Your ankle joints allow your feet to move this way and that so you can run along rocky trails, cruise down snowy slopes and jam your feet into splitter cracks. Unfortunately, they’re also prone to twisting; sprained ankles are a particularly common injury among outdoor adventurers and they can happen with nearly any activity, including hiking, biking, skiing, snowshoeing, climbing or running. Given just how frequently sprained ankles can occur, knowing how to treat one is a valuable skill to have.
When you sprain an ankle, ligaments (the tissue that connects two bones) stretch and sometimes tear, which is painful and possibly debilitating. When this happens in the outdoors, miles away from modern medicine, it’s typically not possible to diagnose the exact injury (such as the specific grade of the sprain or severity of a fracture). Instead, you focus on assessing whether the ankle is usable or not. Here’s how:
A sprained ankle, even one that you’ve determined is usable, can hurt a lot. You can help comfort the patient by managing the pain in these ways:
Once you’ve determined that the ankle is usable, adding support with tape, a wrap, a brace or even a hiking boot can make walking easier and more stable. This is especially true if you’re traveling over uneven terrain or carrying weight on your back.
To tape a sprained ankle, start with one full roll of standard athletic tape, then:
Wrap a piece of tape around the leg 2 inches above the outer ankle bone. This will serve as a landmark.
From under the arch of the foot, apply a piece of tape that runs up to the landmark tape, crossing directly on top of the inside and outside ankle bones like a stirrup. Then apply two more equal-length pieces that will slightly overlap either side of the initial stirrup. Apply another piece of tape as you did in step 1 to secure the three stirrups in place. Tip: You can measure the appropriate length of tape for the stirrups by placing the non-sticky side of the tape against the skin and unrolling tape from the landmark on the outside of the ankle, down under the arch of the foot, and back up to the landmark on the other side.
Apply three overlapping pieces of tape that start at the landmark tape on the uninjured side of the foot and run underneath the arch of the foot, across the top of the foot and end where it started.
Starting in the same place as you did with the J’s (on the uninjured side of the ankle), apply three overlapping pieces of tape that run under the arch of the foot, across the top of the foot, over the inside ankle bone, behind the Achilles tendon, over the outside ankle bone, across the top of the foot and back underneath the foot. End the pieces of tape underneath the foot. The figure 8 is formed by having a loop behind the Achilles and a loop under the arch of the foot that cross each other on top of the foot.
Look for any gaps in the tape or spots that may cause discomfort. You can fill gaps with little pieces of tape.
Check the patient’s circulation, sensation and movement by asking if they can tell you which toe you’re touching and if they can wiggle their toes. Have the patient walk around for a bit and tell you how the ankle feels. If the tape is too tight or is pinching skin or pulling hair, make adjustments.
If you’re on a multi day trip and have lots of tape, you can remove the tape at night (use a pair of medical shears for easiest and quickest removal) and replace it with an elastic wrap wrapped in figure 8s. If you’re short on tape, you can leave the tape on at night so long as the patient has good CSMs. Tape tends to stretch out and become less supportive over time, so it’s a good idea to add a few more figure 8s in order to tighten up the tape job.
A sprained ankle can take weeks, if not months, to heal, which can seriously curtail your outdoor fun. Here are some ways you can help prevent an ankle injury:
