Treating Common Outdoor Injuries: Sprained Ankle

Treating Common Outdoor Injuries: Sprained Ankle How many times have you been on a backpacking trip where someone stepped off a rock just slightly pigeon-toed and rolled their ankle? Or was whittling the perfect roasting stick and had the knife slip awkwardly into some part of your body? Or maybe your fire dance got a little too intense and you ended up getting a bit more heat than you bargained for? Injuries in the outdoors usually fall under minor in threat if you’re in the front country, but the nuisance escalates rapidly the further away from civilization you go. If left untreated, they can even turn into dangerous infections or life-threatening wounds. This series takes a a look at some of the most common injuries that occur outdoors and how to treat them — and whether leaving the backcountry is necessary for prolonged care. We'll work our way through a variety of injuries in this series. To get started, let's take care of the infamous sprained ankle.

Part I: Sprained Ankle Misplaced footsteps can lead to the ankle rolling outward or inward, resulting in a sprain. The pain associated with this injury can make the use of the foot unbearable; if so, the injured may need to be assisted out of the backcountry or stay at a base camp until it is feeling better, depending on the length of your trip. In other cases, the foot is still usable and a walkable bandage can be applied to help stabilize the sprain. Either way, the first step is R.I.C.E. To treat the sprain in the backcountry: R.I.C.E.: a common acronym that anyone trained in first aid can recite off the top of their head. In case you aren’t familiar with it, here’s what you need to know:

R = Rest. Refrain from using the injured body part as much as possible.

I = Ice. During the first 72 hours, keep a hydration bladder filled with snow or cold water and apply to the injury for 20 minutes every 1-2 hours.

C = Compression. Use an ACE bandage to wrap the ankle. It should cover from the foot to above the ankle so the injured area is completely covered.

E = Elevation. The injured area should be raised above the heart as much as possible throughout the day and while sleeping.

(Note: Ibuprofen or similar pain medication may be taken for pain.) To make a usable splint: (Note: this is for those who are ready to walk on the injured foot. Make sure their pack is as light as possible!) Using athletic tape:

1. Create the preliminary structure of the splint.
   1. wrap a band around the leg about 2” above the ankle; this acts as an “anchor” for the splint;
   2. put the foot in a walking position (flat, perpendicular to the leg) and create a stirrup under the foot, with the sides of the stirrup going directly over the ankle bone on both the inside and outside of the foot; the stirrup’s ends should touch the band of tape wrapped around the leg.
   3. Create two more of these: they will both overlap the first, but one strip will be in front of the original stirrup and the other will be behind (basically covering the ankle bone).
   4. Wrap another band of tape around the top to secure all the ends.
2. Make 3 “Teardrop” wraps around the foot.
   1. Starting on the uninjured side of the foot (if the person rolled inward, start on the outer side of the foot and vice versa), stick one end of a long strip of tape to the top band, continue the tape under the arch of the foot, and then across the top to reconnect at the starting point, making a teardrop shape.
   2. Do two more of the same, both overlapping the original teardrop, but with one to the front of the original strip and the second to the back.
3. Do 3 “Figure 8” wraps around the foot.
   1. Unrolling as you go and starting at the same point as the teardrop wraps in step 2 (uninjured side), place one end of tape on the band at the top of the ankle, and follow the same path as the teardrop shape until you reach the top of the foot; then
   2. instead of running the tape back up to the beginning and closing off in a teardrop shape, go from the top of the foot to the back of the leg, making sure the tape runs across the top of the ankle bone along this path.
   3. Continue the tape across the tendon on the back of the leg toward the top of the foot again, this time making sure the tape runs across the top of the ankle bone opposite from the one in step 3b.
   4. Continue from the top of the foot to the bottom of the foot’s arch, where you will end the first figure 8 wrap.
   5. Repeating steps 3a-3d, create two more figure 8 wraps around the foot, overlapping the original.
4. Make sure foot looks comfortable.
   1. Look for any exposed skin within the tape job area and cover, if necessary, with a bit of tape. This prevents irritation of exposed skin.
   2. Make sure the tape is not too tight, that the injured person can wiggle their toes, and that they have full feeling, normal color, and no tingling or numbness in their toes or leg (numbness, tingling, or a blue hue to the skin means blood flow is restricted and the splint has been wrapped too tightly).

The foot can now be placed in a sock and boot and used with care, but make sure to monitor for any changes or pain. Next, be sure to check out Keeping Safe Around Wildlife.