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Running Rehab: How To Start Running On A Sprained Ankle

Getting back to running after an injury is always a little bit overwhelming. You want to run, but you also want to make sure that you don’t overdo it.

In this article, we’ll cover how to start running after an ankle sprain, including discussing roughly how long you should wait before running again and how to best return to running after an ankle sprain.

What is an Ankle Sprain?

It’s easy to injure your ankle because if you twist or turn it just the right way, you can injure it. A sprained ankle occurs when the ligaments in the ankle that hold the joint together are overstretched.

These ligaments help prevent unnecessary movement in the ankle. If the ligaments are overextended beyond the typical range of motion, a sprain may result. Often, sprained ankles occur on the outer side of the ankle.

There are four ligaments in the ankle, including three smaller ones on the outside and a larger one on the inside. Only five percent of sprains involve a tear in the large ligament. These are more severe than sprains involving the outer ligaments.

Typically, you don’t need to see a doctor to treat a sprained ankle unless it is very severe. If you’re not sure whether you should see a doctor, ask yourself these questions:

  • Is it excruciatingly painful?
  • Am I unable to walk?
  • Is there still swelling after 48 hours?

If the answer to all of these questions is yes, then it’s definitely a good idea to check in with a professional to get their recommendation.

Common Causes of Ankle Sprains

Sprained ankles occur when the ankle is forced outside of its normal range of motion, causing the ligaments to overstretch and/or tear. While some sports activities like soccer can contribute to ankle sprains when someone lands on your foot during a game, that’s not likely to happen to a runner.

Instead, runners are more likely to get sprained ankles when they are severe underpronators or overpronators. Rolling the feet more, either inward or outward, makes a runner more prone to sprains. Running on uneven surfaces, such as broken sidewalks, cobblestones, or trails with exposed roots and rocks, also increases the likelihood of sprains.

You might be more likely to get an ankle sprain as a runner if you have had an ankle injury before or if you aren’t wearing shoes that fit you well.

How Long Should I Wait Before Running Again?

It all depends on your situation. If you have a mild sprain or are wearing a brace, you likely can return to running within a few weeks. However, full healing will require 12 weeks, and that clock resets every time you overstretch a ligament even if it has been healing.

You’ll want to ensure that you’re pain-free, don’t have any limits in your motion, and have the same strength in both your injured ankle and your good one. Try going for a light jog. If anything feels funny, stop immediately and wait several days before trying again.

Because you don’t want to make the healing process longer than needed, you might want to check in with a doctor to see what they recommend in terms of how long you need to wait before running again.

If you start too soon, the ligament will scar, making it significantly more likely for future tears or sprains in the same location.

You’ll likely want to wait until 3+ weeks after the sprain during the remodeling phase in the healing process, as it’s safe to run then.

How to Return to Running After an Ankle Sprain

It goes without saying that you should be fully healed from an ankle sprain before you start trying to run again. Here are some specific things to keep in mind.

Make Sure You are Pain and Swelling Free

If it still hurts to walk, you should definitely not start running. Make sure that you are pain-free, and your ankles, feet, and legs feel exactly the same on the injured and uninjured legs.

Additionally, wait until the swelling is completely gone. You can use the RICE method to reduce swelling: Rest, Ice, Compress, and Elevate.

Focus on Range of Motion and Strengthening Exercises

Strength, strength, strength. So many runners ignore the need for strength work. When returning from a sprain, strengthening the ankle joint is more important than ever. While restoring strength, don’t forget that you can still get cardio in like through swimming, deep-water running, or kayaking!

Range of Motion Exercises

One of my favorite exercises is tracing the alphabet with your feet in the air. You can do this seated or standing up. Try doing it several times, but mix it up every time. Maybe one time you go backward or another time you do it in cursive.

Another option is to sit in a chair with your foot in line with the floor and then move your knee gently side to side while your foot stays pressed on the ground. Do this for several minutes.

Finally, consider doing a pronation/supination exercise. Stand or sit with your feet hip distance apart. Then turn both feet (or just the injured foot) outward and then inward. Repeat this 10 times.

Strengthening Exercises

One expert recommends walking on your toes and then later on your heels to help stabilize your ankle and building up to three to five minutes for each type of walking. Another option is to do something you likely did as a kid: stand on one leg and stay balanced for at least 30 seconds.

Once you’ve mastered that, make it harder by closing your eyes or doing a standing leg squat by lifting your uninjured leg off the ground with the knee extended and doing a squat as long as you can go. Do 5-10 reps of this exercise.

You may even want to do something fun like standing on a pillow or another uneven surface with your eyes closed for 30 seconds to make sure that you have enough balance on your injured side.

Start Slowly

When you actually do get back to running, make sure you do it slowly and cautiously. If anything starts to hurt, just stop and try again a couple days from now. It’s better to get an extra rest day if things don’t feel right than to spend tons of additional weeks in recovery.

If you’re a trail runner, avoid technical trails until you’re fully recovered. You don’t want to sprain your ankle again and have to start the process all over.

Also, make sure to run on flat surfaces as you’re getting back into running. Hills work your muscles more and can increase your chance of falling—the last thing you want if you’re healing from an ankle sprain. Plus, it will just be easier to get back into running on a more comfortable, flat surface.

Concluding Thoughts

Injuries are never fun, especially ones like an ankle sprain that can take you out of the running game for a little while. However, if you take the time to strengthen your ankle again and figure out all the races you want to run in your free time, you’ll be back to running before you know it.

Rachel Basinger
The Wired Runner