Most of us will at some time experience an ankle sprain, whether just a minor tear of a few fibres that is little more than a mild pain and inconvenience, or a major rip of the ligaments that takes months to recover fully.
If it happens when you are out on the hill, it is going to be much more of a problem than if it occurs in the gym or on the street.
I’d like to show you how you can make a simple and effective splint out of gaffer tape that will usually allow you to walk off the hill – and take care of your leg hair for a few weeks! You can find a lot of good demonstrations of complex ankle taping on Youtube: these are mostly for giving support to ankles with old ligament injuries, and should not be used immediately after a tear, as you will see that they encircle the ankle and risk cutting off the circulation to the foot, as you can expect the ankle to swell after a sprain. What I’m describing here is purely for first aid.
Now, let’s be clear that walking on a sprained ankle is not the best treatment for it: ideally it wants rest, ice, and elevation in the first 24 hours, but if you are miles from assistance then the best thing for you and your ankle is to get off the hill as quickly as possible, and if you are able to walk, then doing just that won’t cause much more damage, and the splint will protect you from pain and from further injury. First, a bit of anatomy: the ankle joint is formed by the tibia, fibula, talus and calcaneus bones, held together by strong ligaments. Fig 1
The most common injury is caused by ‘going over’ your ankle, when the sole of your forefoot turns inwards, and so is no longer supporting your weight directly. The weight is thrown on to the ligaments on the outer side of the ankle joint, and these start to tear from the front backwards.
Thus the anterior talofibular ligament starts to tear first, and once it has ripped through, the calcaneofibular ligament starts to tear, and if the tear is completed, the ankle has no support on the outside and is unstable. Fig 2
In a simple sprain, the area of the ankle that is most painful, starts to swell and becomes discoloured is just in front of the prominent bone on the outside of the ankle.
The gaffer tape makes an ‘artificial ligament’ to support your ankle and take the pressure of the damaged ligaments. First, cold applied to the damaged area helps to prevent further bleeding and swelling inside the tear, so if you are near a stream, or snow, then immerse the ankle in cold water or apply snow on top of your sock (not bare skin) for 10 minutes.
Dry your skin well, and then apply a strip of gaffer tape starting just beyond the ankle joint, on the top of your foot and gently pull your ankle outwards to take up the slack in the torn ligament to secure it right up the outside of the calf to just below the knee. Fig 3
Now apply 2 more long strips, this time going right from the lower part of the inner side of the calf to the outer side of the calf just below the knee. Fig 4
You will see that, if you have applied the tape correctly under tension, that it is bowstringed away from the surface of the calves, and you now need to apply 3 strips around the ankle to pull this in, making sure that you do not completely encircle the ankle, impairing blood flow. Fig 5,6, and 7
Once the strapping is in place, get your boot back on as quickly as possible before the ankle swells too much. When you are off the hill, you should seek medical advice as soon as possible. Until such time as you are assessed, continue to ice the area for 10 minutes every 2 hours, and rest and elevate your ankle.
It may be necessary to arrange an X Ray to rule out a fracture, and it is always useful to get advice from a physiotherapist, as there is good evidence that supervised rehabilitation reduces residual symptoms and also lessens the risk of further ankle injuries.
Our guides have first aid training. So do not worry as you are in capable hands.
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“A native Highlander who learned to love the outdoors through his father’s footsteps in Strathspey where his forebears lived and worked the land. He gets a real buzz from sharing this fantastic part of the world with other folk. The bulk of Peter's working life has been spent as a family doctor in Grantown on Spey, and in addition he's enjoyed shorter spells working throughout the Highlands and Islands, and in Africa, India, and Australasia.”