don’t walk as often or far. But still short outing mid-day with Herman to visit some neighbor cats and dogs hanging around outside our place.
Much of the soreness from walking is because I’m not relaxing as much as I should. it’s a bit difficult to take that “leap” when sudden changes in pressure on the foot hurt most.
My doctor had refereed me to the orthopedist group to get a cast or a boot. I suggested the boot, so I can remove it to wash, shower, etc.. My doctor agreed. But the ortho group told me not to call them until my doctor faxed the referral authorization – which has been done twice now. Then they said they would call me back when they received the authorization, and they never called me.
At two weeks since injuring my foot, and since my foot was healing well (Cathy and I have been on a 2-week mostly raw diet which is probably helping the process), and I believe the walking (very gently), which stresses the foot slightly (not to the point of pain) probably stimulates more healing than if the foot were completely immobilized. Also, this should help keep the muscles from atrophying too much (much like they do in rigid shoes). So I’m thinking I’m not going to worry much about seeing the orthopedist or getting the boot (though it might have been a useful prop in future presentations).
What to do Differently?
One of my neighbors asked an important question, “What would you have done to prevent this injury?”
The answer begins at least 24 years ago, when I twisted and sprained my ankle while racing down stairs at work. At the last step I tried to turn 90 degrees while I still had too much momentum and my ankle rolled over and was badly sprained, leaving it weakened, and also injuring my foot (I was wearing running shoes at the time).
What I would have done differently, would have been to not wear shoes while racing down those stairs, and especially not to turn so sharply at the bottom of those stairs. Both of these contributed to weakening my ankle and foot. The shoes especially, with their thick-ish sole increased the torque on the ankle when rolling.
That I could run fairly well (if I say so myself) since then, was more likely due to abandoning shoes for running shortly after that incident, except for twice in 1998, once on severe gravel trails, and again after running too much in too short of a time. But mostly exclusively barefoot since 1990 – and probably the foot had never healed properly all that time. Now I believe that this break may be allowing it to heal properly for the first time!
What I am doing now, is exercising my ankle to build more strength, while allowing my foot a full 6 weeks to heal (it has been 3 weeks now).