Dr. Eric Anderson, a charter diplomat of the American Board of Family Practice and a former president of the New Hampshire Academy of Family Physicians, is a regular contributor to Travel Tips 'n' Tales. He is widely traveled and published, having written a travel health column for Travel 50 & Beyond and a weekly online column, Ask The Doctor, for The New York Times Syndicate.

Dr. Anderson invites you to send your questions regarding travel health issues to ericmd@lorrypatton.com

Question: I sprained my ankle on a trip four weeks ago and it's still not back to normal. When I got home, my doctor prescribed an air cast, which I wore as recommended. Is there anything else I can do to help myself heal faster such as strengthening exercises? How soon will I be back to normal? I'm a runner.

Answer: Ten million North Americans sprained their ankle last year. Ankles take ages to heal and finding yourself not back to normal at four weeks is fairly typical for ankle injuries. It is after all a weight-bearing joint.

Assuming that your X-Rays were normal, that you didn't completely disrupt the ankle joint and you can now, off crutches, fully weight-bear without pain, you should continue with warm to cold soaks and a full range of motion exercises in a warm bath. Keep doing toe raises and balance stands and straight-ahead-activities like walking on smooth, level surfaces.

After four weeks most physicians would increase your activities to walking, then running lazy figures-of-eight on smooth, level surfaces. As you improve, they would want you to exercise more, still on level ground, jogging and changing directions in "sharp Zs" before you resumed running regularly.

How soon will that be? It varies according to your progress -- two to four more weeks wouldn't be unusual. The delay is worthwhile: a prior ankle sprain often leads to another within a year.

That said, I'm a little concerned about you, a runner, who from the sound of it probably suffered some delay before being treated. Ankle injuries do best if they are handled promptly with the classic RICE (rest, ice, compression, elevation) and it's hard to do those things when you're far from home. Who out there, for example, would go back to his or her hotel in Rome and skip the rest of a visit to the Colosseum just to ask the concierge for ice? But there's one thing travelers can do, especially those who have previously injured an ankle: carry a 3 inch elastic compression bandage in a camera bag or purse. Such a bandage has so many other uses from fastening the leg back on a camera tripod to binding a suitcase with a partly broken zip. And it goes without saying that persons with previous significant ankle sprains should be particularly sensible when it comes to choice of shoes on vacation.

A final consideration I would have is whether there was an explanation for the cause of your ankle sprain. If you tripped over something or were bumped or knocked down by another person you may have had a normal consequence: a fall injuring the ankle. But if out of the blue, your ankle suddenly gave way and you simply fell, that raises another question.

Sports physicians and podiatrists are interested, these days, in what they call "biomechanical" issues. They are big on measuring length of legs and dropping a plumb line from the hip to see if the anatomical architecture of the ankle joint is sound. If it isn't they suggest building up the shoe to make things normal for that person. I don't feel every person with an ankle strain needs such assessment but a world traveler who fell inexplicably might. As they say: an ounce of prevention...

NOTE: Lorry Patton's Travel Tips 'n' Tales would like to remind you to always consult with your personal physician before following any medical advice and to please read the Travel Tips 'n' Tales "Terms of Use" found on the bottom of each page of this website. Dr. Anderson's opinions are not necessarily the opinions of Lorry Patton or Travel Tips 'n' Tales.