Healing By Primary Intention

My injury is only a minor rolled ankle. The damage appears to be a strain to the peroneus longus tendon, which is an area of trouble with tightness in the past. My approach to minor soft tissue injuries is mainly based on allowing the body to heal itself with a little extra guidance just to make sure function isn't reduced.

For this injury, the timeline and reasoning behind management is as follows:

Rolled ankle -> nil treatment as I didn't think I had actually caused any damage.

Long run, then one hour later development of localised pain, redness, heat and swelling behind left ankle. -> follow NO HARM principle (no heat, alcohol, running or massage) for the next 24-36 hours to allow for initial acute inflammatory response.

Nil running. To allow for destruction and removal of injured cells. Nil ice, compression or anti-inflammatory drugs applied as swelling was not significant. I believe these methods are only required when the injury is more severe or the inflammatory response becomes excessive and is like to cause secondary tissue damage (ie. from too much swelling restricting blood flow in a joint or similar).

Wednesday - Friday:
Light, very easy running of 45-60 minutes with light progressive stretching.
The swelling has reduced, there is minimal pain, therefore the exercise should promote increased blood flow and promote healing in a more functional way. That is the connective tissue, such as collagen fibres will be aligned in the correct pathways as opposed to a cross-hatch design. Hopefully the exercise level is enough to stimulate enhanced healing with imposing any damage.

Initial acute response take 2-4 days. Restoration and repair typically takes another 2 weeks to regain 80% of pre-injury strength. Depending on nature of injury full recovery can extend up to two years. This injury was only at a level that many people would usually continue to train through, including any planned hard sessions. I like to make sure the injury doesn't progress further and limit me later on.

In the end I have only missed one day of running, one hard run and one moderate length run. Not a problem in itself, even when not taking into consideration that it is ensure I do not develop a more limiting injury. Now I will be right to race the Sri Chinmoy Williamstown Foreshore 10km run on Sunday.


  1. Jason, 'no HARM' is a new one to me. Given your credentials and profession, I'm thinking you could amplify on that principle, or at least provide a link.

    I thought my philosophy of dealing with injury was pretty evolved (if you like, see my blog post re: ice massage http://triexpert.com/coach/coach-q-and-a-2 to which a PT had a cogent comment), but I'm always on the path of kaizen! ;)


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