Twisted Ankle on the Trail: Can They Keep Walking?

In pairs, students work through how to handle a twisted ankle during a hike: assess the injury with simple criteria, immobilize it with a triangular bandage over the boot, and decide whether the injured person can continue, should head back with company or needs outside help. The focus is on the decision, not just the bandage.

How to play

1. Explain the assessment: pain when pressing on the bone, ability to take four steps in a row, deformity and swelling; and the three possible decisions (5 min).
2. Demonstrate the figure-eight wrap with a triangular bandage over the boot or sneaker, without removing it (4 min).
3. In pairs, one plays the injured hiker with a case card only they read; the other assesses, asks questions and decides (8 min).
4. The first aider applies the right wrap and explains the decision out loud; switch roles with a different case (8 min).
5. Discuss borderline cases and how the decision changes with the distance to the trailhead and the time of day (5 min).

Rules

• The wrap must not be tight: check that the toes keep their color and feeling.
• Never force a partner's ankle; only press gently.
• The simulated patient never walks on the wrapped foot if the case says they cannot.
• Case cards are not shown to the first aider.

Variations

Adaptations

• Limited mobility: acts as first aider on a partner seated at the same height, or assesses and directs a helper verbally.
• Hearing impairment: cases are written and the pair communicates with written questions or agreed signs.
• Touch sensitivity: practices the wrap on their own ankle or on a manikin or a bottle.

Learning goals

• Assess a twisted ankle using simple, objective criteria.
• Immobilize an ankle using items found in a hiking backpack.
• Decide responsibly whether to continue, turn back or call for help.

Equipment for a class of 25

• triangular bandages: 15
• elastic bandages: 15
• exercise mats: 15
• worksheets: 15

Teacher tip

Remind students that the criteria are a guide for decisions in the outdoors, not a diagnosis. Prepare at least six different cases with context: time, distance, weather.

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