Badly sprained ankle - when can I ride

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Badly sprained ankle - when can I ride

Postby ICU812 » Mon Sep 24, 2012 4:41 pm

I sprained my ankle pretty badly last week on Thursday - so injury is about 5 days old. Unable to weight bear for 2 days - x-ray was ok and used crutches. My foot is very colourful (bruised) and still swollen, but I can now walk on it ok without much pain. I'm using a brace to help with stability. It still hurts on rotation of foot exercises. I can't seem to get into a physio for weeks and by then it would be hardly worth it. I went to the gym and the instructor didn't think it was a wise thing to do any classes including RPM for at least another 2-3 wks. So I've put my membership on hold for now. But I have no idea when to start doing cycling etc again. Should I just try and stop if it hurts?
Thanks heaps Sam
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by BNA » Mon Sep 24, 2012 5:20 pm

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Re: Badly sprained ankle - when can I ride

Postby jet-ski » Mon Sep 24, 2012 5:20 pm

I would ride ! just make sure you 'spin' and don't get out of the saddle - that exerts too much force on an injured ankle.
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Re: Badly sprained ankle - when can I ride

Postby PawPaw » Mon Sep 24, 2012 6:18 pm

If you can walk on it pain free, you should be able to pedal reasonably.
However, you almost certainly will have issues trying to de-cleat if using cleats.

Normally, a second x-ray is recommended around Day 10-12 for a really bad sprain. the first doesn't always pick up hairline fractures.
However, pain free wt bearing would discount that need.

Based on your info, I'd recommend you do gym bikes from tomorrow, very light resistance, 10 minutes, then break, then do another 10mins 20-30 minutes later if the ankle feels ok. This will help circulation and modeling of new ligament and capsule fibers.

Wear a compression bandage for the next week, when walking ONLY, to reduce swelling. Keep your foot up when sitting.
For the next 3 days, do alternate ice and heat every 5 minutes for 30 minutes, 3-5 times a day.
Then do heat only for 30 mins.
(cold source should be 2-3 trays of ice crushed into a wet tea towel. heat source a wheat bag or bucket of hot water.)

Expect some aching and light swelling to linger for up to 6 months.
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Re: Badly sprained ankle - when can I ride

Postby ICU812 » Tue Sep 25, 2012 1:43 pm

Thanks PawPaw. It's really hard to know what to do when you have been given the advise to 'just walk on it in a few days to stop it being stiff' and that's all. It has been the worst twisting of my ankle I have ever done on that side and it has always been that side. Three quarters of my foot is black. I eventually managed to get an appointment with a physio tomorrow from a cancellation. I appreciate your advise and I will carry it out. Many thanks, Sam
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Re: Badly sprained ankle - when can I ride

Postby Baalzamon » Tue Sep 25, 2012 3:07 pm

They just did an x-ray when you couldn't walk on it? I would have thought they would have given you an ultrasound as well to check out those tendons and ligaments in the ankle joint. I rolled my ankle and I could barely walk and had a hobble. Doc got me an ultrasound and they picked up of all things that I had an avulsion fracture where the tendon doesn't snap. Instead the tendon stays connected to the bone but where it connects starts to pull away from the rest of the bone. X-ray couldn't pick it up
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Re: Badly sprained ankle - when can I ride

Postby biftek » Tue Sep 25, 2012 3:10 pm

listen to your body and mind , if you handle riding on the ankle ride on it , if you can't handle it then don't ride on it
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Re: Badly sprained ankle - when can I ride

Postby ICU812 » Tue Sep 25, 2012 5:28 pm

Baalzamon wrote:They just did an x-ray when you couldn't walk on it? I would have thought they would have given you an ultrasound as well to check out those tendons and ligaments in the ankle joint. I rolled my ankle and I could barely walk and had a hobble. Doc got me an ultrasound and they picked up of all things that I had an avulsion fracture where the tendon doesn't snap. Instead the tendon stays connected to the bone but where it connects starts to pull away from the rest of the bone. X-ray couldn't pick it up

They only did an x-ray when I did it. I don't think they would even think of doing an u/s where I live in rural NSW. I wasn't even taken into emergency room. I just waited in the public waiting area, no ice treatment, nothing and the dr spoke to me for 2 seconds in the public waiting area with other waiting patients who could hear what he said and that was it. The dr didn't even look at the injury. All they did was look at the x-ray, it is not broken, go home. Maybe the physio will do something - I will ask.
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Re: Badly sprained ankle - when can I ride

