How To Treat A Sprained Ankle

This article delves into various treatments, explaining their benefits and methods, to guide you through a swift and effective recovery.

Find out more about general ankle pain here.

Rest: the foundation of recovery

Rest is important in the initial phase post-injury. Limit movement and weight-bearing activities to prevent further damage and allow the healing process to commence. During this period, it’s crucial to avoid activities that cause pain or discomfort to the affected ankle.

Rest doesn’t mean complete immobility; gentle movements to maintain circulation are beneficial. The duration of rest varies depending on the sprain’s severity, but typically it spans a few days to a week.

Ice: reducing swelling and pain

Applying ice is a tried-and-tested method to reduce swelling and alleviate pain. The cold constricts blood vessels, reducing blood flow to the area, thereby diminishing swelling and providing pain relief.

Ice therapy should be initiated as soon as possible post-injury and continued for the first 48-72 hours. The recommended approach is to apply ice for 15-20 minutes every two to three hours. It’s essential to wrap the ice in a cloth or use a cold pack to prevent frostbite.

Compression: supporting the injured ankle

Compression, a key element in treating a sprained ankle, involves securely wrapping the injured area with an elastic bandage or wearing a specially designed ankle brace. This technique aids in stabilizing the joint and reducing swelling by applying uniform pressure around the ankle. Proper compression not only supports the healing process but also provides a sense of stability as you gradually return to movement.

When applying an elastic bandage, start from the toes and move upwards towards the mid-calf, ensuring each layer partially overlaps the previous one. This method helps in creating an even distribution of pressure, which is crucial for effective swelling control. The bandage should be snug to provide support but not so tight that it cuts off circulation. A good rule of thumb is ensuring you can slide a finger under the bandage.

Regularly check the toes for any signs of poor circulation, such as blueness or excessive coldness. Adjust the bandage as needed, especially if you notice any tingling, increased pain, or if swelling develops below the wrapped area, as these are indicators that the compression may be hindering blood flow rather than aiding in recovery.

Elevation: aiding the healing process

Elevating the injured ankle above heart level, especially during the first few days, aids in reducing swelling. This position facilitates fluid drainage away from the injured area, thereby decreasing inflammation.

Ideally, elevate the ankle for about 2-3 hours a day. Using pillows to prop up the leg can make this more comfortable.

Pain relief: managing discomfort

Self-medicating with over-the-counter (OTC) pain relief medications is a common approach to managing the discomfort and inflammation associated with a sprained ankle. Ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), and paracetamol, also known as acetaminophen, are widely used options. When taking ibuprofen, the usual dosage is 200 to 400 mg every 4 to 6 hours, while for paracetamol, it’s typically 500 to 1000 mg every 4 to 6 hours. However, it’s crucial to not exceed the maximum daily dosage: 1200 mg for ibuprofen and 4000 mg for paracetamol.

Before self-medicating, it’s important to consider any pre-existing health conditions or current medications, as these drugs can interact with others and may not be suitable for everyone. For instance, ibuprofen should be used with caution by individuals with kidney problems, ulcers, or those who are pregnant. Similarly, excessive use of paracetamol can lead to liver damage, especially when combined with alcohol.

If the pain is severe or persists beyond a few days, it’s advisable to consult a doctor rather than increasing the dosage or frequency of these medications. This is because persistent pain might be indicative of a more serious injury that requires professional medical attention.

Range-of-motion exercises: restoring flexibility

Once the acute pain subsides, gentle range-of-motion exercises can be initiated as they’re essential for restoring flexibility and preventing stiffness.

1. Sit in a comfortable chair or on a bed where you can extend your leg.
2. Ensure your injured ankle is free to move without restriction.
3. Imagine your big toe is a “pen.”
4. Slowly use your toe to “write” each letter of the alphabet in the air.
5. Move only your ankle and foot, not your leg.
6. As you form each letter, aim to move your ankle through its full range of motion.
7. Go from A to Z, making the letters as large as you comfortably can.
8. While performing the exercise, be mindful of any pain or discomfort.
9. If a particular movement causes pain, reduce the range of motion or stop the exercise.

Perform this exercise 2-3 times a day. As your flexibility improves, increase the size and complexity of your movements, perhaps moving from block letters to cursive. Regularly performing this exercise is important for regaining ankle mobility so tack your progress over time, noting improvements in flexibility and any reduction in discomfort.

Strengthening exercises: building ankle stability

Strengthening exercises are vital for rebuilding the strength in the muscles around the ankle, which helps in stabilising the joint and preventing future injuries. These exercises should be started only when you can bear weight without discomfort. Resistance bands are a useful tool for these exercises, providing gentle resistance as you move your ankle in various directions.

Bracing or taping: additional support

Using an ankle brace or taping provides extra support and stability to the injured ankle, especially when you start to resume normal activities. These supports help to prevent abnormal movements of the ankle and can instil confidence as you return to daily routines.

Gradual return to activity: a balanced approach

Resuming activities should be a gradual process. It’s essential to listen to your body and avoid pushing through pain. Start with low-impact activities like walking or swimming and gradually increase the intensity and duration. You should always pay attention to how your ankle responds during and after these activities and adjust accordingly.

Alternative therapies: complementary treatments

Some individuals find relief in alternative therapies such as acupuncture, massage, or hydrotherapy. While these should not replace conventional treatments, they can complement them, for example, they might help in reducing pain, improving circulation, and enhancing overall well-being during the recovery process.

Physical therapy: a tailored approach

In cases of severe sprains or if recovery is not progressing as expected, consulting a physical therapist is advisable. Physical therapy offers a personalised exercise regimen, alongside other treatments like ultrasound or massage, to expedite recovery. A therapist can also provide guidance on proper techniques to avoid re-injury.

It’s crucial to seek medical advice if there’s significant pain, inability to walk, or if symptoms do not improve within a few days. A healthcare professional can assess the severity of the sprain and recommend additional treatments, such as imaging tests or a referral to a specialist. This step is vital to rule out more serious injuries like fractures or ligament tears.

If you’re not sure whether you have a sprained ankle, but still have ankle pain, you can find out more about ankle pain here.

More information

• If you have a foot problem that’s bothering you, speak to your GP who may be able to refer you to a specialist orthopaedic doctor. (If you don’t have a GP, you can make an appointment with one of our private GPs.)
• The King Edward VII’s Hospital Orthopaedic Surgery department is a world famous centre of excellence for orthopaedics offering help with ankle pain and sprains.