Ankle Injury

January 12, 2014

Jacqui asked The Guru for the following Physiotherapy Advice:

Dear Guru,

I have an issue with my ankle. To give a bit of background, I used to run quite a bit, but only really shorter distances of 5 miles or so. I had an injury 2 years running, which was located up my calf which felt like the ligament had torn and I could not put pressure on my foot to walk. This healed and as mentioned, the following year the same happened. I believe this was due to inadequate stretching before and after exercise. I may add that I was running a lot outdoors rather than in the gym.

I have now overcome this issue (hopefully), and have been running both in the gym (5K runs + a half hour on the step machine) and also outdoors (circa 5 miles). I few months ago I participated in a 10K run and I have a half marathon to run in 2 weeks time. I have noticed over the past 2 -3 weeks that I have pain just behind and under my ankle bone (outer ankle) if I point my toes and turn my foot outwards (no issue inwards). If I point my toes and rotate my foot in a circular motion, then my ankle is painful. It is more of a dull pain than sharp. I had been trying to research online about what this could be and what the treatment could be for this, more importantly, if i can still train on this injury. Is this a sprain? Should I perhaps restrict my exercise to low impact machines at the gym (such as the crosstrainer) over the next week while using the RICE technique before I try to run again? I can still run, but it is painful afterwards and I have noticed a stiffness afterwards in my ankle and foot when I try to place my foot flat on the ground to walk, particularly after long periods of non-movement, such as sitting for a few hours or in the morning after I’ve been asleep all night.

I’m hoping that you can help

Jacqui
January 12, 2014

Hi Jacqui

On all probability I think this may be related to your previous 2 injuries [sports physiotherapists advice], which makes me think why?

I think you’ve got an issue with you peroneal tendons – which helps pull you foot and and help with control over the foot and ankle. They can commonly become frazzled because they have to do too much to make for stability elsewhere. This elsewhere may be the link between your old calf issues, and this.

The tendon issue may just be the symptoms and the cause may well be an issue higher up, like poor pelvis stability, lower limb control or poor endurance patterns.

Keep icing, see what your single knee squat control wise is like on the good versus poor leg and then practice lots and lots of single leg balance work for the next few weeks. Anti inflams (if you can take them) will also help. The less impact you do the better, but anything with a fixed foot (step, cross trainer, bike) shouldn’t be be a problem.

The Guru

Six Physio

Guru Responded

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