Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.See all posts »
Support for Ankle Sprains
Sprained ankles are the bane of existence for hikers, trekker, and joggers—indeed for most athletes or anyone who has the opportunity to twist a foot on an uneven service, stepping over a rock, or falling into a hole. The classic first aid treatment is “RICE”—rest, ice, compression, and elevation. The utility of rest is obvious, because it allows the stretched or torn ligaments to heal and avoids a repeat injury. Ice is the application of cold, which helps to limit swelling and pain in the early post-injury hours (usually recommended for the first 24 hours). Compression is generally applied with an elastic bandage (such as an Ace wrap) to limit swelling and perhaps create a bit of stability to the ankle joint. Elevation means trying to keep the injured part at an altitude above the level of the heart, which perhaps lessens swelling and thereby promotes mobility and perhaps healing.
In an article in the European Medical Journal entitled “Acute ankle sprain: is there a best support?”(2011, 18:225-230) authors Gabrielle O’Connor and Anthony Martin looked at acute lateral ankles sprains, which account for 85 percent of all ankle sprains. In an emergency department in Ireland, they peformed a prospective randomized controlled clinical trial to compare the outcomes in terms of ankle function, pain improvement, and return-to-work times in adults presenting within 24 hours of a first-time acute lateral ankle sprains, among three external supports. The three modalities that were compared were a double Tubigrip compression bandage, Elastoplast bandage, or no support (compression). They were able to include 54 patients, who were divided approximately equally between the three groups, across a spectrum of ankle sprains judged to be mild to severe.
In this study, the patients who were treated with Elastoplast bandaging had a tendency to better average ankle function at the times when this was evaluated at 10 and 30 days after the injury, compared to the other two modalities. They also showed a return to work an average of two days earlier. So, while there was not a statistically significant difference in ankle function between the modalities, it appeared that compression was subjectively useful.
What to make of this for the outdoor enthusiast? I think that it confirms the overall clinical impression that there is value for compression, even if it is not a miracle part of therapy. Compression helps limit swelling, which might otherwise cause it to be difficult to fit into boots or other footgear (although the wrap itself will change the foot and ankle dimensions while it is in use). It also somewhat limits motion and provides a bit of stability to the ankle, which is important if the risk factor of continued activity is present. Lastly, decreasing motion also reduces pain, provided that the wrap itself is not too tight.
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