Something bad has gone down, and you’ve grabbed your bag and set off on foot, according to the plan. Then the foot lands in a way that was not in the plan, there’s pain, and it’s clear something in that ankle is damaged. Now what?
The best plan, of course, is to not be in this scene; particularly when there isn’t good medical help, and extra particularly when you really need to walk somewhere. Salty and I start out this podcast with some ideas on how to avoid such injuries in the first place. Spoiler alert: The right footwear for the job is the best protection. Although I love my sneakers, those shoes that are so great at gripping dry pavement are surprisingly poor on wet surfaces.
Sometimes however, life is just that way. That makes the next mission diagnosing the problem. Some types of injury are much more dangerous to try to use than others. While neither Salty nor I am a doctor and we’re not going to give medical advice, we have seen quite a few more leg injuries than we’d have wished, and have some observations about those experiences. What does it mean if the lump is immediate as opposed to taking ten minutes to develop?
Suppose there is a soft tissue injury – a sprain or strain or tear. What then? The favorite acronym of the sports med community is RICE: Rest, Ice, Compression, Elevation. Well, rest and elevation are pretty much of the table if you have to be walking, but ice and compression are still great ideas.
We talk about some options to have in the med kit to help take care of this. An elastic wrap (Ace bandage style) is worth a lot more to a hiker than a pack of small bandaids or a sting kit. You can walk home without the bandaids. An ice pack (squeeze to freeze) is nice, but you might not have the weight and space to carry it. Anti-inflammatory drugs (NSAIDS) are another issue entirely: Very light and very valuable, not just for pain control but also for keeping the joint functional by reducing swelling. Trekking poles are another option; they can be invaluable in certain circumstances but you have to carry them even when you don’t need them. I let the terrain decide that one, as the worse the footing is the more the poles are needed.
Then there are the practical issues of walking out on an injury. How tight to make the wrap? I go by the color of the limb beyond the injury. If the wrap’s on the ankle and the toes turn funny colors, it’s probably time to loosen the wrap. Otherwise, a firm wrap provides swelling control and more support. Placement of the feet is key. Lots of injuries can support weight placed evenly and without torsion, but twisting things will just tear you up.
Totally resting the joint for more than a couple of days is probably not a great plan anyway. It’s going to remodel as it heals, and you want it to remodel to take the kinds of stresses you’re going to put on it. Careful use of the joint while it heals can promote that.
Does all this walking sound like a bad deal? Biking might be a great option, for better speed and more weight carrying, so long as you’ll be on roads. In this earlier podcast (click here) we talk about the bike as a bug-out vehicle.
As a bonus feature for the interested, after the normal sign-off I (Spice) talk a bit about the physiology of the inflammatory reaction and how it is and is not good for you.
* Harrygouvas at the Greek language Wikipedia [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/)], via Wikimedia Commons
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