Sprained ankles are a common injury. They happen if your ankle rolls in or out suddenly. This abrupt movement causes the ankle joint to move out of place.
An inward ankle roll is called an eversion sprain. This type of injury affects the ligaments and tendons along the inner part of the ankle. These tendons also help support the arch of the foot.
An outward ankle roll is called an inversion sprain. Inversion sprains affect the outside ankle ligaments.
Ligaments are strong, fibrous tissues that connect the bones of the ankle to the bones of the leg. Both eversion and inversion sprains cause the ankle’s ligaments to stretch or tear. This results in varying degrees of pain and swelling.
Reasons to see your doctor for a sprained ankle include:
- extreme pain
- odd shape
- severe swelling
- inability to walk more than a few steps
- limited range of motion
How you should treat your sprained ankle depends on the severity of the injury.
Mild sprains can often be treated at home. The traditional RICE method (rest, ice, compression, elevation) was once considered tried and true. But it may not always be your quickest route to recovery.
Some experts, including Dr. Gabe Mirkin, an early advocate of RICE and credited for coining the acronym, have reevaluated the benefit of rest over exercise and the need to ice a sprained ankle.
PRICE is another acronym for a method of managing injuries like sprains and simply highlights the strategy of protecting your injured limb along with rest, ice, compression, and elevation. It advises protecting or keeping the injured area still in the first moments, hours, and day of the injury.
Rest or activity?
According to the Institute for Quality and Efficiency in Health Care (IQWiG), mild exercise may help speed recovery after resting for a period of one or two days. A position statement published by the National Athletic Trainers’ Association (NATA) indicated that gentle exercise is good for blood flow and that it helps speed up healing. Exercises that strengthen muscles in the calf and ankle can be helpful for improving balance and stability, reducing the risk of reinjury.
A systematic review completed by researchers at The Academic Medical Center in Amsterdam found that immobilizing a sprained ankle with a brace for up to 10 days may help decrease swelling and pain. They also discovered that completely immobilizing an injury for more than four weeks may actually worsen symptoms and affect recovery negatively.
Start with gentle strengthening exercises. Don’t continue with any exercise that seems to aggravate your symptoms. Talk to your doctor or physical therapist about the types of exercise that might be beneficial for you.
Ice or heat?
NATA’s position statement also noted that the conventional wisdom about icing sprains isn’t based on much solid research. On the flipside, research reported in a 2012 issue of the Journal of Athletic Training didn’t find enough data to say icing a sprain has zero affect.
Every injury is different, and RICE is still widely recommended, even by NATA. If icing your sprained ankle provides relief, do it.
Use an ice pack for 15 to 20 minutes every two to three hours for the first 72 hours. This may not be appropriate for people with health conditions, such as diabetes, damage to the peripheral nervous system (peripheral neuropathy), or vascular disease.
Don’t ice your ankle for more than 20 minutes at a time. More doesn’t equal better in the case of applying ice.
Compression helps decrease swelling and provides stability to your ankle by immobilizing it. You should apply a compression bandage as soon as a sprain occurs. Wrap your ankle with an elastic bandage, such as an ACE bandage, and leave it on for 48 to 72 hours. Wrap the bandage snugly, but not tightly.
Elevating your foot above your waist or heart reduces swelling by promoting elimination of excess fluid. Keep your foot in an elevated position as much as possible, especially in the first few days.
Nonsteroidal anti-inflammatory drugs (NSAIDs) may be most effective if you use them during the 48-hour window after you sprain your ankle.
While pills like ibuprofen (Advil, Motrin IB) or naproxen (Aleve) may be the first anti-inflammatory medication to come to mind, there are also topical options that you can rub or spray directly over the site of pain and swelling. Topical NSAIDs can be just as effective as the NSAIDs you take orally. NSAID gels might also be a good option if you tend to experience common side-effects from NSAID pills, like an upset stomach.
Certain exercises can rehabilitate your ankle. Your doctor or physical therapist may recommend a series of movements designed to restore strength to the area so you avoid future sprains.
Balance and stability training, as well as stretches designed to improve flexibility and range of motion, are especially helpful. The sooner you’re able to start exercising your foot, the better. This will help promote healing. But don’t overdo it!
Here are a few exercises to try when you’re able:
- Walk, either with or without crutches.
- Trace the alphabet with your toe. This encourages ankle movement in all directions.
- Stand on one leg for 25 seconds to one minute to improve strength.
- Sit on a chair with the foot of the affected leg flat on the floor. Move your knee from side to side while keeping your foot flat. Do this for two to three minutes.
- Stretch your calf by placing your hands flat on a wall and positioning the injured leg behind you. Straighten the leg and hold for 25 seconds. Do this two to four times.
You can also talk to your doctor or physical therapist about using resistance bands in your exercise and recovery routine.
Your ankle is uniquely designed to support your body weight — many times over — when you walk, run, and engage in day-to-day activities.
Your ankle is made up of:
- bones, covered by cartilage
- blood vessels
The ankle joint is formed by three bones. It works like a hinge to allow your foot to move easily in all directions. These bones are called:
Ligaments connect the bones to each other, holding them together. There are three ligaments on the outside (lateral area) of the ankle. The inside (medial area) of the ankle contains the deltoid ligament. Several ligaments also support the lower leg where it meets the ankle.
Tendons connect muscles to bones. The most well-known ankle tendon is the Achilles. In the ankle, tendons help to maintain stability and strength.
The muscles of the lower leg are important too. They work to support the ankle’s function and ability to move. Conditioning, stretching, and strengthening these ligaments and muscles that support your ankle can help to keep your ankles healthy and stable.
A sprained ankle can happen to anyone, but there are several things you can do to take care of your ankles long term and to speed recovery:
- Avoid footwear that makes your ankle unstable, such as high heels.
- Stretch before and after exercising.
- Stretch your ankle and legs regularly.
- Continue with exercises designed to strengthen your ankle.
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