Healing a Sprained Ankle

One of my most dreaded fears on runs, hikes, and job sites reared it's ugly head again, the sprained ankle. We embarked on a regular Saturday morning trail race in a wonderful County park with rolling hills. Not much different from my "home trail" except no real elevation gain. Knowing the Memorial Day weekend was full of anticipated projects I was completely and utterly content at starting of somewhere mid pack, take it slow, pass when the opportunity presented itself and find a good pace pack to run with. My fear was starting to creep into the back of my mind as I got bunched up with a pack running at a conservative pace leaving me blind to the trail and staring at the heels of the runner in front of me instead of the trail. When the trail opened up on a downhill slant I was able to stretch out to a normal pace and find my stride. The race was a double loop and I took my time at the halfway point, a little hydration, shake some stones out of the shoes, breathe in the wooded air. The next two miles I found myself out on the trail alone as runners spread out along the course. At some point I lost focus and got too comfortable  enjoying the whoop-de-do's and mountain bike made banked turns. Somehwere around the 8 mile mark Pop, Face Meet Trail. That leaves 5 more miles of hobbled trail navigation to go.

 As I have noted in past injury related posts, I AM NOT A MEDICAL PHYSICIAN, but seeing as this sprain is somewhere between the 22nd or 25th on this ankle and one on the right ankle I have a pretty good amount of empirical evidence to feel comfortable in my recommendations.

If you have never sprained an ankle and you found this article, YOU WILL RUN AGAIN, promise. It's usually not as bad as you think the moment it happens and after the inital pain wears off. Basically there are 3 levels, if your hear a pop and you find yourself catching your balance on something or taking an awkward tumble, you see some stars and you get a little nauseous it's a level 1, you'll be just fine. If you hear a pop, face plant into the ground and scream in agony on the ground its probably a level 2, these ones really hurt and you'll probablly be out of commission for a day or two plus not running for at least 3 weeks. If you hear a snap, have no idea how you ended up laying on the ground rolling in your own vomit, feel like it's 200 degrees  and the world is ending it's likely a level 3 or you broke it. A level 3 is a complete tear and you will be out of commission for a week and not running for 6 weeks (at least), if you can't put any weight on it and you puke in your mouth when you take a step it's likely fractured. The shitty news? There's not a whole lot you can do about it and will likely have to immobilize it while it heals.  So what can we do if it falls in the not so bad news of level 1-3?

Everyone is likely aware at this point about RICE (Rest, Ice, Compression, Elevation) but for those who find themselves out on the trail somewhere Compression is about all your going to be able to do if you can't find a cold stream or snap pack in a medical kit. By the time I finished the 5 miles to the finish line my ankle was pretty much mush. An ice pack wouldn't do much but if you can find an ice bucket or ice bath I strongly suggest full immersion. You made need a heavy jacket or a heated blanket (or a flask)  to ward off the shock but full immersion is the only thing that is going to reduce swelling and pain. The next is Compression but you need to be careful here, after the damage has occurred and the trauma has passed you'll need those new red and white blood cells pumping through your veins to start the repairing process. In my backpack I carry two Mueller Ankle Braces rolled up small and tight and a knee brace plus an ace bandage or two (ok, the ace bandage had to be left behind due to shortages of TP during a mountain excursion) After all the sprains I have had I can tell you I can't stand the agony of sitting in a waiting room to have someone tell me its a sprain and we'll have to bandage it up, RICE, and "stay off of it for while", here's your bill. What I can tell you is that out of 2 or 3 of these instances I did have the availability of an acupuncturist and did sit until my butt went numb with needles sticking out of me like a pin cushion. These 2 or 3 times were the fastest helaing sprains I have EVER had and have to recommend that if you have suffered an injury like such, acupuncture IS part of the healing process. The next couple days are going to be painful, and this particular time around I am still getting pulsated throbbing throughout the day and night on Day 7 of this injury. So as far as pain relievers go I prefer Beer, but that has limited use do to work, driving and using equipment ( And I refuse to take anything stronger than Naproxen Sodium). Two natural remedies that I have had great results with have been Arnica and Bromelain. These combined with nightly hot soaks in Magnesium Sulfate (Epsom Salts) reduce the throbbing, help blood flow for repairing damaged tissue, aid in sleep, and reduce tightening. I can say that the biggest part I struggle with in RICE is the resting part. I did have some shock after the race and did sleep for a considerable amount but the following days I tried to resume "semi" normal activity. As I am realising that's not the greatest idea I should have written this article while soaking my ankle in hot epsom salt while drinking beer, Well, stay healthy and read up on your next training, watch some running videos, write some articles and fear not, the Mountains Are Calling, We Will Go Again. 

