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Wednesday, August 02, 2006

Ankle pain

What's your advice for an ankle that's sore when running that doesn't get better with several weeks of rest?
Gary Moller comments:
First of all, as I understand it, the person suffering the ankle pain is quite a large person for a runner. My general rule of thumb is that runners over about 75kg are much more prone to injury than their lighter compatriots. They must ensure that their shoes have plenty of shock absorption; whereas a light-footed 60kg runner can pretty much get away wearing slippers!

I encourage injury-prone heavier runners to run just 3 times a week (of the short and high quality kind) and to do other forms of exercise in between, like aqua-jogging and cycling. Cycling can become the principal form of endurance training and the running is fartlek, running drills, including hill-bounding and short races as examples. Hill-bounding and stepping and striding up sand dunes is one of the best ways to build dynamic strength and stability of the ankles.

The heavier the runner, the more critical it is that they have as near to perfect biomechanics and pounding the pavements does little for good mechanics. The most common fault by far is pronating feet and this is much more common nowadays since fewer people are raised bare foot. Read my e-pub about weak, pronating feet. In it I show how to strengthen the feet. Bear in mind that the feet and calf muscles must forcefully contract thousands of times during a run, so you must be diligent and give these exercises months and months to steadily build sufficient strength to resist collapse. It may be beneficial to replace your shoe innersoles with Formthotics Active which are semi orthotics.

If the feet tend to collapse upon foot impact with the ground, the outside borders of the ankle joint can literally be crushed by the pincer action of the bones as they come together. This will cause swharp/dull and generally agonising joint margin pain with little in the way of swelling. A runner will notice the consequences most of all the next morning and it will tend to settle as the day goes by.

Even if your feet are healthy and pain-free, you might like to give those hard-working joint surfaces a little relief:

Get down on the ground and brace yourself (refer to photo). Get someone with strong arms and hands to grasp the foot and heel. Relax the leg and feet muscles as the foot is pulled, so that you feel the ankle joint gapping. This may take some grunt by the puller and you have to concentrate on relaxing the leg and not resisting. Once the joint is gapped, the "puller" can slowly twist, rotate and glide the ankle joint back and forth. There should be little pain since the joint surfaces are being pulled apart and therefore should not be grinding.

This gapping, gliding and rotating in all directions will stretch any tight scar or other tissue about the joint and will even break down any roughening of the joint margins. It will encourage the healing processes by stimulating circulation to the areas that are being excessively compressed most of the day.

A further therapy is to have a firm foot massage, concentrating on the tender areas, wherever they might be.

The foot exercises, stretches and the massages should happen without fail about every 3rd day until complete relief is had. In conjunction with this should be a course of glucosamine and chondroitin to help ensure healthy joint tissue and healing.

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