How To Treat An Ankle Sprain
Dr. Weatherby is a fellowship trained orthopaedic surgeon specializing in adult reconstructive foot and ankle surgery. He received his undergraduate degree in biology from Wofford College in Spartanburg, SC. He subsequently went on to earn his medical degree from the Medical University of South Carolina in Charleston,... more
About 10,000 ankle sprains happen in the U.S. every day and are often under-treated by other health care providers. Simple treatments such as rest, elevation, ice, and compression are good in the first 12-24 hours, but a few more modalities are needed after this. Keep in mind that a sprain of any joint in the human body by definition is an injury to the stabilizing ligaments of that joint. They are either stretched (Grade 1), partial torn (Grade 2), or completely torn or ruptured (Grade 3). Thus, depending on the severity, an ankle sprain can sometimes be as bad as a bone fracture.
With bad sprains (severe swelling, bruising, pain, limp while walking or inability to walk) an orthopedic walking boot (easily purchased online) is recommended for the first 10-14 days. This provides rigid immobilization and support to the ankle, facilitating decreased swelling and pain, and allowing the patient to walk. If the sprain is not as bad, or after the boot, a medical-grade brace that can be worn with a shoe is recommended, such as an ASO brace (available online). This provides support and compression but is less cumbersome than the boot. This is typically worn for about 8 weeks.
In addition, during the first 2-3 weeks of a sprain, the body is generating an inflammatory reaction around the ankle joint in response to the injury. To address this, one should consider the use of an over-the-counter anti-inflammatory such as ibuprofen, Motrin, or Aleve. Take an appropriate dose 2-3 times per day. Consult with your primary care doctor if there are any concerns about taking this medication if you have other medical conditions.
Lastly, the number one reason to have long-lasting issues after an ankle sprain is the lack of appropriate rehabilitation. Meaning, physical therapy is important. So, at a minimum, one should work with a physical therapist for at least 2-3 visits to be taught an extensive home exercise program and be educated on the equipment needed to do this (theraband & BAPS board, both available online).
If after 10-12 weeks, significant pain or instability (ankle rolling frequently even with a brace) persists, then seek an evaluation with a foot and ankle trained orthopedic surgeon.
