Ankle Sprains
Ankle sprains are one of the most common ankle injuries we see in the clinic. Ankle sprains occur in people of all ages. Less than half of all ankle sprains happen while playing sports. When I see an early ankle sprain in the clinic, I usually have two main goals: 1) have a good recovery from the sprain (return to work, sports, and usual function), and 2) prevent long-term ankle instability.
So you’ve just sprained your ankle, what do you do?
Interestingly, in the last 10 years, some strong evidence has been published suggesting that ice and rest alone isn’t enough for a good recovery.
So should you ice?
Well everyone is different. Based on current clinical practice guidelines, ice is not necessary, but should be individually determined. If you use ice, it should definitely be used in association with therapeutic exercise to address your symptoms and improve function.
I will usually give advice on managing swelling, recommended ankle support (taping or bracing), and early weight bearing. Weight bearing is important, and if you have difficulty with it, we find other ways to increase load tolerance in your ankle. I also go over patient-specific exercises to promote optimal healing, keeping in mind the sports and hobbies you participate in. Return to sport can happen the day of the injury, or it may take a few weeks, but full recovery can take months. As things start to improve, I will usually prescribe exercises to continue working on rehab at home.
One thing to keep in mind: If you just rolled your ankle and are unable to put weight on it soon after injury it may be an indicator of a more serious injury. This may require X-rays prior to continuing your rehab. A physician consultation is likely needed in this situation.
So back to the initial questions: What do I do?
Ice isn’t necessary, but can be used in an effort to reduce swelling and pain. Reducing swelling and improving range of motion and weight bearing is important, and bracing or splinting can help. With physiotherapy we can also prescribe therapeutic exercises, perform manual therapy, help clear you for return to sport and guide you on a successful recovery.
This blog was written by Tim Schmidt, MPT, with references adapted from:
(1) Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision, Robroy L. Martin, Todd E. Davenport, John J. Fraser, Jenna Sawdon-Bea, Christopher R. Carcia, Lindsay A. Carroll, Benjamin R. Kivlan, and Dominic Carreira, Journal of Orthopaedic & Sports Physical Therapy 2021 51:4, CPG1-CPG80
(2) Ankle Sprains: What Updated Guidelines Mean for You, Journal of Orthopaedic & Sports Physical Therapy 2021 51:4, 161-161
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