We often utilize sports, exercise, and fitness activities to improve or maintain our physical and mental health, and it is common to occasionally encounter an injury that sidelines our efforts. This can be a sudden unfortunate event such as rolling our ankle on an uneven sidewalk, or it can be a more insidious process that comes on gradually over many weeks such as a painful heel from plantar fasciitis. When an injury forces us to cut back or stop doing the activities we love, there are far reaching effects on our being.
Many of us use exercise as a very healthy and productive means of managing stress. Sustained exercise has been shown to promote the release of biochemicals known as endorphins and enkephalins in our body that reduce pain and promote a sense of well-being. When we are not able to exercise due to an injury, there is a negative effect on our capacity to manage the stresses of our day, which can ultimately impact our mental health. For this reason, it is paramount that we have a logical and proven path to restoring and healing our body to a healthy state so that we can again enjoy our active lifestyle.
The first phase in our injury prevention is to recognize any signs that we need to seek formal medical care. When there is an event that causes an injury, such as rolling our ankle or dropping a heavy object on our foot, we may need some help to determine the extent of the injury. If we notice a visible lump or abnormal contour to the injured area, we should seek medical evaluation. This is also true if the part swells quickly or bruising is apparent as these are signs of more serious injury. The small bones of the foot are particularly at risk, so if there is sudden pain or direct trauma to the ball of the foot or toes, it is wise to get an x-ray to make sure nothing has been broken. If we are unable to walk normally on the leg, that also warrants an x-ray to make sure there is no bone fracture present.
For less serious injuries or those that come on more gradually, we begin by protecting the area and controlling the body’s natural reaction to the injury. For recovery from injury to our legs, we should find a way to elevate the leg above the level of the heart and apply some form of cold to the area. This can be a bag of ice, a bag of frozen peas or corn, or a commercial cold pack that remains soft and pliable even when stored in a freezer. We should also place a light dry cloth such as a pillowcase between the pack and the skin to protect the skin from possible frostbite. The cold reduces our pain and reduces the blood flow that causes more swelling and inflammation. When we have to be up and standing or walking, a sock with light compression or a carefully wrapped compression bandage can help to minimize reactive swelling of the injured area.
After a few days of protecting the area and using ice and elevation to jumpstart the healing process, we want to begin the process of introducing motion to the area to prevent the joints from becoming stiff and to maintain muscle tone to prevent atrophy of the muscles. We begin with small movements in the pain-free range of movement. Start with small patterned movements such as drawing the alphabet with your foot. As we do these movements, we will find that the stiffness begins to ease, and the range of movement gradually increases.
If the swelling has begun to resolve, we can test our ability to bear weight on the injured leg. It may prove helpful to try to wear a shoe with the laces loosened to allow for the extra volume of the injured/swollen foot. It is important that we keep the load to what the body can tolerate throughout the recovery process. It is never a good idea to try to walk on an injured leg that causes us to limp. A limp transfers the loads to other parts of the body such as the knee, hip or back, and this may in turn cause irritation or future injury to those areas.
As our limp goes away and the swelling resolves, we can begin working on addressing muscle weakness and restoring the strength to the area by introducing light resistance to the involved muscles. If there was a specific mechanism of injury such as rolling to the outside of the ankle, we should avoid reproducing this stress to the area and instead focus on the other directions. You can get a much more specific program designed for your individual needs by consulting an injury specialist such as a physical therapist or athletic trainer. When doing exercises to improve strength the goal is to fatigue the affected muscle so that the body will go through the process of building more muscle. For this reason, you should incorporate a day of rest between strength sessions as part of the recovery process.
The final step of the injury recovery journey is to integrate a gradual return to our sport or activity. Start with a small “dose” of the activity at a lighter workload or pace. It is normal to feel a bit of stiffness at the beginning of the exercise… if this does not increase or gradually abates, it is safe to continue. If you experience sharp pain or you cannot move without favoring the injured leg, it is still too soon to return to the activity. As a general rule, we suggest increasing the “dose” of activity or exercise no more than 10% per week to allow the body to gradually adapt and recover normal patterns of movement.
As you navigate your road to recovery from injury, consider the importance of supportive footwear. Vionic offers a range of shoes and orthotic inserts designed to promote proper alignment and foot health, providing comfort and support as you return to your active lifestyle. Whether you’re recovering from an ankle sprain or plantar fasciitis, investing in proper performance and recovery shoes can make a significant difference in your rehabilitation journey.
Explore Vionic’s collection today and step towards a healthier, happier recovery.
About the Author:
Specializing in orthopedic and sports physical therapy, Brian Hoke, DPT, SCS, has a particular interest in the biomechanical factors influencing lower limb rehabilitation. He is the owner of Atlantic Physical Therapy, a private practice in Virginia Beach, VA.
Brian is a board-certified Clinical Specialist in Sports Physical Therapy, a distinction achieved by fewer than 600 physical therapists in the U.S. He works with athletes of all levels—from recreational runners to elite professional and Olympic athletes. He has contributed chapters to two textbooks on the treatment of running injuries.
Brian is an avid educator, lecturing extensively in the U.S. and internationally. Since 1985, he has been a faculty member of the popular continuing medical education seminar, “When the Feet Hit the Ground, Everything Changes.” He co-developed and has taught the “Take the Next Step” course since 1990. In addition, he has been an adjunct faculty member of physical therapy programs at Old Dominion University and Touro College on Long Island, NY.
Brian’s expertise in sports physical therapy is a particular asset to Vionic’s athletic line of footwear. He and Phillip Vasyli have also collaborated to create a foot orthotic designed for problems with supination—when feet roll outward too much.
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