Sprained Ankle – Heal Fast and Strong with Self Treatment

Treating a sprained ankle the RIGHT way early on means a stronger ankle, faster recovery and less chance of re-injury. In this series I will tell you what a sprained ankle involves, the most effective self treatment and the best rehab exercises to get you back out there!

This post is Level 1 but when you need to step it up after the first 48-72 hours, switch over to the Level 2 and Level 3 rehab exercsies.

First of all, a little information about what a sprained ankle involves, but if you are in the know about Sprains already, skip the info and scroll down to Self – Treatment

Sprained ankles are known by a few different names:

  • Twisted ankle
  • Rolled ankle
  • Lateral ankle sprain
  • Inversion ankle sprain
  • And of course “Oh no!”

The most common type of sprained ankle is the lateral ankle sprain (85%), and that is what we are going to discuss and sort out today.

Mechanism of injury: The plain and simple is that a sprained ankle is typically when your foot is forced inward (inversion) and down at the same time (often when changing direction, turning and/or on uneven surfaces). This puts the ligaments under too much stress too fast which causes a tear of one or more of your ankle ligaments.

sprained ankle - lateral ligaments

 

Quick anatomy: The lateral (outer) ankle has 3 ligaments supporting, with the weakest of these (and so most often injured) being the ATFL. The ATFL is the Ligament at the front of the ankle shown here and in most simple sprains, this is the one torn with or without the ligament below it.

 

Sprained ankle recovery time: The general recovery time is 2-6 weeks (if looked after properly) and keep in mind, even if it feels bad now, if you do all the right things you will be one of the 95% who return to sport and activity within 6 weeks.

 

Not taking ankle rehab seriously often leads to far too many chronic ankles, long-term disability and other injuries so YOU NEED TO TAKE THIS SERIOUSLY!

Note: it is important to rule out fractures early on. An accurate way of doing this is using the Ottawa ankle rules, or going to see your local Physio for a quick assessment – These rules are great for minimizing unnecessary X-rays.

 

Self – treatment

Initial management: In the first 72 hours it is very important to follow the RICE and HARM principles – This will take weeks off your recovery.

DoRICE injury treatment, heal strong and fast: RICE

  • Rest – From running etc.
  • Ice – 10 minutes at a time, no more, every hour you are awake.
  • Compression – Eg Tubigrip.
  • Elevation – Get your foot above your heart when possible.

Don’t: HARM

  • Heat
  • Alcohol
  • Running
  • Massage

HARM increases blood flow to the area, worsening inflammation and so causing more secondary damage and a longer healing time.

Keep moving (within reason of course) – It is important not to baby sprained ankles and start weight-bearing through them as soon as possible to normalize movement and decrease loss of muscle activity. If necessary you may need to be on crutches for the first 24 hours (if very painful and you really have tried to walk on it) then move to partial weight-bearing and then full weight-bearing.

Foot paddling is a great exercise to do in these early days – In sitting or lying, simply point your toes up then down repeatedly in a pain-free range. You can try doing small circles with your foot also, remembering not to push into pain. Do this every 1-2 hours (little and often)

Footwear: Wearing good supportive footwear with heel and arch support(such as your runners) is great as this takes the pressure off the injured ligaments and lets them heal well. DO NOT WEAR HIGH HEELS (Please!).

 

AND THEN: After the first 48-72 hours of doing this, click over to rehab exercises and get started rehabilitating your sprained ankle! And remember you still use ice after the first few days whenever it is sore or swollen.

 

Check out this quick balance and stability test when healing well to check if your hip strength is holding you back (especially if you have had a lot of lower limb injuries lately).

 

Don’t forget to favourite this page so you can find is easily when needed 🙂

 

About PhysioPrescription

Providing you with easy and practical self rehab exercises, tools and techniques so that YOU can reach your peak.
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43 Responses to Sprained Ankle – Heal Fast and Strong with Self Treatment

  1. Sagur says:

    After i twisted my ankle in the football field, i did not go to the hospital or do any of the above instructions!.. instead i just massaged my ankle with an ointment. After 3 weeks i got a cast on my leg!.. i had to wear it for 4 weeks!.. and now i still have the same pain! The doctor said its a chronic sprain!.. what should i do now? it still hurts and i cant move my ankle forward!

