How to treat a twisted ankle

The joints of your ankles allow your feet to move this way so you can run on rocky trails, descend through snowy slopes and clog your feet in crevices. Unfortunately, they are also prone to twisting; Crooked ankles are a particularly common injury among outdoor adventurers and can occur with almost any activity, such as hiking, biking, skiing, snowshoeing, climbing or running. Considering the frequency with which twisted ankles can be produced, knowing how to treat them is a valuable skill.

How to treat a twisted ankle

Evaluate the lesion: determine if the ankle is usable or not, considering how it was injured, observing the signs and symptoms and performing a usability test.

Manage pain: using ice, raising the ankle and taking pain killers are options for pain relief.

Support the ankle: if the ankle is usable, you can apply tape, a wrap or an ankle brace to provide support.

The information in this article is taken from NOLS Wilderness Medicine, sixth edition, which is the basis of the curriculum taught by NOLS instructors. You can take a NOLS Wilderness Medicine course at many REI stores:

Step 1: Evaluate the injury

When a sprained ankle is done, the ligaments (the tissue that connects two bones) stretch and sometimes tear, which is painful and possibly debilitating. When this happens outdoors, miles away from modern medicine, it is usually not possible to diagnose the exact lesion (such as the specific degree of the sprain or the severity of a fracture). Instead, it focuses on assessing whether the ankle is usable or not. That is how:

Determine the mechanism of the injury: understanding how the patient is hurt can help you decide how to proceed with the treatment. Questions to ponder include, how did the injury occur? Did the pain come suddenly, maybe from a fall? Or, did it slowly ignite and progressively get worse? In many cases, the answers will be obvious, such as when the patient tells him that he stumbled and rolled an ankle. However, at other times, things may not be as clear, as when the pain is not related to a sudden incident (such as a fall) or if the patient hit his head and can not remember all the details.

Evaluate the signs and symptoms: remove the patient's boot and sock so that he can examine the injury by looking, asking and feeling. Look for swelling and discoloration and ask the patient if they have pain. The pain of pressing a specific point or obvious deformity may indicate a fracture. Severe pain, the sound of a snap at the time of injury, and large swelling areas immediately are signs of a severe sprain or fracture and require immobilization of the injured ankle and evacuation of the patient. While evaluating, it may be helpful to remove the sleeve and sock from the uninjured foot so you can compare the shape of both ankles. This allows you to more easily detect subtle swelling or deformity.

Perform a usability test: if you think the ankle may be usable, have the patient try to move it through its full range of motion. If there is no pain during this is a good sign. Now, make them try to support ankle weight. If you can do it without significant pain and the swelling is not serious, you may be able to tackle the injury in the field and possibly continue on your way. If the patient can not use the ankle, he must immobilize the injury and evacuate the patient.

Step 2: handle the pain

A sprained ankle, even one that you have determined is usable, can hurt a lot. It can help to console the patient by managing pain in these ways:

Rest: Have the patient eat something, hydrate and relax for a while. This could be an hour or two if the injury is not so serious, or a whole day if the pain is more annoying and you have time (such as on a multi-day trip).

Use ice: the application of ice, if you have it, can help reduce the pain caused by a sprained ankle. If you do not have ice, a cold stream or a lake could provide relief. Try chilling the ankle for 20 to 40 minutes at a time. You can do this every 2-4 hours or after using the ankle. The goal here is to apply ice from time to time to reduce pain, not to suppress the swelling.

Elevate: raising the ankle above the level of the heart can help reduce swelling and control pain. This can be useful for resting during the day or sleeping at night.

Consider pain medications: For pain that prevents the patient from resting, consider over-the-counter pain medications, such as ibuprofen.

Step 3: Support the ankle

Once you have determined that you can use your ankle, adding support with tape, a bandage, a brace or even a trekking boot can make walking easier and more stable. This is especially true if you are traveling on uneven terrain or carrying weight on his back.

Tips to prevent a sprained ankle

A sprained ankle may take weeks, if not months, to heal, which can seriously reduce your outdoor fun. Here are some ways you can help prevent an ankle injury:

Wear the right shoes: the choice is yours to wear on your outdoor adventure, but before you leave, take a minute to think about how well your shoes can handle the terrain you will find. Consider things like traction, ankle support and cushion in relation to the surfaces on which you will travel.

Warm up: instead of taking the cold trail or climbing a rock climb, take about 15 minutes to warm up the muscles and tendons by performing dynamic stretches that mimic the movements you will perform during your activity. Things like high knees, jumps, leg movements and arm circles are good ideas.

Be careful: a path full of roots, rocks and loose dirt is waiting to trip you up. Be careful when traveling, especially if the road is wet and / or steep.

Combat Clumsiness: Injuries occur more frequently in the late morning and late afternoon when dehydration and fatigue occur, resulting in less awareness and increased clumsiness. It is also more likely to occur when you are tired, cold, dehydrated, rushed or feel sick. To combat this, dress up according to the weather, drink plenty of fluids, and stay energized at breakfast, dinner, and three or four light snacks throughout the day instead of the traditional three-meal-a-day routine.

Slow down: moving too fast can often cause injuries. Plan realistic schedules for your departure so you do not feel rushed and take many breaks, especially before the difficult sections of the trail.

Get in shape: it can take a lot of effort to walk, backpack, ski and climb. In the months leading up to a great trip or a season full of outdoor adventures, focus on endurance, flexibility and strength training to prepare your body. Being physically fit for your exits can help prevent injuries and increase your enjoyment.

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