How to Treat a Sprained Ankle

A sprained ankle is the most common sport injury, though not the worst.  If not treated properly, it could stall an exercise routine or sports career by several months.  Initial treatment is vital to the long term success of recovery from the sprained ankle. 

First, to review, there are simple steps that need to be taken after a sprain has occurred.  It is commonly referred to as the R-I-C-E method.  Acronyms make things so easy to remember, don’t they? 

R – Rest:

Stay off the ankle whenever possible.  At first it may seem impossible to use the ankle.  Over time, as it recovers, there is a danger of stressing the ankle before it has fully recovered.  Exercise during the first few days should be limited to swimming and cycling.  Never push yourself beyond what your ankle is capable of.

I – Ice:

Icing should be done in 15 – 20 minutes, once an hour.  Icing should be done as soon as possible after the injury.  Icing is most effective for the first 48 hours to fight swelling.  You can use a Ziploc bag of ice (with a little water), ice pack, steak or a bag of peas.  Ice needs to be applied soon and often.  Just do not ice for more than twenty minutes, as frostbite does not help the injury.

C – Compression:

Compression can be done with an Ace bandage wrap or a brace purchased from any drug store.  It should be snug, but not constraining.  Compression is important when the foot is not elevated and will have any strain placed on it.  Moreover, wear shoes, not sandals or flip flops.  The additional support can only help.  At the end of this article you will find a video demonstrating how to wrap an ankle properly after an injury.

E – Elevation:

The ankle needs to be elevated when you are not walking.  Elevation refers to a level higher than you heart.  This, in addition to the other guidelines, will reduce and minimize swelling.  A couple pillows or a folded thick blanket under the ankle should be enough elevation.  This will help in circulation of the blood through the ankle. 

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Follow these guidelines, and the damage can be minimized.  The next step is to see your doctor or a trained professional.  The damage that has occurred can range.  There are two types of sprained ankles, inversion and eversion.  An inversion sprain is the most common and occurs when the sole of the foot is forced to face inward, thus straining the ligaments on the outside of the foot.   This type of injury represents 40% of all sports injuries and 80% of all sprains. The anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) is the most commonly injured.  The rarest ligament damage is to the posterior talofibular ligament (PTFL).  Sprains are classified under a three level graded system.

Grade I:                The ligaments of the foot have had no macroscopic tears, most likely and over stretching.  There is mild pain and tenderness.  Swelling is present and there is not loss or a very limited amount of loss of mobility.  There is stiffness and difficulty walking.

Grade II:              A partial tear has occurred in the ligaments.  Pain and tenderness is moderate.  Swelling is present and the joint is stiff.  Minor bruising is present.  The ankle is having trouble supporting weight and is painful to attempt.  The joint is instable and mobility is an issue.

Grade III:             There ligament is completely torn.  Pain is severe and tender to the touch.  The ankle cannot support weight at all.  There is gross instability of the joint and is essentially unusable.  The bruising is extensive.

Do not self-diagnose.  After a sprain, consult a doctor.  Your doctor most likely will advise you to have an x-ray to check for a break or a fracture.  What may seem to you a simple sprain may in fact turn out to be serious damage.  Injury can range from strains or tears of the aforementioned ligaments, small fractures, breaks, avulsion fractures, or even osteochondral lesions.  Due to the wide range of potential issues, consult a professional.  Once the doctor has diagnosed the issue, rehab can begin. Good luck in your recovery.  For some rehab ideas click here.

How to wrap an ankle.