Bum Ankle

[ted]

This is long and drawn out, but anyone interested with some advice or tips from similar experiences is greatly appreciated.

My right ankle seems screwed. Both ankles have about 10 years of steady abuse on them. Over that time ive consistently rolled my ankles with about 3 severe sprains in that 10 year period on the right ankle.Two years ago, I started trail running in Merrel barefoot shoes and it seemed as if the problem disappeared with not even a rolled ankle in that time period. Within the past couple months I increased my trail running in preparation for winter climbing. My feet started to hurt, so I switched back to a minimal running shoe. That fixed that. But the ankle problem came back. Most recent was a month ago coming off the approach from dip wall. It wasnt severe but it had me limping for a couple days and ive rolled my ankle several times since then. In the last several years ive notice my right foot to lean to the right naturally at rest (feet propped up). While im walking, my right foot naturally points outward while the left points forward. I know there wont be a quick fix, but what are some of the possibilities as to what the injury is? Is this something where physical therapy should be considered or am I just SOL?

[Meadows]

Having sprained my ankles about 18 times with 5 being severe, I suggest therapy. I do my own and you can google ankle exercises. I use a balance disk and do heel lifts as well. Stretch, stretch, stretch. A good stretching exercise is to spell the alphabet with your toes and sometimes I sit on the top of my ankles to stretch the top. Balancing yoga poses are also the bomb for ankle therapy.

One of my feet points outward as well, but I use orthotics for running to add balance to my knees and hips. Make sure you're using the right shoe too - there are a couple of simple tests to see if you're neutral,a pronator, or a supinator.

[Saxman]

WOBBLE BOARD! Buy one. Get the Fitter First 20" Birch with adjustable 3 position ball on bottom. Use daily for a month and then 1-2x weekly for the rest of your life.

[ted]

Thanks alot! Ive always warmed up prior to exercise to include joint rotations, but it seems im gonna have to take a more focused approach in care to sustaining this ankle. I read about the alphabet exercise in an earlier post, it makes sense. Heres my question though. You also have a foot that points out as well, do you think its a result of numerous sprains and prior injuries?

[crazyhair]

I've found that resistance based exercises really help- if you slackline at all, i would recommend putting your right foot evenly on the line and slowly going from a flat foot to on your tip-toes (this may be difficult to near impossible if you don't slackline) and start out at 5 reps a day 2-3 days a week and slowly increase that number. If you can't do that, simply walking the line seems to help. I've found that when I slackline consistently, the stabilizer muscles in my ankle become stronger and I am less likely to sprain it. I use an "Active Ankle" brace, but it's kind of bulky and uncomfortable- I've heard good things about the malleoloc brace, and it seems as though it can be worn with climbing shoes.

[Meadows]

Thanks alot! Ive always warmed up prior to exercise to include joint rotations, but it seems im gonna have to take a more focused approach in care to sustaining this ankle. I read about the alphabet exercise in an earlier post, it makes sense. Heres my question though. You also have a foot that points out as well, do you think its a result of numerous sprains and prior injuries?

Could be. However, I'm more inclined to think I'm just designed that way. I know already that a hip is tilted causing one leg to be longer. The rotation of the hip or even the knee could also be the cause of the turn out. Mine is not severe and not really that noticeable. If this is something that seems new to you, I can't help but wonder if while recovering from your injuries, the other leg compensated and maybe found another position. Keep in mind, I'm not an expert but if you have xrays from the past, maybe you can compare it to a current snapshot.

[climb2core]

One leg turned out more than the other could be caused by multiple things:
-Leg length discrepancy-Can be either from a bone being longer or from rotation of the pelvic bones as Meadows mentioned.
-Tight Hip External Rotator muscles
-Femoral torsion (bony deformity where the bone is literally twisted a bit)
-Tight calf muscles
-Limited ankle joint mobility (flexing foot upwards)


However, it may or may not be relevant to rolling your ankles. The best thing you can do is do some PT if you have insurance for longterm strength and proprioception (basically working on your balance/response system). Ankle brace or taping will help in the short term. A good PT should be able to help guide you if the foot turning out is clinically significant. Off the top of my head, It typically is the foot that turns in more that tends to be more susceptible to rolling as it tends to stay supinated longer and this is a position of ankle instability. So if it is the foot that turns out more that is injured, it is the foot that is most likely pronating more and less likely to be a cause of why you are rolling that ankle.

[Crankmas]

I have had ankle issues over the years that sound like some have described. My bone structure on my left ankle is quite different than my right. The boney protrusion at the ankle on my left is much more pronounced than the right which appears more " normal", does anyone else have a similar scenario? Lots of sprains over the years from walking out in the dark and stepping in ruts and having a loose fitting pack shift as the ankle rolls and then plenty of pain, swelling, discoloration etc. Meadow's tips are what have helped me the most without any extra $$$ being directed though the board Sax mentioned sounds both fun and helpful. Have never slacklined, maybe it would be a good seminar at the next climbers throw down. Good Luck, mine are still a bit touchy, usually extra careful if I'm in stiffer or extra flimsy shoes, hiking in a ankle covering approach type boot is helpful.

[ted]

It typically is the foot that turns in more that tends to be more susceptible to rolling as it tends to stay supinated longer and this is a position of ankle instability.

This is what ive thought as well. Which led me to believe the right foot pointing outward had to be a result of consistent injury and not healing back properly. But I dont know. Its not holding me back from anything yet, but I think having a PT look at it is going to be my best bet. My main worry is severe arthritis years down the road.

Thanks guys! Slacklining seems like a good idea, but Im going to pick up a wobble board for the convenience factor. Perhaps throw in some resistance training and put the stinking barefoot shoes back on

[jhwatts]

A lot of good ideas here. It also could be a tight rectus femoris ( lateral hamstring) caused from driving regularly. I can go further into that if you are interested. Also many runners have a tight vastus lateralus (lateral quad) which can pull the tibia outward. Check out a good PT or an orthopedic massage therapist. To get a good idea on what is happening. Then the rehab can be much easier. I am an orthopedic massage therapist, but I am not commenting here to get business, just offering more ideas.

Joe