Ankle Sprains: Rehabilitation and Prevention

An ankle sprain is a soft tissue injury that would greatly benefit from a board-certified podiatrist’s care. Lateral ankle sprains account for almost a quarter of all sports injuries, and treatment options are varied.
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Overview

Ankle sprains are very common injuries that can lead to long-term pain, instability, and pain if not tended to properly.

An ankle sprain is a soft tissue injury that occurs when an injury stretches or tears the ligaments that connect bone to bone. Lateral ankle sprains account for almost a quarter of all sports injuries and are commonly seen in Emergency Departments. Conventional treatments are varied and range from immobilization and minimal wrapping to surgical repair.

If you believe you or a loved one may have suffered from an ankle sprain, make an appointment today with one of our board-certified podiatrists! We’ll evaluate the severity of your sprain and start you on a path to recovery.

Establishing the Basics

What is an ankle sprain?

A lateral ankle sprain is the rupture of one, two, or all three ligaments on the outside of an ankle. There are two different types of sprains: acute sprains and chronic instability. Acute sprains are injuries that happen suddenly. Chronic instability is the subsequent looseness of the ankle and recurrent sprains months after a traumatic event.

Who is at risk for spraining their ankle?

Anyone can suffer from an ankle injury simply from a misstep or a traumatic event. Athletes who participate in activities with vertical jumping, fast cutting movements (i.e., basketball, tennis, volleyball), and/or running on uneven surfaces are more likely to suffer from ankle sprains. Additionally, those who have high arches, tight heel cords, or a history of previous sprains are also predisposed to this type of acute injury.

How do I know if I have a sprain?

The first symptom of an ankle sprain is likely to be pain, especially when you attempt to walk on the affected foot. With ankle sprains, your foot will swell, and bruising will occur. Extreme pain and stiffness are also common symptoms of an ankle sprain.

Treating an Ankle Sprain

There are several components to healing from an ankle sprain, including RICE, medicine, functional therapy, and physical therapy.

To RICE or not to RICE

Most folks are common with the acronym RICE (Rice, Ice, Compression, and Elevation), which is used to help with pain management and to reduce swelling. However, recent research has shown that RICE is most effective in the short-term and is not to be used as a long-term solution.
  • Rest: Rest is crucial following an ankle sprain. Your ligaments need time to heal. If you push them too fast and too soon, you’re likely to cause more damage to your ankle. Limit your activities and walking following a sprain to start your path to recovery.
  • Ice: Following a sprain, it is encouraged to apply ice to the area for 20 minutes per hour. Ice or ice packs should never be applied directly to the area. Instead, wrap up the ice pack in a towel and then wrap it or put it on the affected area. Research shows that icing the area is most effective within the first 48 hours of the sprain.
  • Compression: Compressing your injury helps keep any swelling to a minimum and may also help with the pain. It should not be tight enough to restrict blood flow, just enough to support the affected area. This is also an element that is most useful within the first 36-48 hours following the injury.
  • Elevation: Within the first 24-36 hours, it is crucial to elevate your ankle as much as possible – ideally above the level of your heart. When your foot is lower than your heart, your blood will travel downwards and can cause more swelling and bruising. Try to elevate and ice your foot at the same time to offset the pain and swelling. RICE is a critical component to recovery within the first 36 hours of injury, as it encourages proper healing. If a sprain isn’t given a chance to heal correctly, your ankle can become weakened and is more likely to be reinjured. That said, relying on the RICE method as a long-term solution is not recommended as it could impede your healing and recovery. Your board-certified podiatrist can share rehabilitation recommendations to help your ankle heal.

Pharmaceutical Management

Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) are used both for pain management and anti-inflammation. Examples of these include Advil, Aspirin, Ibuprofen, Naproxin, etc. These medicines can help with pain control in the short-term but functional and physical therapy should be used for your long-term recovery.

Preferred Functional Therapy

Once your sprain diagnosis has been confirmed, you often leave the doctor’s office or Emergency Department with a walking/immobilization boot or semi-rigid brace. Elastic bandages, taping, and casting can also be used for lateral ankle sprains. Depending on the severity of your sprain, a medical professional may also recommend crutches to further protect your ankle.

