Updated on July 23, 2020

Note: If your ankle won’t bear your weight, if it is significantly swollen, or visibly misaligned, or if your ankle or foot is numb or turning blue, see a doctor at once.

There are two common forms of ankle injury. One is the familiar ankle strain or sprain, often caused by rolling the foot inward or outward. These injuries involve damage to ankle ligaments and range from mild to quite severe. 

Acute ankle injuries such as strains and sprains can usually be treated with the traditional sequence of RICE: Rest, Ice, Compression, and Elevation. Be sure to let ankle sprains heal completely before stressing the ankle again. Insufficiently healed ankle sprains are the leading cause of chronic ankle instability and pain.

The second common type of injury involves chronic ankle pain and instability. This may be caused by stretched or damaged ligaments or damage to cartilage in the joint and is often caused by not giving previous ankle injuries enough time to heal. 

If a sprain or strain does not heal completely, the ability of the ligaments to support the ankle can be compromised. That can lead to lasting pain and instability, often causing a tendency to roll inward or outward easily. This can re-sprain the ankle and cause even more cumulative injury. 

The best way to manage these injuries is prevention: always allow ankle sprains to heal completely before resuming normal activity. If you already experience chronic instability or pain in an ankle, that prescription isn’t very useful. These injuries may never be fully resolved, but you can manage them and continue to hike in spite of them.

Once again, your primary preventive measures are regular stretching to maintain and increase the ankle’s range of motion and strength training to build up the surrounding muscles, allowing them to support and stabilize the joint. 

One of the best things you can do for your ankles is regular hiking, but if you have a history of ankle pain or ankle injuries, you may want to start out carrying relatively light loads and walking smoother trails that minimize the potential for ankle rolling. As you get stronger and more confident, you can gradually take on more challenging trails, but stay aware of your ankles and avoid stressing them too much too soon.

If you have ankle problems, consider wearing an ankle brace when hiking. Wear hiking boots that provide solid support to your ankles, and wear your ankle brace when you try shoes on. You may have to size up to accommodate the brace. Always break shoes in thoroughly before hiking in them. 

If you’re heavy, you may wish to consider losing weight. And regardless of your body weight, you should try to minimize your load weight until you are fully confident in your ankles. Trekking poles can help you maintain stability and minimize the probability of ankle rolling, and they can also divert some weight from your ankles to your arms.

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