Ankle Sprain Treatment

  • Treatment

    There are many cases in which you should seek medical care for an ankle sprain.

    • You are experiencing severe pain and can’t put any weight on the injured ankle
    • The ankle is very tender when you touch it
    • You can’t move the ankle
    • Your leg gives way when you try to walk on the ankle
    • The ankle feels numb
    • The ankle looks misshapen or has unusual bumps (other than the swelling)
    • You have pain, swelling, or redness over a bony part of your foot
    • You have previously injured the ankle
    • You have diabetes
    • You’re not sure about the seriousness of your injury

    Treatment for ankle sprains begin with self care. Rest, ice, compression, and elevation (RICE) are recommended.

    • Rest. Stop doing any activity that causes pain or discomfort to your ankle until the injury has healed. To help relieve weight on the injured ankle, use a cane or crutch on your uninjured side.
    • Ice. Press an ice pack (or a bag of frozen vegetables) over the affected area four to eight times a day, for 20 minutes at a time.
    • Compression. Wrap your ankle in an elastic bandage to reduce swelling. Don't wrap it so tightly, however, that you inhibit circulation.
    • Elevation. You can minimize swelling by keeping your ankle elevated as much as possible. For best results, prop your ankle up so that it’s above the level of your heart.

    Take measures to reduce swelling during the first 24 hours after the injury. To reduce swelling, avoid the following things in the first 24 hours:

    • hot showers or baths
    • ice packs
    • medicated heat rubs
    • drinking alcohol.

    Your doctor is the best source of information on the drug treatment choices available to you.

    Your doctor may recommend that you wear a brace or a cast to limit motion in your ankle while it is healing. You may also be provided with crutches so you can avoid putting weight on the injured ankle.

    When the pain and swelling has significantly lessened, your doctor will prescribe rehabilitation exercises, perhaps under the guidance of a physical therapist. The exercises are designed to reduce swelling, prevent stiffness, increase strength and flexibility, and restore normal, pain-free range of motion in your ankle. It is very important that you do these exercises. Studies have shown that lack of rehabilitation after an ankle sprain can delay the healing process and a return to normal activities.

    Rehabilitation exercises for ankle sprains fall into the following categories:

    • Range of motion (to regain normal ankle motion). Figure 02
    • Muscle strengthening (to regain ligament strength). Figure 03
    • Balance training. Figure 04

    Your doctor or therapist may also recommend more advanced rehabilitation exercises; particularly if you regularly engage in sports and want to resume your previous level of activity. These exercises will not be started, however, until you can walk comfortably and without a limp. Advanced rehabilitation may include doing stair climbing, hopping, and running in figure eights. You’ll also be advised on how to return gradually to your sport.

    Your doctor may recommend that you continue to wear an ankle brace when you return to a strenuous sport or activity. You can return to your sport when:

    • your ankle recovers its full range of motion (up and down, side to side, in and out);
    • the muscles surrounding your ankle regain at least 80 percent of their strength;
    • you have good, steady balance when standing;
    • you experience no pain when exercising.

    Click to enlarge: Range of motion exercise

    Figure 02. Range of motion exercise

    Click to enlarge: Muscle strengthening exercise

    Figure 03. Muscle strengthening exercise

    Click to enlarge: Balance exercise

    Figure 04. Balance exercise

    If all efforts at treatment fail and/or you continually sprain your ankle, your doctor may recommend surgery to reconstruct or repair the damaged ligament. This surgery may involve sewing the torn ends of the ligament together or using a graft from a tendon from the ankle joint to reconstruct the ruptured ligament. The surgery is usually done on an outpatient basis, but you will need to rest for at least 48 hours afterwards with your leg elevated. During this period, you will also need to apply ice to your ankle every hour for about 20 minutes.

    After the swelling from the surgery has subsided, your doctor will place your ankle in a cast, which you will need to wear for about six weeks. Once the cast is removed, you will then need to begin a physical therapy program to regain full use of the ankle.

    Alternative therapies should be used only to complement conventional medical treatments.

    Always consult your physician before taking supplements, as supplements and herbs can interfere with other medications you may be taking.

    People with diabetes and other conditions that can numb the nerves in the feet--such as AIDS or a traumatic injury— may not be able to feel the pain from a sprained ankle. If you have one of these conditions, be sure to seek medical care when you fall on or twist your ankle, even if you are feeling no discomfort.

    Most ankle sprains heal without complications. People with grade I ankle sprains are usually able to return to their normal activities within one to two weeks of the injury. Those with grade II sprains can do the same within two to four weeks. Grade III sprains require a much longer healing time--usually 12 to 16 weeks. High ankle sprains often take the longest to heal.

    Once you have sprained an ankle, you are more likely to injure it again. Some people develop a condition known as chronic lateral ankle instability, which is characterized by persistent ankle pain, stiffness, or swelling. The ankle may even “give way,” or suddenly fail to support the body, when standing or walking. Chronic lateral ankle instability may require surgery.

    You need follow-up care for an ankle sprain only if the ankle is not healing well. This may indicate that you have a previously undetected fracture or that you have completely torn a ligament.

    Call your doctor if:

    • one week after the injury, you still cannot walk on your ankle;
    • two weeks after the injury, the ankle continues to hurt.

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