    • PhysioPrescription says:

      Hi Sagur

      I would suggest starting with the level 2 exercises for the next 3-6 weeks before adding in level 3. Also because it was in a cast I would suggest you see a physiotherapist for mobilisation of your ankle and foot. It tends stiffen up a lot and physio can really benefit this.

  2. Erin says:

    This is my 4 th week. Should I keep walking with air cast boots and when I go weight training or can I take boots off? I am level 2 first week.

    • PhysioPrescription says:

      Hi Erin

      I would recommend that you get out of the air cast boots and wearing some good supportive runners. New research shows that longer periods of unloading and over-protecting are harmful and produce adverse changes to tissue bio-mechanics and morphology. Getting you walking as normally as possible, safely of course is the best thing for you and your recovery.

      Bottom line is that optimal loading is needed for good recovery, so when you can, normalise walking etc as much as possible. You can read more about this here if needed:

  3. Rakesh says:

    I sprained my ankle when I fell yesterday doing hurdles. It didn’t hurt much today but later it started swelling and hurting a bit when weight was applied. I am going to the trainer tomorrow. What do I do and when can I get back to running?

    • PhysioPrescription says:

      Hi Rakesh
      Get started on the rehab explained int he post – Always Ice, Compression and Elevation in the first two days followed by the level 1,2 and 3 rehab exercises.

      If you do this then you should be back to running within 2-4 weeks. The fact that it didn’t swell straight away indicates that it is most likely not a high grade sprain.

      And just remember if it hurts to run, don’t do it.

  4. Sagur says:

    Thank you.. This website is really great.. and i did what you asked me to do and i feel much better now! Started playing football and I feel absolutely no pain! Thank you for your support

  5. Sherman says:

    My life in a nutshell, skateboarding and sprained ankles are close friends to me

  6. ben says:

    hi mate i sprained my ankle playing football and im going to be deployed with the army in a few weeks any advice on whati can do

    • PhysioPrescription says:

      Hi Ben

      Sorry to hear that but it is a good thing that you have 2-3 weeks to get it as good as possible. Start rehabbing it straight away after the initial 2-3 days of RICE. See the link on the bottom of this post for rehab exercises – get started on these and progress as pain allows. It is very important to get you balance back.

      And remember the first week always feels the worst but persevere.

  7. Jeff says:

    Hi – I sprained my ankle last night playing soccer. The sprain isn’t terrible (was able to walk on it today, with no more than slight pain) it is swollen but not extremely bad.

    My club is traveling next week from USA to Italy to play in a few matches, do you have any tips to help me recover even quicker than what is mentioned above? Including today I have nine days until my first match.

    Your article was very helpful thus far, thanks in advance

    • PhysioPrescription says:

      Hi Jeff

      The best thing you can do after a ankle sprain is to do the RICE protocol for the first 48 hours, followed by getting into the rehab exercises (balance work, theraband strengthening). The other things that can help speed things up is getting access to a Gameready machine which can help speed up healing (if you can find a practice or team with one).

      Then find someone that is great at strapping up ankles or a good lace-up ankle brace for a weeks time. – Good luck!

  8. Emmanuel says:

    Is there an alternative to ice, just in case if don’t have any?

    • PhysioPrescription says:

      Absolutely, compression is a great option as well if you get hold of a compression garment or tubigrip. Also doing contrast baths can help – alternating between cold and warm water, always ending with cold. Hopefully you will find something that you can use!

  9. Anon says:

    Could a sprained ankle heal in one week? As a ballet dancer, I can barely afford to take one week off, let alone six

    • PhysioPrescription says:

      Hi Lauren – Ankle sprains vary in healing time depending on degree of injury, age and many other factors – the best thing you can do is control the controllable – look after it and rehab it best you can to give it the best shot of a speedy recovery

  10. Bosh Kis says:

    Hi guys, I sprained my ankle badly 3 days ago.. I still can’t bare any weight on it.. (well hardly any).. but there is no pain unless I move my ankle side to side of step on it.. I’ve been using rice properly. I’ve pushed against all bones to test for pain and there is none at all. Could it more than a sprain since I still can’t put weight on it.. there’s near to no pain otherwise just stiffness.

