How To Move Without Pain

What’s the best way to treat an ankle sprain?

by Meghan Griech, PT, DPT, cert MDT, CKTP

This article takes 6 minutes to read

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A sprained ankle occurs when you roll, twist, or turn your ankle in an awkward way. The ligaments of the ankle help with stability and  preventing excessive movement. These  ligaments can be strained (or overstretched) when the ankle is twisted or rolled, and usually involve injuries to the ligaments on the outer side of the ankle.

Ankle sprains are very common in athletes yet can happen easily to anyone. Walking off a curb or stepping awkwardly, slipping on the grass, or tripping on the sidewalk are all common causes of ankle sprains.

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A quick overview of what happens in an ankle sprain:

When an ankle is sprained, the ligaments, which surround the bones, are injured. Ligaments (which connect bones together) support the joints by adding stability, and are not meant to stretch or rebound like a tendon (which attaches muscles to bone). If the ligament becomes injured it is stretched too far and could result in a partial or complete tear.

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The best way to treat an ankle sprain is to know the severity of the injury. There are three degrees of ankle sprains. 

First degree symptoms – when the ligaments have been overstretched but not torn. Symptoms include:

  • Mild pain
  • Mild swelling
  • Possible joint instability (feeling loose)
  • Mild joint stiffness
  • Difficulty jogging or jumping

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Second degree symptoms – when the ligament is  partially torn (this sound much worse than it really is, and they will fully heal with time). This is the most common degree of ankle injury. Symptoms include:

  • Significant swelling
  • Bruising
  • Moderate pain
  • Loss of ankle motion
  • Painful walking and could be accompanied by sensations of buckling (giving way)

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Third degree symptoms – this is the most severe of ankle injuries. The  ligament(s) has been torn completely. Symptoms include:

  • Severe swelling
  • Severe pain
  • Instability of the joint
  • Extreme loss of motion
  • Walking can be quite painful

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For immediate self-care of a sprain, try the P.R.I.C.E. approach — protection, rest, ice, compression, elevation:

  • Protect. Protect the joint from further injury, for example by using a support or brace.  This should only be short-term until the degree of injury is known.
  • Rest. Avoid activities that cause pain for the first 2-3 days, swelling or discomfort. But don’t avoid all physical activity.
  • Ice. Even if you’re seeking medical help, ice the area immediately. Use an ice pack or slush bath of ice and water for 15 to 20 minutes each time and repeat every two to three hours while you’re awake for the first few days after the injury (don’t put the ice directly on your skin, use a towel as a barrier).
  • Compression. To help stop swelling, compress the area with an elastic bandage until the swelling stops. Don’t wrap it too tightly or you may hinder circulation. Begin wrapping at the end farthest from your heart. Loosen the wrap if the pain increases, the area becomes numb, or swelling is occurring below the wrapped area.  Remove the bandage to sleep.
  • Elevation. Elevate the injured area above the level of your heart, especially at night, which allows gravity to help reduce swelling.

Painful walking or instability in the ankle may require the use of crutches or a walker to assist in alleviating the ankle pain and preventing further injury. Ankle braces for support, elastic bandages or sports tape can also be used to improve the stability of the ankle while it heals.

In the case of a severe sprain, a cast or walking boot may be necessary to immobilize the ankle while the ligaments heal.

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Physical Therapy

Physical therapy treatments may be necessary to help restore proper ankle range of motion, strength, and stability following an ankle sprain. 

Balance and stability training is especially important to retrain the ankle muscles to work together to support the joint and to help prevent recurrent sprains. 

Resuming sports or other activities should occur when proper healing has taken place. Physical therapists can help determine readiness for return to sports by assessing ankle strength, ability to perform particular activities, and movement tests to determine how well your ankle functions for the sports you play.

*Disclaimer: All information in this article is intended for instruction and informational purposes. The author(s) are not responsible for any harm or injury that may result.  This information is used to supplement not replace any advice you were provided from your doctor or another medical health professional.  No guarantees of specific results are expressly made or implied with this article.

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