Pain management strategies for riders?

[Carly_W]

So, I had a fall about 3-4 years ago which ended up spraining my right ankle, and it never really healed correctly. I have pain in my ankles if I sustain a half seat (especially at the trot) or otherwise am ‘down in my leg’. The pain is on the outside of my ankle - not the Achilles tendon, but right above the ankle bone.

I tried spring stirrups and I hated them - they made the pain worse. I currently ride in the Royal Rider stirrups which alleviate some of the pain, but not all. Regular fillis irons are painful as well.

The pain always gets worse in cold weather, and I’m looking for suggestions to help manage the pain. I’ve pretty much given up on the hope of pain-free riding at this point, but I’d at least like to be able to complete a lesson without having to pull myself out.

Any thoughts or advice would be much appreciated!

[Calvincrowe]

See a doctor–preferably a sports medicine or orthopedic surgeon who specializes in sports rehab. Something is not right in there, and no amount of pain medication will make it better. This would be a good first step to finding out the cause and the treatment plan. Good luck!

[Tyrus_Mom]

I have an ankle that was broken many years ago and not treated so it didn’t set right. Didn’t give me any problems for many years, now it is. I found I’m too old to have it fixed according to the doctors and it gives me pain when I ride, as well. I bought an ankle support to wear when I ride, that helps. Stirrups with padding help. I still hurt, sometimes the pain is pretty bad, but that’s the way it is.

I did see a doctor about it and all they did was give me a cortisone shot that didn’t help very much and wears off after a couple of months and also said I could have the ankle fused so it would be un-moveable. (Really, who the F does that? Sounds awful! You’d walk like Igor for the rest of your life!)

[gypsymare]

Try to keep the swelling to a minimum with compression like ace bandages when you arent riding and ibuprofen before and icing after rides. If you can, ride with you foot a little deeper in the stirrups to take a bit of stress off the ligaments. Try touching the inside branch of the iron to the inside of your boot if your sprain was to your lateral ligaments. I like the Compositi Reflex stirrups I put on my saddle… They add a bit of shock absorption.

[TWH_Girl]

Second the ortho or sports medicine check. An MRI may be helpful, or may provide info you’d rather not have…i.e.surgery needed. More than likely, some PT would help.

​ I sustained a bad right ankle sprain as well. Even having the pressure of covers on the bed made it ache. I did a lot of exercises and used Meloxicam as needed, as well as the compression braces. It’s improved over the years but still acts up when walking for exercise. I ride Walkers so don’t have the posting issue. Riding hasn’t bothered me but plenty of other things do.

[Bogie]

I broke my ankle in January and while the bone has healed, I still have ligament pain in the outside of my ankle after longer rides. I’m still doing PT and it’s definitely getting stronger, but I also wear compression socks when I ride. That helps a lot.

[Renn_aissance]

If you were a horse, you would have seen the vet and been on a treatment plan that probably would have involved some degree of physical therapy. Go see the doctor and look into PT.

I have an old peroneal ligament injury that gives me pain similar to what you describe and a PT plan made a big difference. We also spoke about the mechanics of building strength in other areas of my leg and loading my ankle differently to reduce the risk of reinjury.

[kaya842]

Besides saying go to the doctor (which you should) I will share my pain “remedies”. I have disc issues in my back (also bad knees and ankles) and the first thing is to get the equipment right - your shoes and stirrups will make the most difference. You might want paddock boots and half chaps most of the time to 1. offer more ankle support than tall boots and 2. give you the freedom the wrap your ankle when you ride. Stirrups are preference but I believe wide tread is very nice. I recommend getting a back on track brace. I have one for my knee and my back and I love them they help immensely when I use them.
If I have pain despite preventative measures (see above), then I use bio freeze gel, tens unit + heating pad, voltaren gel (prescription needed), then finally prescription pain medicine. Obviously I start with the least and work my way up. I will say since getting my tack right my back issues have all but disappeared (they are there but not painful).

[Pennywell_Bay]

Never give up riding pain free.

1. As other posters have said- see a good sports medicine doctor
2. Stretches

I had a major car accident 21 years ago. The last 5-6 years I have had knee pain. Shrug. I’m pushing 50, I have about 75 surgical procedures from the accident. I guess I have to live with the pain and medicate, as needed. WRONG.

Went to a sports medicine doctor in the spring, he said “I can’t believe you are still walking”. The wires in my knee has broken into 15 (they counted when they did the surgery to remove it) pieces!!! I had the surgery in June and fast forward- no pain. Why the hell didn’t I do this 5 years ago? Poster is correct- if my horse had been limping around she would have been at the vet.

Be proactive with your health and comfort.

[stargzng386]

I also second going to a Dr but I also recommend the Back on Track physio ankle brace. It’s kind of like a compression sock around your ankle using their material. I bought mine at WEG and it made my old ankle sprain pain free for 8+ hours walking around. I alternated each day to really test it out and without it I was in significantly more pain. With it I honestly didn’t notice it. I ended up buying a few to use for long drives and riding.

[Anna.m]

Seems right ankle injuries are very common!
a few years ago I came off and *hurt my right ankle, during a very expensive clinic. I got back on and finished my lesson. I figured even though it hurt that it was fine, and didn’t get it checked. It wasn’t fine. After a lot of pain and feeling like my ankle was getting ‘stuck’ and feeling like bone on bone I got it checked. I destroyed all of the cartilage in my ankle. They need to do a full replacement, but wont because I am barley 25.
Now I ride with a compression brace with copper. I find it makes a ton of difference. Not every ride is completely pain free, but it is manageable. But you do have to replace them every couple months. I’ve started a show in an old brace and almost scratched because I couldn’t finish my warm up. Thankfully I was able to get a new brace, and I was able to finish my day with no pain. I also use a Back on Track brace when the ankle bothers me when I am not riding. I also switch between copper and magnetic bracelets.

