3 golden rules to prevent ankle sprains on the trail running

The physiotherapist David Valenzuela, CEO of BOX55, tells us in this article about ankle sprain, the most common injury in competitive sport and, without a doubt, the injury most suffered by corredpray and heartredtrail hours running. This physiotherapy expert explains why it is such a common injury and offers 3 tips, “3 golden rules”, to prevent ankle sprains and prevent them from becoming an injury that limits you in sports.

As David Valenzuela assures… running is not just hitting the ground.

Sprained ankle, the most common injury on the trail running

Recently, for the winter holidays, I was in my town, Sot de Chera, a small mountain village just 70 kilometers from Valencia. Sot de Chera is located in the Los Serranos region and has a population of about 300 inhabitants, although during the holidays the population increases and the whole town becomes a kind of traveling circus full of circus activities for the little ones. I have 2 girls, Vega and Gala, so the excuse to visit the town was perfect.

While the girls were having fun in the children's activities, I had the opportunity to chat with Antonio Blanch (“El Sifri” to friends and also known as “El Guerrillero” in the trail world. running) and I asked him about the latest crazy thing he had proposed, since every once in a while he prepares for one of those races that in your head are impossible due to the mileage, the unevenness... Sot de Chera, like a good mountain town, has its trail club running with tradition and its flagship race: La Guerrillero Romeu, a 110-kilometer mountain test in complete self-sufficiency.

It seemed strange to me that "the Guerrilla Fighter" did not run the I edition of La Guerrilla Romeu Mountain Festival, since it was a race set in some historical events of our town.

He then told me that his latest "folly" had been The Bandit race, in Tarragona, a race inspired by the Barkley marathons, and in which the participants (35 in total) had to try to complete five laps of an unknown circuit, with a maximum time margin of between 11 and 12 hours per lap. An ultra trail resistance and orientation test only suitable for athletes with great physical and mental preparation.

Despite having the necessary physical and mental strength to aspire to fight until the end, in the third round he had to retire due to three consecutive ankle sprains. From that moment, as expected, we began to talk about what can be done to avoid ankle sprain.

Types of ankle sprains

Many people ask me why ankle sprains are such a frequent injury and the answer is very simple. ANDThe ankle is a very unstable joint when the foot is plantarflexed. (tiptoes). The ankle is designed to be protected by 3 external ligaments and one internal ligament that prevent inversion (turning the foot inward; this is the most common “twist”) and forced eversion (turning the foot outward; a less common “twist”) .

The ligaments are structures with very little elasticity (from 3 to 10% of their size) and are the security mechanism when the muscle cannot protect the joint that due to fatigue or overload is no longer functional. In addition, the ligaments have the quality of stabilizing and learning to correct themselves in delicate moments, this is proprioception, which is lost when you are injured and you must try to train in the rehabilitation processes and as prevention.

Once you injure your ankle, there are 3 types of ankle sprainDepending on whether it is a strain or a ligament tear, whether partial or total, they are classified as follows:

• Grade I ankle sprain, strain without rupture, is the mildest.
• Grade II ankle sprain, partial tear.
• Grade III ankle sprain, total tear (if it affects all the ligaments it has a surgical solution).

3 golden rules to prevent ankle sprains

Now, what can we do to avoid suffering an ankle sprain injury and be able to enjoy our sport in good health?

Here are the 3 golden rules to prevent the dreaded ankle sprain:

1. STRENGTHEN FOOT MUSCLES. A first piece of advice would be try to go barefoot at home whenever possible (the longer the better). Another tip to strengthen the foot muscles is to exercise on the beach: do circuits of running technique or running on the beach. The unstable base produced by the sand and the exercise on the beach help to improve the musculature of the foot, correcting the plantar arch (bridge) so necessary for the foot to be neutral and to be able to be stable. Also, it is very important do work to strengthen muscles peroneous, which is the musculature that protects from forced inversion (which is the most common "twist" and in many cases resulting in a sprain).

2. RELAX CALF AND SOLEUS. The gastrocnemius and soleus (or the triceps surae muscle, as it is known in physiotherapy) generate that, due to overload, the foot that is in the aire when the impact occurs on the ground it is too plantar flexed (toe tiptoes), a way of landing in which a lot of instability occurs; If we add to that the fact that downhill terrain implies instability and plantar flexion due to the inclination of the terrain, we have the ideal situation for an injury to occur. A contracted musculature is not functional. The physiotherapist is the solution to your problem.

3. PROPIOCEPTION EXERCISES COMBINED WITH STRENGTH. Its instability exercises combined with rubbers that help improve the strength of the articulation in the degrees of tiptoe that a mountain race demands.

Even if you follow the 3 golden rules, the risk of suffering an ankle sprain is still high because it is a functional weakness of the human body, so much so that anatomical studies already find people who have three peroneal instead of two peroneal as it is the normal. In other words, we are designed to be able to injure our ankles if we play sports on unstable surfaces.

What to do to heal an ankle sprain well?

At BOX55 Sports Physiotherapy we have two clear lines of approach for ankle sprain injuries:

1. RESPECT THE PHYSIOLOGICAL CURING TIME OF A TISSUE. In case of ankle injury, depending on the severity, this time can range from 21 days to 50 days. There are physiotherapy techniques that shorten times and functional bandages can be applied that help to be able to compete. A swollen ankle is not bad, it is necessary for the immune system. But within this period the ligament is damaged and therefore cannot perform its function.
2. PREPARE THE TISSUE FOR FUNCTION. It is necessary to think that a fabric must adapt to the environment in order to perform its function well. For that we need a period of adaptation and cushioning training where impact stabilization is essential.

So let's get out of the tendency to think that the impact phase is what hurts, because during the race there is more time in the flight phase. Forks more important how the foot is positioned in the flight phase to adapt to the ground than the impact that occurs. Because the impact causes the tendon to suffer, but the ligament doesn't even notice.

Other articles by David Valenzuela in the blog of 42K

You can learn more about the running injuries and start to prevent possible problems, since they are the main limitation with which you can find yourself. Also, keep in mind the importance of a good muscle bandage, a runner's lifeline that is used to allow, encourage, limit, or prevent a specific movement.

Text to 42K of :

David Valenzuela Diaz

Physiotherapist at BOX55

David Valenzuela Díaz has a degree in physiotherapy from the Cardenal Herrera CEU University and a Master's degree in assessment, physiotherapy and sports rehabilitation from the University of Valencia. He is CEO of BOX55 Fisioterapia y Academia SL, of BOX55 Academy and of Valobando SL Functional Biomechanical Analysis.
David Valenzuela, CEO of BOX55

Other entries by David Valenzuela Díaz

• Injuries to the running, Prevention is better than cure
• Low back pain, the good weather injury
• Paleo diet, pros and cons of a lifestyle