Ankle Injury
 

Hello all,
I managed to roll outward over my right ankle three times on Saturday, once on a ruck march with a 30-50 pound ruck. I could not ice or bandage it Saturday night, but am now back where I have such things available to me. It does not cause me pain unless I try to move it far in any direction (limited range of motion). There is no swelling or tenderness on the inner side of the ankle, only the outerside. Right now I have it bandaged fairly tightly. I was wondering if there were any other techniques you could recommend to me to ensure a speedy and full recovery?
I've linked two pictures of the foot in question.

Top of right foot
Outer side of right foot
Thank you,

Solid

Impressive.

What sort of boots were you wearing, if I might ask?

TR

Just take it easy on it, elevate it when possible, and I usually use Advil for pain/anti-inflammatory.

Standard issue black leather Wellcos. Someone mentioned the risk of calcification if it remains this way- is that at all a possibility?

Thank you for your replies. It isn't half as bad as it looks.

Solid

1. If you do not know if you have 30 lbs., or 50 lbs., you have a problem.

2. That boot provides pretty decent ankle support. You may have weak ankles. Consider taping or wrapping them while you find a conditioning program.

Just my .02.

TR

TR,

Thank you for the advice. I only seem to roll my right ankle in the boots, which supports your idea. We were told to pack a minimum of 20 pounds in our ruck, but were expected to have all the items on the packing list, which would bring it to over 20 pounds. On top of that, I carried all the rope for rope bridge- I don't know how much the ruck weighed, but it was definetly over 30 pounds. Normally I would certainly weigh it.

Thanks again,

Solid

I would concur with TR's recommendation, not that he needs it, of taping your ankles prior to any rucking or hiking. The local Walgreen's, CVS, Eckerd's, or sporting goods shops should carry both athletic tape and underwrap. It is important that you use both when taping your ankle.

If you dont have the goods available, or you have not conducted the 6-P's, 100 mph tape on the exterior of the boot will suffice for a short time, but it is a stop gap method.

In the meantime rest, elevatation, and advil.

Thank you for the advice, guys.

That looks familiar...

Left ankle:

Let an old guy add some advice. I broke my ankle in Ranger School as a young 2LT. There was no way I was going to go thru that again so I laced up my boots as tight as I could and completed the last two weeks without ever taking my boot off. I have paid the price for that many times over with repeated sprains, strains and minor breaks because it obviously never healed correctly. I am still paying the price for physical excesses throughout my career because I sort of thought that toughing it out was more important than common sense. Now I am still a little short of common sense, but there is no reason that you should be. Give it the time to let it heal.

Jack Moroney

I'm missing the next two FTXs for exactly that reason, which is painful but I think necessary. The Doc here says it'll be a minimum of two weeks, probably longer.

For more background- I'm acutely aware of my weak knees and ankles, and that they jeapordize my ability to perform physically. As such, had I not been in a competition scenario where my team relied on me, I would've instantly hopped into the chase van to avoid further injuring my ankle. As it was, because I was in that scenario I managed to sprain my ankle twice more- raising total sprains on the right ankle that day to a grand total of four, two with rucks.

Thanks for the advice. Is there any specific way I should wrap it?

Thanks,

Solid

the powers of the internet... this is so much better than typing out a description.

http://www.csuchico.edu/~sbarker/inj...e/tapeankl.mov

I wouldn't recommend taping over shoes/boots/etc as the lack of intimate contact prevents adequate restriction of the ROM. In my experience ( as the patient untold number of times back in the day:D ), you should shave your foot/shin at the level appropriate to allow for direct taping onto the skin with no prewrap. This will ensure the best possible taping. As Cric said, 100mph may help a little in a pinch, but that is really minimal help and a stop gap.

During this initial healing phase, MAKE SURE you have adequate blood flow distal to the taping in your toes. Remember, during the initial 24-72 hours, you may still have increased swelling so be vigilant. Keep it elevated when possible either compressed with an ace bandage or taped to prevent excess swelling in the joint space, ice it 20 on 20 off, rest it completely if possible.

Good luck solid... you did a good job on that ankle, its real purty. :D

Here is an good ankle rehab program, IMO. Check it out.

x

Doom-
One of my pre-med buddies from RC had it happen to him, but not off of a sprain. He even has the extra lump to prove it :)

Ankle is looking better now as the bleeding seems to have stopped and is being absorbed. Still massively swollen, but hey! I love my war-wounds.

I've noticed that some of the blood, having been displaced by the bandage, has come to settle over the knuckles of my toe. Is this dangerous in any way?

Thank you,

Solid

Not from the sprain itself, but from avulsion? I tore a deltoid ligament and had a medial malleolar avulsion. The fragment was later removed surgically.

Here is (what is purported to be) a posterior capsular avulsion with curvilinear calcification adjacent to the posterior tibial margin (ooh, don't I sound all doctor-y?):