Emergency Ankle Care | Sports Medicine Sept. 2011

This may sound familiar (and if it doesn’t now, it might in the future): you’re out on a trail run by yourself. You’re having a great time—one of your longest and fastest runs ever. All of a sudden—SNAP! You awkwardly step on a root and roll your ankle. Searing pain wells up inside the joint and it seems to immediately swell up to the size of the grapefruit you have waiting in your car as a post-run snack. Well, so much for this run. Now what?

Well, my hope is that you’ve told someone where you went, which is the first rule when engaging in outdoor activities (as Aron Ralston so kindly gave us a fine example of, when he ended up having to cut off his own arm).

Still, you’re not that psyched about sitting in the woods for several hours waiting for your friends and family to notice you didn’t get back on schedule, form a search party, and actually find you. You can call for help if you have a phone and service, and be prepared to be as detailed as possible to help rescuers find your location. If you can’t call for help, or it will take long to arrive, what do you do?

First of all, don’t panic! Whether you realize it or not, you have everything you need to provide temporary treatment to allow yourself to get to help. If you have ibuprofen in your pack (always an excellent idea), take the recommended dosage.

• If there is a stream nearby, submerge your ankle in it. The cold water will help bring down the inflammation and swelling and probably help numb the pain some degree. Keeping your sock on will help keep the foot cool even after you take it out of the water.
• If there is no stream, elevate the ankle above heart level and gently roll it around a bit. This will also lessen the swelling to some degree and help bring circulation to the site of the injury.
• Locate some downed branches to fashion a splint. Two, eight-inch long by half-inch diameter pieces of dry wood will do. Put one piece on either side of your ankle, behind the ankle bones, tucking the bottom ends inside your running shoe for additional support. Then take the sock from your good foot (or a handkerchief if you have one) and tie it securely (but not too tight) in a square knot around the top ends of the sticks. Now you have some stability in the ankle at least, plus the compression will probably help the inflammation and pain a bit more.
• Next, try to find one or two Y-shaped branches, preferably ones that come up to about your armpits, to use as crutches. Use your pack or T-shirt for padding your armpits if you need to.
• If you can’t find a decent Y-shaped branch, try a regular walking stick instead. Break it so that it’s about waist-length to use more like a cane. If you only have one crutch or cane, use it in the same hand as the unaffected foot. With each step, weight the hurt foot as gently as possible, shifting as much weight as you can to the cane in the opposite hand. Most people have a common misconception that the cane should be used on the same side that is hurt.

Carefully and patiently make your way to the nearest road or shelter to find medical attention. If you make it to your vehicle, let’s just hope your don’t drive a car with a clutch.