Ankle: Loud Pop Ankle Roll

Recently I was working a boulder problem over and over with no success. Getting frustrated, I decided to try some new beta and found myself 10 feet up and sideways. I greased off, and fell onto my ankle, which rolled like Silly Putty. With a loud pop, it misaligned, and started ballooning, promptly reaching the size of a small elephant. I figured I had just sprained it, but x-rays demonstrated a few chips. How do I strengthen my ankle so that I don’t roll it when I step on a pebble? Should I tape my ankle when I get to go climbing again?

—Noxiousfish / via rockandice.com

Oh, I feel for you. The sudden shift. The noise. The passing out! To say you have just sprained your ankle is akin to saying you have just scratched yourself, when in fact you’re squirting blood like a log arm sprinkler. You dislocated your ankle. You are going to suffer.

A few bone chips are the least of your concerns. These will be minor avulsion fractures caused by the ligaments on the outside of your ankle tearing bone off instead of snapping mid-substance. Some cartilage damage resulting from bones grinding across each other as they dislocated and then relocated is also very likely. When you take the boot off, though largely healed, your ankle will not be the same initially and the mechanics around it will resemble an engine with bent pistons.

To be honest, I would rather break my ankle—much quicker recovery. An ankle dislocation creates a gobsmacking amount of soft-tissue carnage, and is disabling for considerably longer than a break. You should be well recovered in 12 months or so assuming you work at it. My medical editor, Barrett, suggests writing the alphabet with your big toe to increase mobility after immobilization. Also, check out the ankle-stretching video on my web page. Exercises to increase ankle stability are imperative, like standing on one foot with your eyes closed and brushing your teeth. Get some professional help.

An ankle brace when you get the boot off is a great idea. Although I am as keen as you are to see you back on the rock, walking normally will be a better starting point. Then toproping. Leading on steep stuff should be straightforward as long as you don’t try heel hooking. Heel-toe maneuvers may induce vomiting.

Taping for a month or two is also advisable. A couple of stirrups going from the inside to the outside will give you peace of mind that it won’t go over again. A PT will be able to show you this as well.