The Marathon Metaphor

I've often heard many a comparison between the marathon and arduous struggles. It has always made sense to me as I have experienced the physical and psychological speed bumps discovered through 26 miles of running. During my run this weekend I was thinking through the joys and pains of running and thought I'd take this autumn running season to reflect. If this post doesn't receive many views so be it, if you are the future me, your welcome, you've been here before and you will be here again, this too shall pass.

Running during this time of year is exhilarating! There is a crisp fresh air that cools the nostrils, there is a fresh dew on the ground that blankets the dust, and there is the fresh smell of leaves on the ground. Sometimes I have to stop as I notice a wonderful view that was obscured through the summer by a large Maple tree. Sometimes I stop to observe the fungi taking over a patch of decomposing mulch. Sometimes I think back at all the runs I have enjoyed and the injuries I've had. Here come the metaphors! One step at a time, never stop trying, keep moving forward, even running backwards gets you to the finish ( I use this one when I'm cramping bad and need to transfer fatigue to other muscles) and it's the journey not the destination, etc....

So I think back at some of these times as I work through another strained lower back injury and remember all the other times I've had to throttle myself after trying to hard an injuring myself.

I'm not alone in this and some other runners will nod in agreement and have their own stories. Here are the times I was broken and out of commission.

Sprained Ankle ( too many to count, maybe 20 or more?) recovery (2-8 weeks)
Hamstring ( both legs, different years both from Kenpo not running) recovery (3-4 months)
Lower Back Muscle ( one of the worst so far, during a 10k no less) recovery ( 6 months and outright terror during rehabilitation)
Foot Muscle (somewhere between mile 18 and 24, I think I was crying at the finish line) recovery (3 months and tender for much longer)
Fractured Metatarsal ( again a freaking 10k, fell on my face the next morning trying to get out of bed ) recovery (8 weeks and mostly only walking for awhile)

All in all it's been a roller coaster of highs and lows but nevertheless I always feel the most alive out on there kicking some trail. There are many a metaphor but to wrap this up, YOU'LL BE FINE, find another hobby in the meantime, and soon, sooner than you can imagine, RUN!!!!!

Marathon Training Week 1, Damn Sprained Ankle

So if running has ever been a paralleled metaphor for life this just had to happen. The first week of training started off and sure enough I caught the edge of an office chair and rolled my left ankle again. I can't recall how many this makes it, but my left ankle has taken more than two dozen rolls and sprains. With that said I thought I'd reflect on my approach to training with a sprained ankle and offer some insight on what or what not to do. This is according to me with the DISCLAIMER: damn it I'm a runner not a doctor!

But................Luckily I know someone who is! Dr. Kotarski is a Naturopathic Doctor in Seattle's Ballard District. The first course of action was of course Rest, Ice, Compression, and Elevation. Having been down this path before I carry (2) ace bandages, (2) Mueller ankle braces, (1) Mueller knee brace, and several ibuprofen.  The second course was a combination of three prescriptions that I can't pronounce so you'll have to check out her website.

The sprained ankle occurred on Friday with a scheduled 6 miler for Saturday. Nope, no go, I was hobbled. So I set in motion my plans for cross training and core work that did not involve pounding my feet against the pavement. Simple sit-ups, leg lifts from the floor, push-ups, and alot of stretches. I will most likely be adding Yoga which will also be a first for me, but that might have to be another post. I started looking for a new bicycle as well so I could continue working on my leg condition and anaerobic conditioning.

Sunday I actually had full movement of my ankle so all wrapped up we went for a hike up in the hills. Surprisingly I made the 4 mile hike with no problem and was able to enjoy the views I normally pass by on my runs. So by Tuesday I had schemed that I was all patched up and ready to go. I decided after work I would try my regular after work run and see how I could do. I have been using Queen Anne for hill training and I figure two or three miles with those hills will be worthy of a workout and keep the pounding on my ankle to a minimum. I was able to complete my runs but they were short, two on Tuesday and my ankle was sore, four on Wednesday and I felt ok, three on Thursday and felt great so I completed an eight miler on Saturday around Lake Youngs.

This was probably not a recommended approach but I do not sit still very well. This ankle sprain recovery was the fastest I have ever experienced and I thought I should put that out there for anyone trying to recover from that blast of defeat you feel when you fall on your ass in pain hearing ligaments tearing apart in your ankle.