Stepped over? How to get there fast
"Many people use ice packs, but it makes the pain worse," explains the professor of physiotherapy.
On a jog, walking the dog, on the way to work or on the living room floor at home.
Stepping over can happen anytime, anywhere and with anyone.
- We have two legs that we use all the time and overstretching can even happen on a flat surface, so it's no wonder that this is one of the most common injuries people experience," says Per Morten Fredriksen, professor of physiotherapy at Inland Norway University of Applied Sciences.
Per Morten Fredriksen
Professor of physiotherapy
According to Norwegian Health Informatics, around 200,000 people a year arrive at Norwegian casualty departments with injuries, but the figure is probably four times higher because the vast majority "treat" the injury themselves.
And then a lot of people make some basic mistakes - which means that the likelihood of a new overdraft is high before a year has passed.
Do not recommend ice for the first 48 hours
"Immediately after the trauma, when the sharp and stabbing pain feels like it's going to burst your ankle, what you do for the next 48 hours is crucial," explains Fredriksen.
Most physiotherapists, including the Norwegian School of Sport Sciences, recommend following the principles of the so-called PRICE model (Protect, Rest, Ice, Compress, Elevate), which is a standard first aid treatment for acute injuries.
The model should lead to less pain, reduce bleeding and lay the foundation for good rehabilitation/training, according to Christine Holm Moseid, who is an authorized sports physician from the Norwegian Association for Sports Medicine and Physical Activity (NIMF).
Christine Holm Moseid
Sports physician at NIMF
Fredriksen agrees with most of the steps in PRICE, but thinks it's a good idea to skip the "I".
- The treatment "everyone" chooses makes the pain worse. The idea that icing is the right medicine is a persistent myth. It may help with pain, but it delays healing," says the professor.
PRICE founder agrees
The enduring myth was created by Gabe Mirkin, the professor who in 1978 introduced what was then known as the RICE concept in the bestselling "Sportsmedicine Book".
A myth Mirkin himself tried to dispel nearly 40 years later when he his blog wrote a post titled "Why ice delays healing".
There he referred to a summary of 22 scientific articles which states that there is no evidence that icing and compression together accelerate healing more than compression alone.
The study shows that ice prevents the release of a hormone called IGF1, which helps muscles and other damaged parts to heal. According to Fredriksen, the secretion of this healing hormone does not only stop when ice is applied, but also for a period after the ice has been removed.
- In addition, this type of injury also ruptures blood vessels. "Icing reduces the formation of new blood vessels, which in turn delays healing," the professor points out.
MAY MAKE PAIN WORSE: Putting on ice can help the pain, but can delay healing, according to several experts. Photo: AndreyPopov
Moseid at the Norwegian School of Sport Sciences writes by email that she is aware that the use of ice is being discussed, but that she still does not want to advise against its use.
- "Pain relief is important in all treatment, especially for children and young people. Ice can be a simple and good measure in the acute phase, where the ice bag can also act as part of a good compression when placed around the ankle," she says.
- "But compression, not ice, is the most important thing in the acute phase. A lot of people forget this because they're too preoccupied with the ice," she says.
She points out that tight compression prevents a lot of swelling, which means you can recover faster in the long run.
If the swelling becomes too large, the blood flow will stop, which delays the healing process as everything that helps to heal the injury comes via the blood.
Fredriksen emphasizes the importance of getting the compression in place quickly.
- If you don't have a compression bandage, use a sock and wrap it tightly around your ankle as soon as possible," he says.
He points out that to prevent the circulation from stopping completely, the compression should be taken on and off every 20 minutes for the next 48 hours.
MOST IMPORTANT AFTER OVERTRAVEL: Many people forget this important measure because they are too busy with the ice. Photo: anyaivanova
- But when you sleep, the compression should be off to prevent blood circulation from stopping completely.
The "E" in PRICE (Elevate) also emphasizes the importance of both Fredriksen and Moseid. Keeping the foot elevated, preferably on a chair or bench, as much as possible for the first couple of days is, like compression, important to avoid excessive swelling.
Okay, so you've done everything right for the first 48 hours. What's next?
Yes, this is when the long training of ligaments, balance and stability starts.
900 minutes of training
According to this studies, published in the British Journal of Sports Medicine, it takes more than 900 minutes, or 15 hours, to train the ankle so that the risk of another overtraining is low.
- One mistake many people make is to stop doing balance exercises as soon as they feel good. This increases the risk of re-injury. If you train ankle stability after an ankle sprain, you can actually halve the risk of re-injury," says Moseid.
According to Moseid, the training for halving the injury takes 10 weeks, where exercises that improves ankle control, balance and stability must be done for ten minutes five days a week.
According to Fredriksen, many people don't bother or forget to do this. He has therefore been involved in developing an ankle trainer, called the Ankle Trainer, which was recently launched on the market.
- Exercise while you walk
According to Fredriksen, this device will cause the foot to be placed at a deliberately incorrect angle, provoking the foot to use its muscles to step "correctly" in every single step.
- In practice, the ankle trainer allows you to train the same functions in the ankle that you do through the boring exercises that many people don't do anyway. In other words, you train while you walk. The ankle trainer will therefore shorten the treatment time considerably compared to doing little or no rehabilitation exercises," says Fredriksen.
He says he has seen promising results on a number of patients, but can currently point to no research to support his claim that the ankle trainer works as he claims.
Moseid says she doesn't know about the ankle trainer, but points out that the exercises she refers to are free.
- "But whatever you choose to do, the most important thing is to actually do something. That way, the risk of re-injury is greatly reduced," she says.