When used for four to six weeks following an injury, these methods of functional therapy can best assist you on your path to healing. No matter which path is best for you, getting the right functional therapy tools as soon as possible from a board-certified therapist is crucial to ensuring your sprain doesn’t worsen.

Rehabilitation: Physical Therapy

Once your pain subsides, it’s time to start rehabilitation. This typically happens about one week after the injury. Rehabilitation, such as physical therapy, is an imperative step to preventing any future reinjuries. It focuses on restoring your ankle’s range of motion and improving your sense of balance. Strong balance equates to strong ankles and feet, so you cannot skip this step.

Physical therapy usually begins with supervision of a physical therapist or rehabilitation professional, and exercises are then continued at home. Recent research has shown that early, gentle exercises can support your healing. Your physical therapy will likely include early weight bearing, ankle range of motion exercises, balance training, and early return to activity with external bracing.

Preventing Reinjury

Unfortunately, once you have suffered from an ankle sprain, you are more likely to suffer from another one in the future – especially if you’re active. As such, the more prevention tactics you can do, the better. This can include physical therapy, proper shoes, and/or orthotics.

Continued Physical Therapy

Once your ankle has recovered, it doesn’t mean that you should stop your physical therapy exercises. Before you graduate away from your physical therapist, make sure to ask for prevention exercises to do at home. Exercises that focus on continued balance training is vital to strengthening your ankles and preventing reoccurrence. The stronger you can make your lower body – especially your feet and ankles – the better.

Proper Footwear

After a sprain, speak with your board-certified podiatrist about which walking or athletic shoe is going to be best for you. Depending on the severity of your sprain, your doctor may recommend a more supportive shoe or a shoe with a wider toe box. If your local clinic doesn’t sell shoes, ask your podiatrist for local running shoe store recommendations as many local shoe stores work with podiatry referrals.

Additionally, replace your shoes when they are worn out. Shoes are not immortal, and most should be replaced after eight months to a year. For athletes and runners, shoes should be replaced more frequently. Routinely examine your shoes for signs of age, wear, and tear, as worn-out shoes can also be the cause for pain and injury.

Orthotics

Orthotics, especially custom orthotics, are a recovering ankle’s best friend. No matter your age, your foot and ankle WILL require more TLC following a sprain. A custom orthotic is designed to specifically support your foot’s dimensions and needs and is a great tool to prevent reinjury. Our office makes custom orthotics from either physical impressions or electronic scans of your feet. Most orthotics are also at least partially covered by insurance, so it’s a win for your feet and your wallet.

Conclusion

Ankle sprains are incredibly common, and they require medical attention to rule out a more serious injury like a fracture or dislocation. If you or a loved one believes they have sprained their ankle, call to see one of our board-certified podiatrists today! Many clinics provide same-day appointments for emergencies. Prompt evaluation and treatment is crucial for optimal healing and not making the injury worse.

Once the severity of your injury has been determined, your podiatrist will work with you on a treatment plan that includes functional therapy tools such as a brace or walking boot, pharmaceutical medicine, RICE, and physical therapy. These are all vital to recovery as an ankle that hasn’t properly healed or strengthened is at greater risk of being reinjured or being chronically unstable.

No matter how bad your ankle sprain is, our office is here to help!

Ankle Sprains - FAQs

If your ankle has a lot of swelling, pain, and bruising, you should be seen by a medical professional to rule out a worse injury. Additionally, if you have trouble standing or walking or excessive tenderness around or on the affected area, you should get in with your podiatrist if they are available same-day or your local Emergency Department.
Within the first 24-36 hours of an ankle sprain, it is important to follow the RICE method: Rest, Ice, Compression, and Elevation. RICE helps with pain management and to reduce swelling. It also ensures that the patient is taking the necessary steps to not make their injury worse. While RICE is effective for the first day or so, it is important to recognize that it is a short-term, not long-term, solution.
This depends on the severity of your ankle sprain. Recovery can last anywhere from a few weeks to several months depending on which grade your sprain is. Make an appointment with one of our board-certified podiatrists to find out the grade of your sprain.

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