Sometimes, he says, the sprain is partially the result of a weakness elsewhere in the body, and if that weakness isn’t found and corrected, recovery will never be complete. After a thorough examination, Abelson will lay out a plan to get the runner back to trail running form.
As long as the sprain doesn’t require surgery (see below), the first step is to go running, but not on the ground. Deep water running can be done even in the acute pain stage.
"A mistake a lot of people make is to not move the ankle for the first few days. A non-impact activity, like deep water running, improves blood flow to the injury and displaces waste products," Abelson explains.
As the ankle starts to heal enough to carry weight, it’s time to work on strength and flexibility. Most of the strength work will be done on wobble boards to gain muscle support and exercise the body’s proprioreceptors at the same time.
Proprioreceptors are found throughout the body’s muscular system. Similar to little nerves, they react to stretching or pulling by telling the brain where a body part is, and what position it’s in. The proprioreceptors fire far faster than the eye can relay a message to the brain and the brain to the body, adjusting the body’s positioning almost instantly. Simply put, properly trained proprioreceptors can realign the body in the split second before a sprain. Wobble boards safely exercise them to fire faster.
No matter how fast one’s proprioreceptors, flexibility and strength recover, it’s important to move slowly. Healing should be gradual and continuous. "You don’t want to see peaks and valleys," says Abelson. "You always want to see the rehab going progressively forward."
If the body isn’t healed properly the first time, it will always be weak and susceptible to future injuries and chronic problems. Proper strengthening lays down different kinds of tissue than the weak scar tissue left behind by an untreated injury. "Tissues laid down without strength training are more susceptible to future injuries," Abelson says. The more someone works out, the more muscle tissue is laid down. Abelson adds, "If you rehab everything properly it shouldn’t happen the same way again."
Proper strengthening and flexibility around the joint can help prevent injuries as well, yet there’s always the accident factor. Abelson sprained an ankle stepping off a curb when he wasn’t paying attention.
McKay knows his injury was no fluke, and he’s doing all he can to keep it from happening again. "I would say to any runner: Get your body in shape to reduce the chance of things like sprained ankles. And if you get one, take care of it properly, because there’s nothing worse than not being able to run because you ran when you shouldn’t have."