Ankle Compression Donuts
Ankle injuries are, unfortunately, all too common on outdoor trips. While both stable and unstable ankle injuries cause soft tissue damage and swelling, field assessment is simple and based primarily on the patient's range of motion (ROM) and whether or not they are able to stand and bear weight shortly after the event. If their ROM is intact and they are able to stand an bear weight, the injury is stable; if not, the injury is unstable.
In stable ankle injuries, swelling can be prevented by placing foam donuts over the soft tissue around both ankle bones (malleoli) and applying a "walking splint" improvised from a padded aluminum splint. Ideally the patient should avoid walking on the injured ankle for 2-5 days. During this time have them do pain-free ROM and light strengthening exercises followed by a 15-20 minutes cold water bath 3-4 times a day. When not exercising, have them elevate their ankle higher than their heart. If the patient must walk to during this time, you will need to support their ankle and significantly reduce their pack weight. Whether a patient requires an evacuation for a stable ankle injury depends on the severity of the injury, the type of activity (backpacking, cycling, canoeing, etc.), and the difficulty of the terrain they can be expected to traverse.
The photos on the left show how to use foam donuts to deliver light compression to the soft tissue surrounding the malleoli to prevent excessive swelling and promote rapid recovery in stable ankle injuries. Not that focal compression can also be used to speed recovery in unstable ankle injuries.
While compression donuts can be cut from foam sleeping pads, you will shorten your pad—assuming you carry one—and the cost of replacing a sleeping pad is significantly more than the purchase price of two our our commercial donuts. The donuts are extremely lightweight and have an adhesive that sticks readily to the patient's skin and are designed to last through numerous cold water baths without falling off.