What is an Ankle Sprain?
An ankle sprain is a pretty common injury that occurs when the foot is taken beyond its normal range of motion, usually forcefully, to one side or the other. A sprain (as I discussed in my Basic Self Treatment Guide) is an overstretch or small tear of the ligament (band of tissue that holds bones together).
Ankle injuries typically occur to the outer ligaments of the foot/ankle and less commonly to the inner foot/ankle. Ankle sprains happen to thousands of people daily but, of course, are more commonly experienced by athletes playing sports that require frequent “cutting” movements, jumping, and/or when multiple players are involved. I have seen many other populations of people, however, that experience ankle sprains.
Wait it Out?
In my experience the most common response to this common injury is to just “wait it out.” “It’s just a little sprain, I thought it would get better on its own, I put ice on it right after it happened” are usually what I hear when I see these patients several weeks after their “little sprain” doesn’t improve.
The problem is that sprained ankles hurt. No one really wants to experience pain, so they either self-immobilize the joint by barely moving it and putting very little weight through it or they use a device such as an ankle brace to immobilize it and avoid the motions that hurt. These methods can help initially with the pain and swelling but should be gradually changed after the first 24-48 hours after the sprain.
Initial Treatment for a Sprained Ankle
So what should you do? As I said, initially (first 24-48 hours), the self-treatments mentioned above are important. They may be more commonly known as RICE treatment or Rest, Ice, Compression, Elevation. You can check out more details of the RICE treatment in my guide.
When to See a Healthcare Provider
- Severe pain and cannot put weight through the injured ankle for more than 48 hours.
- The injured ankle looks “crooked” or has lumps and bumps (other than swelling) that are not present on the uninjured foot.
- Inability to move the injured foot.
- Inability to walk more than four steps without significant pain for more than 48 hours after injury.
- Numbness on any part of the injured area.
- Redness or red streaks spreading out from the injury.
- Any doubt about the seriousness of the injury or how to care for it.
Recommended healthcare providers are your family physician or physical therapist (should be able to screen the injury for free). If you suspect a fracture, emergency room may be appropriate.
Therapy for a Sprained Ankle
Depending on the severity of the injury, the next phase of recovery needs to begin as soon as possible. This includes:
- movement of the ankle (e.g., ankle circles, picking up marbles with toes)
- gradual progression of weight bearing (starting on crutches and progressing as tolerated to putting full weight through the foot)
- evaluation and treatment by a physical therapist.
Too many times I have seen patients that tried to let their ankle injury go untreated come to me having not moved their ankle in 3-6 weeks. They are convinced that because it’s not getting better, it’s broken. A majority of the time it takes two weeks or less for the ankle symptoms to improve and the patient to be reassured that their ankle is actually going to improve.
(The physical therapy assessment can happen at any point after the injury, but in states such as Missouri, you must make an appointment with your doctor and ask for a physical therapy referral before treatment can begin. That takes time, so you may be self-treating for a little while.)
This study in the New York Times cites studies performed that suggest an ankle injury left untreated may lead to a shorter life! What?!? I’m not sure it’s that serious, but the idea that a chronic injury will lead to less physical activity is for real. This article even suggests that if you have healed from an ankle sprain in the past that you should still see a physical therapist for balance testing to ensure that you were not left with any adverse effects. I totally agree!
