I recently sprained my ankle while trail running in Arizona. I recovered from it both quickly and strongly, so I am going to share my protocol. To be clear, this is what I did to help my body heal more efficiently, and that these are things that could foundationally help most people, but every injury, body, and mindset are different. It’ll be nearly impossible to get the same results, even for me when this inevitably happens again (I badly sprain my ankle every 2 years). I’ll be including pictures of the injury, some (most) are gross, but it is just an ankle so I know you can handle it.
I don’t think I’m super great because I recovered quickly, but I DO know how important it is to get back out there after an injury, so this is my story I’m sharing with you.
15 days after I sprained my ankle, I completed a 12-Hour Mountain Endurance Challenge that resulted in 28.4 miles of hiking/running with 12,000′ of gain on snowy single track. It meant so much to me to participate in that race, so my recovery was honed in on being able to complete that challenge, and I feel so lucky to have been able to do so.
When we get injured, we get frustrated and emotional because we think of the races and training runs we’re about to miss. Total FOMO ensues. Well, if you have an event much like mine that means a lot to you, I hope you can gather some tips in this blog on how to recover fast (but smart) to give yourself the best chance possible at being on that starting line.
Injury: Lateral ankle inversion sprain (L)
Story: One mile into a solo run I misjudged a patch of rocks (photo below) and cracked my ankle not once, but twice. That was a first. I yelped in pain and then muttered to myself “welp, here we go again.” Luckily, I was able to maintain my balance and didn’t fall, so I tested how much pressure I could put on my left foot and immediately turned around to hike back to my hotel. And I mean immediately. Whenever I get hurt I pop right back up and turn around to make it back to safety, wherever that may be at the time. And I hold off on crying until I get there. For this particular injury, I believe a big reason why it happened was because it was at the end of a full week of hiking and running, and I was pretty tired. It was around 8am, and I was just looking to do 3 easy miles before I left the area after breakfast. I was in Sedona, and the morning light was too good to pass up, so albeit tired, I laced up. The trail was flat and smooth (compared to the steep rocky trails I had adventures on all week) so I for sure got too comfortable and let my mind wander away from my foot strike. I remember seeing the set of rocks and thinking “oh fun!” —> CRACK. Run, complete.
So here we go, time to start the recovery process! I think what I did (and did NOT do) in the first 3 days were the most central reasons I was able to get it recovered within 2 weeks:
1. Cry it out: Got back to my hotel room, and took off my shoe. Gasp. Cry. Panic. Be really dramatic for 5 minutes (amputation is necessary!). Send photos of it to PT friends. I’ve sprained my ankle in this manner probably over 5 times in my life, and it’s never looked like this before. This is why the panic was pretty high this time, it was a new view. So acutely plump, freaked me out big time.
2. Accept help from a stranger (who happened to be an ER Doctor): I was on vacation, so I checked out of my hotel and hobbled to the nearest coffee shop. This is where I get all warm inside, because the support of strangers I got during that day it happened was unbelievable, so many people politely butted in, and I am so grateful for that. This woman’s name is Joanne and I have been trying to find her contact info ever since because she deserves at least a thank you card. She is (was?) a Pediatric ER Doctor for 30 years and was behind me in line at the coffee shop. She said she couldn’t help herself but to ask “that just happened didn’t it?” Given, my ankle was huge, I was limping, and my eyes were puffy from crying, but still, most people would have ignored it. I said yes, about 45 minutes ago. She told me her profession and that if it’s not too weird, she’d happily work on it GENTLY for a few minutes. I began to tear up and said that is not weird AT all, and I’d be incredibly appreciative.
Joanne spent 10 minutes “recreating the injury in order to re-plane the fascia,” and then gave my ankle a gentle lymphatic massage. She told me she was really uncertain if it was broken or not, so she’d be very careful. Parts of it slightly hurt, but I didn’t mind. The swelling went down by both our observation after those 10 minutes and it felt so much better. I asked if I could take a photo and she said yes of course. Thank you, thank you, thank you, Joanne. Also, it was obviously a weird sight to be seen at a coffee shop, and the 2 ladies near us were massage therapists from SF, so things just got really sweet, to be honest. I was thoroughly pleased by my pick of coffee shops that morning. Never made a better decision in my life
3. DON’T ice it: this is where it gets sticky. I can’t tell you how many people (with good intent) told me to ice it or assumed I was doing better because “you must have been icing it like crazy.” I didn’t ice it once. Only in the past year or 2 I learned this information on icing and how it delays recovery, so it has completely changed my recovery game.
The pain was bad the first 2 days, especially that first night, but I knew I could handle it. Only ice your injury in the first few days if the pain is intolerable, and know that you ARE delaying the healing. I understand it’s hard to change your mind on something that was hammered into your head since you were playing intramural sports, but give it a try the next time you have the misfortune of getting injured, I think you’ll be pleasantly surprised with a quicker recovery!
