How to Treat an Ankle Sprain

Most people will experience an ankle sprain at some point in their life. Whether you twist your ankle while climbing stairs or suffer an injury during sports, an ankle sprain happens when the ankle is forced into an incorrect position and rotates away from the foot, causing the ligaments to stretch or even tear. This condition can lead to pain and swelling. Fortunately, mild sprains can be treated at home with proper care. Start by applying ice and elevating the ankle on a soft pillow or chair, and then consider other treatment options.

Assess the severity of the sprain. Sprains are classified into three levels. Level 1: Mild ligament damage with slight pain and swelling. Level 2: Partial ligament tears, causing moderate pain and swelling. Level 3: Complete ligament rupture, with severe pain and significant swelling around the ankle.

• Level 1 sprains typically do not require medical attention. However, almost all level 3 sprains require a doctor’s visit to prevent further damage to the ankle.
• The treatment methods for all three levels are similar, but the recovery time increases with the severity of the sprain.

See a doctor if your sprain is moderate or severe. A level 1 sprain may not require medical attention, but levels 2 and 3 should be evaluated by a doctor. If you find it difficult to bear weight on your ankle for more than a day, or if there is severe swelling and pain, call your doctor to schedule an appointment as soon as possible.

Rest your ankle until the swelling reduces. Avoid walking on the injured ankle until the swelling decreases and you no longer feel pain when putting weight on it. You should also try to refrain from putting any pressure on the injured ankle. If necessary, use crutches to distribute weight and maintain balance while moving around.

• You may consider using an elastic ankle bandage. The bandage will help stabilize the ankle and reduce swelling as the ligaments heal. Depending on the severity, you may need the bandage for 2-6 weeks.

Apply ice to the ankle to reduce swelling and alleviate pain. Wrap some ice cubes, an ice pack, or frozen vegetables in a cloth or thin fabric, then place it on the injured ankle and leave it for 15-20 minutes. Apply ice every 2-3 hours while swelling persists.

• Apply ice even if you plan to see a doctor. Cold compresses help minimize inflammation, particularly within the first 24 hours after the injury. Ice also helps reduce swelling and bruising for all types of sprains.
• Another cold therapy option is to fill a bucket with ice water and soak your foot and ankle.
• Remove the ice for at least 20-30 minutes between sessions. Prolonged ice contact can cause frostbite.
• If you have diabetes or circulation issues, consult your doctor before applying ice.

Wrap your ankle with an elastic bandage. Use a compression bandage, elastic wrap, or stretchy bandage to reduce swelling. Wrap it around the ankle and foot, securing it with a metal clip or medical tape. Make sure the bandage stays dry by removing it when applying ice, and rewrap it after each session.

• Wrap the bandage from the toes up to mid-calf with even pressure. Continue wrapping until the swelling subsides.
• If your toes turn purple, feel cold, or begin to tingle, loosen the bandage. It should not be too tight, but not too loose either.
• You may also use a self-adhesive wrap that can be adjusted. This type of wrap is beneficial as it applies even pressure without cutting off circulation to your foot.

Elevate your ankle above heart level. Sit or lie down and place your foot on a stack of pillows or a cushion to raise your ankle. Keep this elevated position for 2-3 hours each day until the swelling is gone.

• Elevating your foot helps reduce swelling and bruising.

Take over-the-counter pain relievers. Over-the-counter pain medications like aspirin, ibuprofen, or naproxen sodium are usually strong enough to help reduce pain and inflammation from an ankle sprain. Follow the dosage instructions on the label and take the recommended dose to alleviate pain and swelling.

Perform ankle strengthening and stretching exercises. Once your ankle has healed enough to walk without pain, your doctor may suggest doing exercises to strengthen the ligaments. The type of exercises and their frequency will depend on the severity of your sprain, so be sure to follow your doctor's advice. Some helpful exercises include:

• Slowly rotate the ankle in small circles, starting clockwise and then counterclockwise.
• Try tracing letters in the air with your toes.
• Sit upright and comfortably in a chair. Keep the injured foot flat on the floor and gently lift your knee outward for 2-3 minutes, making sure the foot stays in contact with the floor throughout the exercise.

Gently stretch to improve ankle flexibility. After an ankle sprain, the calf muscles often become tight. It’s crucial to work on restoring normal movement. Without proper exercises, you risk further injury. Like strengthening exercises, always consult your doctor before attempting any stretching routine to ensure your ankle is ready. Here are some stretches you can try:

• Sit on the floor with your legs stretched out in front. Wrap a towel around the bottom of your foot and pull the towel towards you while keeping your leg straight. Hold the stretch for 15-30 seconds. If it's too painful, start with just a few seconds and gradually increase the duration. Repeat 2-4 times.
• Stand facing a wall, placing your hands on it. Position your injured foot behind your other foot, keeping the heel flat on the ground. Slowly bend the front knee until you feel a stretch in your calf. Hold for 15-30 seconds, breathing deeply and steadily. Repeat 2-4 times.

Work on improving balance. Ankle sprains often affect your ability to maintain balance. Once you're healed, try exercises that help restore your balance and prevent future sprains or injuries.

• Purchase a balance device or stand on a firm cushion. Always stand near a wall in case you lose your balance or have someone assist you during practice. Start by holding the balance for 1 minute, then increase the time as you get more comfortable.
• If you don't have a balance device, try standing on your injured foot while lifting the other foot off the ground. Extend your arms out to help with balance.

Consult a physical therapist. You should consider seeing a physical therapist if your ankle injury is taking a long time to heal or if your doctor recommends it. If self-treatment methods and home exercises don't work, a physical therapist can offer alternative approaches to help with your recovery.

Warm up before exercise or engaging in activities requiring significant effort. Make sure to warm up with stretching and cardio exercises before participating in any intense activity. For example, before starting a run, begin by walking slowly to loosen your ankle joint before picking up speed.

• If you're prone to ankle injuries, consider wearing an ankle brace during workouts.
• When trying a new sport or exercise, be careful not to overexert yourself until you’re fully accustomed to the movements.

Wear appropriate footwear. Some people find that high-top sports shoes help stabilize the ankle during exercise. Regardless of the activity, always wear shoes that fit well and are comfortable. Ensure the soles aren’t slippery to reduce the risk of falling, and avoid wearing high heels if you need to stand or walk a lot.

Continue performing exercises and stretching. Even after your ankle has fully healed, it’s essential to keep doing ankle exercises and stretches. Daily practice for both ankles will help maintain strength and flexibility, preventing future injuries.

• You can even incorporate ankle exercises into your daily routine, like balancing on one foot while brushing your teeth or doing light tasks around the house.

Wrap your ankle when in pain. Wrapping your ankle for mild pain, such as joint aches or a sprain, helps support your foot while still allowing movement. The technique for wrapping is similar to using an elastic bandage, but with additional steps that need to be followed.

• Place heel and toe pads on the ankle before applying the first layer of bandage.
• Wrap the entire ankle with the bandage.
• Secure the upper and lower parts with athletic tape to keep it in place.
• Apply the tape in a U-shape from one ankle to the other, going under the heel.
• Finish by wrapping the remaining tape in a triangular pattern around the ankle and beneath the arch of the foot.

• If you experience severe pain, it's important to request an X-ray to ensure there's no fracture in your ankle.

• Ice pack
• Elastic bandage
• Over-the-counter pain relievers
• Recliner chair
• Towel
• Exercise bandage
• Balance training equipment or cushion