What to do when you get an ankle sprain
Unless you’ve had one yourself, an ankle sprain might seem like a pretty simple injury that doesn’t require much management. Just ice and elevate, rest, then it gradually gets better, right? Not so much! While an ankle sprain is certainly less complex than a fracture or tendinitis, that doesn’t mean that it doesn’t need to be managed properly and mindfully. In this article I will outline how you should manage it and why.
Quick disclaimer: This article is by no means meant to be medical advice for your individual circumstance. These are general guidelines that are appropriate for a mild to moderate ankle sprain. Severe ankle sprains may need bracing and other unloading measures for a short duration of time. If you think you may have a more severe ankle sprain, it is best to get assessed by a qualified physical therapist first.
ICE & ELEVATE
Yes, I am in absolute agreement with this one. As soon as you can, get some ice on it and prop it up above your heart. Do this for 10-15 minutes. Ideally repeat every 2-3 hours.
WALK NORMALLY
Walking as normally as you can will help minimize secondary stiffness and profound weakness as it heals. I do realize that pain can sometimes prevent us from locomoting with ideal form so do your best. Here’s an important piece to appreciate that will likely decrease your pain: do not be afraid of the injury and be confident that it will absolutely heal. Having anxiety over the injury actually increases your perception of pain and increases guarding. Rest assured that you will recover and get back to your regular life. The more you can calm your nerves, the more you will be able to walk more normally and facilitate faster overall recovery.
MOVE YOUR ANKLE
Keep the foot and ankle moving through pain-free ranges often. The exercise I typically prescribe is called “ankle alphabets.” Essentially you are spelling out the alphabet with your foot and ankle; again, only in pain free ranges. So at first your letters may be small and compact. As your pain and fear start to dissipate you can make your letters larger and larger. Check out the video below to see ankle alphabets. I recommend doing these 3-5 times/day.
ICE BUCKET SQUATS
Keeping the ankle mobile as it heals is important, as indicated above. When we injure an area, our nervous system tends to go into overdrive in protecting the area with excessive guarding. It doesn’t take very many days of this to then result in stiffness that you will ultimately have to work out. The reality is, you can safely move the ankle to prevent this from happening. In addition to walking normally and doing “ankle alphabets,” do ice bucket squats. Check out the video below to see how this is done.
MODIFY YOUR ACTIVITY
Total rest is NOT the way to go. It is important that you stay as active and strong as you can as the ankle heals. However, depending on your regular activities you may need to modify. In general, take a step back from activities that hurt the ankle. Avoid running, hiking, walking more than required distances, repetitive stair climbing (like a stair master or repeated flights of stairs), jumping and any other lower body exercises that seem to irritate the ankle. Depending on how much weight you use and your technique, things like squats and dead lifts may still be totally doable. See how it feels! Biking generally feels fine depending on the type of ankle sprain; once again, give it a try and see how it feels. Swimming with an abbreviated kick is a great option. Strength training for upper body and core typically go just fine. Sometimes even yoga or pilates with some modifications will work. The point is, stay as active as you can while respecting your healing ankle.
SEE A PHYSICAL THERAPIST
Even if you’re feeling great after a week or two of doing the above things, any injury to a ligament results in impaired proprioception (knowing where your body part is in space at any given moment) and joint control. A skilled physical therapist will be able to assess for these nuances and prescribe exercises and drills that will recover these components of the injury. Furthermore, ankle sprains commonly come with injury to the surrounding tendons. You need to have this assessed and then the proper exercises prescribed so that the tendons also recover strength and resilience. All of these things will help to decrease your chances of a repeat ankle sprain AND decrease your chances of a secondary injury because you didn’t recover optimally. Depending on the severity of your sprain, it may take any where from 3 visits to 12+ visits. Generally I recommend starting physical therapy after about a week of doing all that I outlined above.
Once again, your ankle will absolutely heal. Armed with the above knowledge and guidelines, you can be confident that it will heal optimally so that you can have full security in your ankle once again.