Common walking injuries - ankle injuries
Ankles are a common walking injury. Most walkers will, at sometime, have sprained an ankle or developed a tendonitis. This article will help you to identify the basic causes, symptoms and help you to do some basic management of the injury.

Common walking injuries - ankle injuries

Ankles are one of the most common joints injured when hill walking:

Ankle ligament sprain  

Causes - This is a traumatic injury. Usually it's because you've stumbled over something and 'turned' your ankle or got your foot caught and fallen over it.

Symptoms - You'll usually feel a sharp pain over the outside of your ankle and most people are hesitant to move it until they get their breath back. Once settled, you will be able to move the ankle, though it will be painful. You can bear weight on the ankle, but you may limp due to the pain. The more severe the sprain, the less likely you are to want to walk on it - and the less you will be able to do so. Ankle sprains swell quickly, the more severe the sprain, the more swelling that occurs.

Injury management - When on the hill the first priority is to get the victim down safely. Using trekking poles will help to off load some weight. Place the stick on the opposite site to the injured leg, as this helps to bear more weight on the good leg. The boot can be useful in support (compress) the foot. It is usually better keep the boot on as unrestricted swelling can stop you getting it back on again! However, loosening the laces might be appropriate if the swelling is bad and you think that their circulation is being compromised - cold feet and numbness are good indicators! When at home it is always sensible to get an x-ray as sometimes, small fractures are present. Then use the RICE principle.

Rest - keep your weight and pressure off the foot whenever possible
Ice - 10 minutes regularly over the swelling for several days
Compress - use a tubigrip support to gentle compress the swelling. Do not sleep with tubigrip on.
Elevate - get the limb up to help to reduce the swelling.
Do some gentle range of motion exercises to keep all the tissues moving. Arnica cream is a homeopathic medicine that is very helpful with bruising around the joint. If the ankle is terribly badly swollen, then a chartered physiotherapist can help with reducing the pain and swelling and can advise on how to rehabilitate the ankle.

Prevention - It is difficult to prevent this from happening, as it is traumatic, however good fitting footwear will help.

Achilles Tendonitis

Causes - This is typically an overuse injury, usually due to something irritating the tendon over time. Slowly, the tendon gets more and more irritable. Potential causes are: sudden increased activity, lack of flexibility, change of boots ... In fact, there are many potential causes but often they are related to change.

Symptoms - A small niggle in the heel cord that appears and goes away, enough to be ignored, but over time it recurs more frequently and becomes more noticeable. It is usually increasingly painful and will come on during activity. People tend to seek advice when their activity is becoming hampered. Achilles tendonitis rarely stops anyone staying off the hill completely. At the worst they may choose to turn back early because of increasing discomfort.
Calf stretch © Spofi
Calf stretchInjury management - If you are unable to do the activity you want due to pain then seek advice from a chartered physiotherapist. Anti-inflammatory treatments might help but seek advice from a doctor or pharmacist before trying ibuprofen tablets or gel. Regular ice treatments help to reduce inflammation and the heel cord should be stretched regularly (daily, for several weeks).

Use a calf stretch - Do not bounce and hold the stretch for 15-30 seconds and repeat several times. You will need to reduce your level of activity to reduce to allow the tendon to calm down. This does not mean you cannot go out for walks, just that a shorter, easier route with less gradient will be easier for the tendon. Remember that this injury has developed over time, it will not disappear quickly. As the pain subsides, strengthening the calf muscle and increasing your return to harder routes is appropriate. But take your time.

Prevention - Keep your ankles and calves well stretched out and notice any early pain. Do not ignore painful tendons!


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