Ankle sprains are one of the most common injuries sustained from sporting events, training, or even just accidental slips during a rainy day! Unfortunately, having a history of just ONE ankle sprain puts you at risk of another ankle sprain recurrence on the same leg – up to 40% of ankle sprains develop into chronic sprains with symptoms of pain, swelling, and instability lasting at least 12-months after injury (1).
What does this mean? This simply means that even having swelling after a twisted ankle which doesn’t heal in 3 months could predispose you to having those symptoms a long time after. This could be from the ankle not healing well in the initial stages of having an ankle ligament sprain, hence why it is important to treat your sprains properly to prevent long-term damage. To understand the different types of ankle sprains you might be having, you can check out our post here on Understanding Ankle Sprains, but today’s article will be focused on what to do when you have a sudden ankle sprain.
So how exactly should you treat a sudden ankle sprain? There are three things to keep in mind.
Firstly, focus on protecting the area.
Pain, swelling, and difficulty putting pressure on your injured foot are some of the most common and immediate symptoms after twisting your ankle. This is a normal mechanism from your body as it starts to create inflammation and send signals to prevent you from moving more and further damaging the area. Sending back signals to the brain that the ankle is being protected can help to kickstart the recovery process as fast as possible. How?
- Icing – Helps to reduce the swelling by causing the blood vessels to constrict (become smaller) and prevents too much fluid from accumulating. Apply an ice pack to the area for 5-10 minutes every 2-3 hours, 1-2 days after the injury.
- Compression – Wrapping an ankle sprain bandage or tape around the ankle to form a figure-of-eight ankle bandage support also helps with providing protection and support to the ankle.
- Elevation – This means keeping your foot elevated above the heart when you’re lying down. Do ankle pumps while you’re at it, to help to push excess accumulated fluid away from the swollen ankle. This also brings us to our second point:
Secondly, start movement as soon as possible, as much as tolerated.
It might be counterintuitive to start movement when you’ve just sprained your ankle. But studies have shown that once the initial tenderness and pain has reduced, ankle movement exercises should be added as soon as possible because they contribute to earlier time to recovery. Yes, even with Grade 1 and 2 ligament injuries, where there is a torn ligament in the ankle! (2)
- Dorsiflexion and plantarflexion – When there is a Grade 2 ligament injury, ligament damage which can include the ATFL ligament can be painful when twisting the ankle. Dorsiflexion and plantarflexion means moving the ankle up and down, as often as possible (high repetitions), as much as tolerated.
- Inversion and eversion – Once the swelling has reduced, you can start to add in twisting movements. Inversion means moving your foot towards the midline of your body, and eversion means twisting it away. Do this within your tolerable range. Stop if swelling increases, and go back to dorsiflexion & plantarflexion.
Thirdly, get back your ankle stability!
Check with your physiotherapist or chiropractor which exercises are best for you. This can include theraband exercises, more complex weight bearing exercises, or balance exercises. If you’re on your own at home, start with the first two remedies first before proceeding to this step. Once you are able to tolerate putting weight through your foot, start weight-bearing exercises as tolerated. This means starting to apply pressure to the injured foot, like calf raises. A swollen and twisted ankle doesn’t mean that you have to take absolute rest and stay off your feet for weeks, unless you have a Grade 3 sprain and the doctor advises it.
- Calf raises – Activating your calves helps with stabilising your ankle. Make sure you have support next to you while doing this, and start slow.
- Unstable surface standing – Again, make sure you have support and only do this with your eyes open. Closing your eyes while doing this with a twisted ankle will only increase your risk of falls. This exercise will help with increasing your proprioception which also helps recovery and prevents future injury. (3)
All these remedies work to achieve one goal – to reduce the pain, swelling, and stiffness that usually occurs right after an ankle sprain. If you aren’t seeing results or can’t get back to your normal activities even months after your ankle sprain, our practitioners are well-equipped to assess your ankles and get you on an effective treatment program right away. Give us a call or book and appointment today so that we can work together with you to get you back on track!
- Mugno AT, Constant D. Recurrent Ankle Sprain. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560619/
- Halabchi F, Hassabi M. Acute ankle sprain in athletes: Clinical aspects and algorithmic approach. World J Orthop. 2020 Dec 18;11(12):534-558. doi: 10.5312/wjo.v11.i12.534.
- Rivera MJ, Winkelmann ZK, Powden CJ, Games KE. Proprioceptive Training for the Prevention of Ankle Sprains: An Evidence-Based Review. J Athl Train. 2017 Nov;52(11):1065-1067. doi: 10.4085/1062-6050-52.11.16. Epub 2017 Nov 15.