Postby ICU812 » Wed Sep 26, 2012 5:32 pm

Thanks all for your support and encouragement and advise. Very much welcomed.
I went to the physio today. He had a look at the xray and it was ok. He thought there was extensive ligament damage/tearing and severe instability of the ankle, it was very lax.
For the next three weeks I am in a 'Aircast' brace to allow healing and prevent rolling and movement. Ice/warmth 3 times a day.
May be able to try stationary bike at gym, but need to test out if I can do it without difficulty first, or maybe don't bother.
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Re: Badly sprained ankle - when can I ride

Postby scotto » Wed Oct 10, 2012 8:49 am

1. ride straight away, especially on a trainer or exercise bike. outdoor cycling is ok if you can avoid the sideways bending of the ankle / pain. not always possible. in most cases my patient will hobble in on crutches the day after injury and be surprised when i put them on the bike straight away. and surprised its pain free. its a good way to get them weight bearing confidently

2. ice and compression elevation for first 72 hours then dont bother too much.

3. get your physio to strap it to reduce the likelihood of further straining when you become more active. but i agrre about the cleats being an issue !

4. ultrasound's ability to pick up an avulsion fracture not seen on xray = bullsh%t

5. i love the old heat and cold idea. still cant figure it out.
we ice an initial injury to provide vasoconstriction to the blood vessels to minimise bleeding from the damaged tissue (a bit like kinking off a garden hose) after a day or so there 'shouldnt' be anymore bleeding, so ice isnt indicated unless you enjoy the pain relief. heat helps tight contracile tissues relax somewhat and increases blood flow to an area. once the swelling is there, ice wont make it go away.
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Re: Badly sprained ankle - when can I ride

Postby scotto » Wed Oct 10, 2012 8:49 am

1. ride straight away, especially on a trainer or exercise bike. outdoor cycling is ok if you can avoid the sideways bending of the ankle / pain. not always possible. in most cases my patient will hobble in on crutches the day after injury and be surprised when i put them on the bike straight away. and surprised its pain free. its a good way to get them weight bearing confidently

2. ice and compression elevation for first 72 hours then dont bother too much.

3. get your physio to strap it to reduce the likelihood of further straining when you become more active. but i agrre about the cleats being an issue !

4. ultrasound's ability to pick up an avulsion fracture not seen on xray = bullsh%t

5. i love the old heat and cold idea. still cant figure it out.
we ice an initial injury to provide vasoconstriction to the blood vessels to minimise bleeding from the damaged tissue (a bit like kinking off a garden hose) after a day or so there 'shouldnt' be anymore bleeding, so ice isnt indicated unless you enjoy the pain relief. heat helps tight contracile tissues relax somewhat and increases blood flow to an area. once the swelling is there, ice wont make it go away.
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Re: Badly sprained ankle - when can I ride

Postby ICU812 » Wed Oct 10, 2012 3:16 pm

scotto wrote:1. ride straight away, especially on a trainer or exercise bike. outdoor cycling is ok if you can avoid the sideways bending of the ankle / pain. not always possible. in most cases my patient will hobble in on crutches the day after injury and be surprised when i put them on the bike straight away. and surprised its pain free. its a good way to get them weight bearing confidently.


I have been too terrified to do bike riding. I can now weight bear ok. I has been 3wks since injury and still is tender to touch in certain areas. I have been put into a "Aircast" ankle stirrup brace for 24/7 for 3 wks. I can shower without it but that is all. I have one week to go. The only exercise I am allowed to do with a stretchy band bring my toes up and walk
I think the injury was pretty bad. Besides severely tearing the ligaments I have damaged the muscles/tendons along outside of the calf that join onto the foot. I had totally lost any muscle ability/power to push outwards against the physio's hand. Since I have had a history of sprains only on that side, the splint has been used to help proper healing because all the other times I've never sought treatment. This one was so bad I couldn't weight bear at all. x-ray ok.
This injury occurred while walking on a flat surface, my ankle just collapsed and gave way from underneath without any warning.
That is why I'm really nervous that it will collapse at any given moment. My physio said something about getting the ankle stiff??
Yeah I haven't worried too much about ice and heat - the bruising is gone. I'm using an old TED stocking, cut the toes off and using the compression to reduce the swelling. It is still swollen compared to my other foot.
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