Treating an Ankle Sprain
You went to urgent care and were told that your child has suffered an ankle sprain, but you left without any guidance on what to do next.
As an athletic trainer, I’ve seen a number of ankle sprains that occur both in sports and daily activities.
Read on to learn more about general treatment of an ankle sprain.
The goal of treatment of a lateral ankle sprain is to optimize healing by protecting the injured ligaments and providing an environment that promotes healing.
It is important that ankle sprains are properly treated. Failing to properly heal the lateral ankle ligaments can will lead to chronic ankle instability down the road if the ligaments do not heal at the proper length to support the ankle.
While many people promote the use of the RICE method of Rest, Ice, Compression, Elevation, I think it tends to be misinterpreted. I’ll touch on each of those throughout the post.
Treating an ankle sprain
Wearing a boot or a brace
It is important to support the ankle and protect the healing ligaments from additional stress to allow them to heal in an optimum position. This can be done with the use of a knee-high walking boot or a lace-up ankle brace. In some cases, the ligaments will need to be protected at night as well, so the use of the boot at night is recommend.
For a stable ankle, Grade I ankle sprain:
A brace, like a lace-up brace with crossing straps like shown, can be used to be worn during the day if the ankle is stable. The brace should be worn during the day for 1 month and for activity for 3-6 months.
For an unstable ankle, Grade II or III ankle sprain:
An unstable ankle should be immobilized in a tall, knee-high, gray boot day and night for 4 weeks, to keep the ligaments in position for proper healing. This also means sleeping in the boot for the first 4 weeks. At night, the foot tends to plantarflex (the toes point down), which stretches the ligaments, so wearing the boot at night holds them in the normal position to allow them to heal in that position while sleeping.
If after wearing the boot for 2 weeks the ankle is stable, the ASO type brace can be worn during the day, but the athlete must continue to sleep in the boot until 4 weeks after the injury.
It needs to be a tall, knee-high boot and not a short, mid-calf boot because the shorter boot does not stabilize the ankle well enough.
An unstable ankle should be immobilized in a tall, knee-high boot, including sleeping in the boot at night for 4 weeks.
Be sure to read more about stable and unstable ankle sprains in this previous post.
Crutches
Crutches can be used if walking on the ankle is too painful or if the athlete limps and can be used along with a boot. Be sure that the crutches are properly fit.
If crutches are needed, they should be used in addition to wearing a boot, not in place of.
Pain control
Pain is the body’s way of trying to protect itself. The goal is not to eliminate pain, but to control it.
Inflammation is a natural part of the healing process. It is an extensive process that is too complicated to get into in this setting, but in summary, inflammation is necessary to healing as it clears out the “junk” and damaged cells after an injury and brings “healing” cells to the area. Keep this in mind when deciding what kind of over the counter medication to take for pain control.
There are better options than traditional over the counter anti-inflammatories for pain control.
Ice is a pain control measure and it can reduce inflammation. Ice can be used acutely (first 1-3 days after the injury), but should be limited to 3-4 times a day. The skin should be protected from getting too cold and causing additional injury.
Trying to limit the amount of extra standing or walking in the first few days is important for swelling and pain control. There typically tends to be more pain when there is more swelling. When seated, the ankle should be at hip height, say like resting on the couch or another chair.
I like how he is sitting. I don’t like that he isn’t in a boot though. Look at how that foot is slightly plantarflexed and inverted. That is what should be avoided when recovering from an ankle sprain.
Compression
Compression can help limit swelling in the ankle and the foot by applying external pressure to the ankle and “pushing” it back for the body to resorb.
Most people try to use an ACE type wrap around the foot and ankle, but those are difficult to apply correctly and can easily be put on it too tightly and increase pain and reduce blood flow to the toes. They are definitely not my favorite.
Graduated compression stockings can apply the appropriate amount of pressure to the foot and ankle. Sizing up initially will allow for increased acute swelling and be easier and less painful to put on. After the swelling has started to go down, sizing to the appropriate size will continue to give appropriate compression. They can typically be found at a pharmacy or in the pharmacy section at your local Target or Wal-mart.
Properly wearing the walking boot or brace will also apply additional external pressure to help control the amount of swelling.
What questions do you have about treating an ankle sprain? Leave your questions in the comments section below.
Read on to learn more about rehabbing an ankle sprain and returning to sport after suffering an ankle sprain.
Disclaimer: This post is for informational and educational purposes only, does not constitute medical advice, and does not establish any patient relationship with me. I’m not liable or responsible for any damages related to your use of this information. Information given is a generality of athletic injuries and treatments and is not meant to replace traditional medical advice. Please consult a physician for proper care.