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Possibly the most common injury I see when hiking with groups is when someone turns or rolls their ankle. Assuming that access to a vehicle is not feasible, what is the best way to deal with the injury to make it several miles out without causing further damage to the joint?

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This happened to me, 6.5 miles from civilization. Laid me up for six days (fortunately at the NOC, a nice place to be laid up). I recommend prevention: use hiking poles! –  Michael Hampton Oct 26 '13 at 4:27
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There are relatively well known steps to dealing with this out in the wilds. One online resource with pictures is at Backpacker Magazine.

The basic steps (that are detailed there) are:

  • Rest, Ice, Compression and Elevation (which you should do with any sprain, wherever you are)
  • Bandage reasonably tightly - not so tight that you cut off circulation, but tight enough that you restrict swelling and support the ankle. A visual check to make sure the toes aren't turning blue is essential, especially in a very cold environment!
  • Pad the ankle - a scarf, t-shirt or other material helps to make sure the ankle bones are protected.
  • While you can use a branch, a much better option, and the one Backpacker Magazine recommends, is to use a foam sleeping mat as a splint, as it provides support and some impact protection. You can fold it in half, place it down one side of the leg, under the foot and up the other side. If it is too big, cut it - you can always buy another one once you get home. Use your usual mat ties or straps to hold it tight.
  • Once you have got it secure and the ankle is immobilised without it being too tight, and you are confident that it won't be damaged further, take ibuprofen to help kill the pain and reduce inflammation.
  • Support the individual and slowly walk back to civilisation.
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Question on the order of operations. Is there a particular reason to do all the securing before taking the ibuprofen? Why not use the anti-inflammatory before manipulating the injury? –  Russell Steen Oct 17 '12 at 12:49
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Pain can be very useful until you are definite what the issue is. What appears to be a sprain could be a break - leaving the painkiller until a bit later helps you avoid accidentally numbing the pain too much and damaging a broken ankle. Although, as ibuprofen takes 20 minutes to kick in, this could be done earlier. –  Rory Alsop Oct 17 '12 at 13:13
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The modified mnemonic taught these days for soft-tissue injury is IRICE -- Ibuprofen, Rest, Ice, Compression, Elevation. The painkiller in Ibu is not sufficient to mask (and thus miss) critical pain, but the sooner you can get the anti-inflammatory in you the better. –  LBell Oct 19 '12 at 13:54
    
Oooh - that's interesting, and makes sense (see my 20 minutes comment.) I was always told to wait on the Ibu until you had made a definite diagnosis (but this was from a nurse, so her standards may be more technical than the practical outdoors usage). Is IRICE commonly accepted? If so, I'll update the answer. –  Rory Alsop Oct 19 '12 at 14:51
    
Last WFR I took (WMI) was teaching IRICE... can't guarantee they haven't changed it (like they like to do)... UPDATE: Damn. bucktilton.blogspot.com/2010/12/rice-revisited.html –  LBell Oct 26 '12 at 11:43
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