[iJump]

Aloe Vera juice!

I drink at least 1 smoothie daily with AV and L-Glutamine. If I skip a day, I definitely notice it.

I’ve always thought that everyone hurt a little all the time, because I always have.

My left shoulder, elbow, knee and ankle are the worst but both knees hurt all the time. Other parts randomly depending on what I have been doing. Lots of upper back pain recently!

[tmc]

I have strained tendons in the outside of both my ankles that never healed correctly from injuries years ago. The thing that helped the pain most was a good set of wide tread irons. I found that the flexible or cushioned irons didn’t have enough of a stable base. (I wrote a blog post about my experience with the flex irons here: https://breechesandboatshoes.com/2016/01/23/to-flex-or-not-to-flex/) Along with that, using kinesiology tape to help support the side of my ankle that was having issues also helped.

[Cocorona]

Have you tried riding without a stirrup on the side with the hurt ankle? I agree with everyone else about going to the doctor, but if it were me, I would lose the stirrup on the injured side and work on building up that leg muscle around your ankle. No stirrup would mean no pressure on the joint- also, I suspect you’ve been favoring that side and it has likely lost some strength which leaves the ankle vulnerable.
You can obviously drop both if you’re afraid you won’t be able to stay balanced but I think at least getting rid of the one on the injured side and getting more stability through increased work will help tremendously as your doctor works out a plan

[hunterjumper98]

I second @tmc’s suggestion about trying wide tread irons. I have weak ankles that are painful when riding, and the only stirrups that helped alleviate some of the pain are Herm Sprenger Bow Balance stirrups and the Jin stirrups. Both almost completely alleviate my ankle pain in the saddle, but I am currently solely using my Jins.

Good old fashioned ankle strengthening exercises will also help you build back up your strength in your ankle. I like to do heel lifts and spell the alphabet with both of my ankles. Over time, it should help you get back the stability you had pre-sprain and help alleviate pain.

In the meantime, I totally suggest to give Back On Track’s ankle brace a try - both in and out of the saddle. It provides me with a lot of relief when my ankles are particularly bothersome. That and slather on some Absorbine liniment post-ride. :winkgrin:

[Carly_W]

Thanks everyone for the responses! I really appreciate it.

When I had sprained it, I thought I had just twisted it and so I didn’t treat it as a true sprain - I walked on it and rode on it and did all the things you probably shouldn’t do. Never went to the doctor for it either - I was in college and working at a race farm so I never took the time for it that it probably needed. Lesson learned!

I don’t have any pain in the ankle except when I ride, thank goodness. I have a Back on Track ankle brace, but I don’t think it said Physio on the package - is there a difference? Mine is kind of like a sock brace that’s not very compressive, if that makes sense.

[Inclined]

I sprained my ankle two months ago, and using this was what made it possible for me to get around at all: https://www.tractorsupply.com/tsc/product/absorbine-veterinary-liniment-gel-12-oz-5024164?cm_mmc=feed--GoogleShopping--Product-_-5024164&gclid=EAIaIQobChMIteW48cT13gIVGYnICh2dEgzREAYYAiABEgJMi_D_BwE. I know that it’s technically for horses, but it works for people, too. The smell is not ridiculously strong, IMO, and the gel doesn’t run all over the place.

Something my doctor recommended is to write the alphabet letters with your foot while it’s resting. It gently stretches and strengthens the tissues around the ankle.

[Bogie]

The other thing that helped me was Apothocanna CBD cream – https://apothecanna.com/products/extra-strength-relieving-creme. This one is good but if you live in a state with legal weed, the version that contains THC along with the CBD, really helps relieve pain.

[mmeqcenter]

I sprained my ankle in high school, never saw a doctor. Years later, after continuously increasing pain (in the exact same location OP described) that started with riding and progressed to daily life, I finally saw a doctor. After xrays and MRIs, I was informed I needed surgery ASAP, if I waited even six months, I may never be able to ride again. So, I had surgery. Which took twice as long as expected, and ended up being complete reconstruction of my right ankle. Tendon repair, ligament repair, scar tissue removed, shaving of bone to make room for “new” connective tissues, etc. I was four months non-weight bearing afterwards. This was about 8-9 years ago, and I do again have some slight pain in the ankle, but nothing at all like it was before.
Now, my bigger pain issue is my knees. I’ve had two MRIs in the last five years and partly know what the issue is (discoid lateral meniscus in the right, left knee pain is new and not yet investigated), and I need surgery, but no doctors will do it until the meniscus actually tears. So here I am.
I’ll take Ibuprofen or something when it’s at it’s worst, but mostly I just deal with it. I have switched to dressage and don’t jump much anymore (except a horse I had in on consignment), which has helped a ton. I notice a significant increase in pain after jumping.

[gottagrey]

I busted my ankle but good many years ago. I have on/off pain, currently it’s on. Cold weather and A/C seem to aggravate it more. I’ve found that using an ankle support helps a lot. The kind I like are the Ace flesh colored ones as they are thin enough to fit with my shoes yet still provide enough support. Over the years, my orhtho has suggested using support hose (never did but did get “light support” stockings/hose which do help during the day at work. I also found the best thing was actually regular exercise - my ankle has limited flexibility so jogging is out but walking, a x-country sky machine like nordic trak (not very common anymore) and some weight training like leg presses. When it’s really bad I’ll take Advil or Aleve