Inflammation is our body’s healing response. If you have visible acute inflammation, something is wrong and your body is sending in the troops to help it out. Why would you do something to reduce inflammation right away? Why would you want to mute your body’s method of healing? Do we, with a few bags of ice and some ACE wrap, really think we are smarter than our body? Even Dr. Gabe Mirken, the man who coined the RICE method for recovery (Rest, Ice, Compression, Elevation) in 1978, has come out and declared himself wrong in an article he wrote titled “Why Ice Delays Recovery.” He said “anything that reduces inflammation will delay healing.” And to quote another article on the subject, “Mirkin now believes that inflammation is a necessary part of the healing process, and any attempt to thwart it only prolongs recovery. He said, “The term inflammation means that your immunity turns on in response to a harmful stimulus to protect the body. The same chemicals you produce when you mobilize your defenses against germs also respond to an injury.'” He references studies in those articles if you’d like to take a closer look. And this leads me to my next “do NOT do if you can stand the pain” point…
4. DON’T take anti-inflammatories: For the same reasons as above, we don’t want to interfere with our natural healing response. Of course, pain can be REALLY bad, so it has its time and place. But over the counter NSAIDs have a host of side effects, and you especially need to think hard about if you’re taking them just so you can do something active. If you want to heal smartly and strongly, you need to allow your body to give you every indication of discomfort and pain so you don’t push it past its limit and do further damage.
5. Soak in a natural body of water: my ankle always feels best after a soak in a natural body of water. Whether it’s cold or warm or hot, it just feels really good afterwards. I found a pond in the middle of the desert in Arizona on that first day of my injury, and it provided me with some much needed relief
6. Take the weight off it: I was on my way back to Phoenix area from Sedona and the first thrift store I saw I scored a pair of $10 crutches. I used the crutches on and off the first 2-3 days to give it a break. But I’m also a big believer in active recovery and movement to strengthen it back to health. It’s a fine line you’ll have to feel out for yourself and particular injury. Rule of thumb: if it’s painful, don’t do it.
7. Elevate: since I don’t ice or take pain relievers, this is where I find the most comfort
Okay, so that was what happened the first 3 days of my ankle sprain. After 3 days of supporting it with these additions, along with nutrient dense foods and good sleep, I was ready to start bringing in my other tools. Why after 3 days? I’m not sure if I read it somewhere at some point, but intuitively it felt like the right amount of time before I started to supplement with concentrated anti-inflammatories. So I don’t have a study or article on it, it just felt right for me.
Supplements: I just used whatever I already had at home. There were a couple I thought would have been nice to have (boswellia or curcumin), but I kind of just wanted to use what I already had
- Omega-3: 1-2g
- Vitamin C with Bioflavonoids: 1g
- Vitamin D3/K2: 4,000IUs
- Magnesium Bisglycinate: 200mg
- Amino Complex: 1 scoop, 7.7g
- Collagen: 2-3 scoops in things (Vital Proteins)
- Frankincense (boswellia) Essential Oil – one of the top EO’s for pain and swelling in my opinion
- Magnesium Topical Rub from Kind Souls, a Missoula based company
- Light Therapy – I got the Joov GO a few months ago for general muscle/joint recovery and man am I glad I did. I have no affiliation with the company, I just like to try new modalities for things. I have the Infrared and put it 2 inches away from my ankle for 10 minutes 2x/day. As my race neared I increased it to 3x/day, but that is something you have to work up to. This helped exponentially, and also helped me sleep deeper which is exactly what we need during time of healing.
- Ankle exercises provided by a PT friend
- KT tape
- Epsom Salt Soak
- Hot Springs/Freezing Montana River Soaks
- Active Recovery:
- Core/Arm work
- Lap Swimming
- Back on my feet (with a brace) at work
- Training at the gym, but not doing anything that evoked pain
So there you have it, a bunch of stuff I did to heal my ankle pretty fast and steady. Although I didn’t mention probably the most powerful tool for recovery, which is the belief that it will happen. I stayed hopeful through it all, and set mini goals of recovery leading up to my race that increased my confidence that I could actually participate. I visualized myself climbing the mountain over and over, and it felt surreal to actually be out there doing it, when just 2 week prior my ankle looked like a monster. The power of belief is not to be understated, and staying hopeful through all the setbacks is absolutely critical in recovery. I hope no one gets injured soon, but if it DOES happen, I hope this helps keep your hope alive! The body is truly remarkable, and given the right support and the right environment, I believe in its power to heal both strongly and quickly.
Update: it’s been a month and my ankle is pretty rock solid. I’ll spend all day on my feet and it no longer tells me know that was a bad choice to make. I can go on 8+ mile runs without it feeling weak. It’s probably 85% recovered and so I will continue with foundational supplementation, the light therapy, frankincense oil before bed, and of course, focusing on my strengthening exercises, good food, and good sleep.
Hope this helps!