Medical: Ankle Sprains For The Adventure Rider

Most people have sprained their ankle at some point, and it’s a common injury when riding an adventure motorcycle, but what’s the best way to treat and prevent sprains? Doc Edwards tells us how…

Ligaments and tendons become less elastic with age and as you get older, you are more likely to have sprains and strains in them. A sprained ankle is a common joint injury with more than 25,000 ankle sprains occurring each day in the United States. It is worth knowing about their prevention and proper treatment as people who consider it ‘just a sprain’ make a big mistake in not treating it. The consequence of this neglect is chronic weakness, unstable joints and repeated sprains. 

The vulnerable ankle joint 

The ankle, which joins the lower leg bones to the foot, is held together by bands of tough, semi-elastic fibres called ligaments. A sprain results when the ligaments are stretched beyond their normal range. In a severe sprain, the fibres tear partly or completely. 

Sprains occur when the foot turns in or out to an abnormal degree relative to the ankle. Common causes include stepping up or down on an uneven surface or stepping on an object left in the wrong place. In motorcycle riding, common causes include dabbing the foot in a corner or catching it in a rut. Twisting the ankle by hitting rocks and trees are common as well. 

Injuries frequently occur when unprepared muscles and tendons are suddenly called into peak performance, such as in off-road riding. One of the mistakes that I see most often is that sprains are not treated immediately, with rest, ice and elevation and a compression bandage to limit the swelling.

No quick fix 

Ankle sprains are often mistreated or not treated at all, which is why they have the highest recurrence rate of any joint injury and often result in chronic symptoms. The bottom line – ankle sprains usually need more rehabilitation and take longer to heal than most people allow for. By not treating an ankle sprain properly, 30 to 40 percent of people with simple ankle sprains develop chronic long-term joint pathology. 

A lack of pain is not always the best indicator that it’s safe to ride again or resume activities. 

The pain of an ankle sprain often subsides quickly, but that does not mean the injured ligaments have healed. Research shows that with any ankle sprain, the ankle should be immediately immobilised for at least seven to ten days to protect the joint and allow the injured ligaments to heal.

Treatment 

The newest recommendations for first aid of an ankle sprain goes by the acronym PRICE: P for pressure, R for rest, I for ice, C for compression, E for elevation. In other words, wrap the ankle with an ace bandage, get off the foot, raise it higher than the heart and ice it with a cloth wrapped ice pack applied for about 20 minutes once every hour.

This should soon be followed by a visit to a doctor or physical therapist, who will likely recommend a period of immobilisation and rehabilitation exercises. An anti-inflammatory drug like ibuprofen may be recommended and crutches provided for a few days, especially if the ankle is too painful to bear weight.

The healing process 

Immobilization is best done with an immobilisation boot. One of the most effective immobilisers is the AirCast ankle brace. On the trail, a motorcycle boot is adequate until proper care is reached. Bracing provides ligaments with the needed rest and reduces the risk of re-injury. Even a complete ligament tear can heal without surgery through proper immobilisation. But too much immobilisation can cause muscle atrophy and stiffness. So truly seek a professional who will help you manage the injury properly. 

Rehabilitation usually includes range of motion, proprioception and stretching exercises, and strength training. Even after an injury has healed, the ankle often needs extra protection during physical activities like riding. Wearing a lace-up ankle brace is more effective than taping the ankle. They easily fit into a boot and I have used them with great success during the Dakar Rally and other adventure rides.

Final word – prevention 

Warming up seems to only apply to the motorcycle and seldom to the rider. Stretching seems to be on everyone’s to-do list, but it is often the last to be done. I cannot express in words just how important a stretching program is to anyone riding a motorcycle. The key to decreasing injuries is to maintain flexibility. At 70 years old, former Belgian motocross champion, Roger DeCoster is very active and still enjoys riding.

DeCoster says that he used stretching throughout his motocross career and especially after injuries to speed up recovery time. What does stretching do for you? Stretching decreases injuries by keeping the ligaments, tendons and muscles flexible.

Stretching improves blood flow to the tissues, tells the bones to maintain strength and increases neuromuscular coordination. Develop a short stretching routine to be done every time you mount the motorcycle. Like anything, consistency is the key.