    Thank you.

    • PhysioPrescription says:

      Hi Bosh
      If you still can’t weight-bear on the ankle after a few days, that is something we can’t ignore. It might be worth heading along to your doctor to get an x-ray done to rule out (hopefully) an avulsion fracture or talar dome injury. Once that is done and comes back clear you can carry on with rehab and get your ankle right. Good on you for checking for bony tenderness and keeping the Ottawa ankle rules in mind!

      Regards,
      Shaun

  11. I sprained my right ankle just last night during a basketball game and usually it just hurts for a few seconds and then I am able to run again (because I sprain my right ankle often), but this one hurts until now. I can walk normally but tip toeing hurts so much. Same case with Lauren, I can’t afford a day off because there’s a big event coming up this August. Is it okay if I practice tonight with an ankle brace or taping?

    • PhysioPrescription says:

      Hi Melanie

      If you must play, then definitely support the ankle with taping or a good brace. As well as that though it is so important to look at the long-term picture as well. If you have sprained your ankle multiple times in the past (as it sounds like) then I am not surprised it is worse this time as the ankle can become more lax (loser) and the chance of re-injury higher with a history or injury. Play, but ensure that you do the rehab exercises in level 2 and 3 fully and stick with them for at least 6 weeks to decrease the chance of future re-injury.

      Look after yourself – It isn’t the end of the world if you miss one practice.
      Shaun

  12. Mario. says:

    What if after first 72hrs of RICE ankle still bruised but pain has decreased. Should continue to step 2 or ?

    • PhysioPrescription says:

      Hi Mario

      Yes, ease into step two for sure. As you start using the ankle more with rehab exercises, this will help get rid of the bruising.

  13. Mauman says:

    I twisted my ligaments while playing football from that day I been wearing a plaster on my ankle now its been 3 weeks and I removed my plaster.The pain is gone but still I’m having trouble moving my ankle.And my ankle is swollen.what should I do to be able to move normally again.

    • PhysioPrescription says:

      Hi Mauman – Great, now you need to start rehabbing the ankle – start with level 2 and build from there.

      It is normal to still have swelling and very standard to have stiffness after coming out of a cast, so start getting it moving and use compression for the swelling.

  14. Anshul says:

    Hey
    I sprained my ankle 3 times in a month
    Will it cause a problem in future ??

    • PhysioPrescription says:

      Hi Anshul

      Rehabilitate it as well as you can over the next few months to make the chances of it giving you a problem in the future less and less.

      The biggest risk factor for having an ankle sprain is a past ankle sprain – so rehab it as well as you can and use a ankle brace if there is any instability.

  15. Dan says:

    I would like to use the picture on rice for my in class presentation. Thank you.

  16. Anonymous says:

    Thanx!
    it really really worked
    whoever you are
    you are awesome

  17. twinkle162 says:

    Ruptured my atfl 4.5 weeks ago, doing rehab with physio but using boot when having to stand or walk long distances. Should I b aiming to get out of it completely at this stage? ?tha ankle brace or better to just persist with as normal a gait as possible?

    • PhysioPrescription says:

      Hi, if you have fully ruptured the ligament then the moon boot is a good option if you want to avoid surgery. Best to be guided by your physio in this case.

  18. Javier becerra says:

    Very helpful information

  19. Marc says:

    Hey guys .. I sprained my ankle playing volleyball about 3 weeks ago and I didn’t take the best care of it an i had to work an it still hurts is there something I can do !? I mean it’s the 4th time I sprained this ankle but I jus figured after 3 weeks it wud be better

    • PhysioPrescription says:

      That’s easy Marc – Follow through with the Level 2 and 3 posts I have linked to in the post until it is 100% and it would help to get it checked by a good physio to ensure there is not too much ligamentous laxity

  20. PhysioPrescription says:

    Hi there, yes heat can be used after the initial inflammatory period as long as it doesn’t increase swelling too drastically. Try following the above tips and subsequent. posts for rehab exercises to follow

  21. Sanket says:

    I had an ankle sprain a week ago.. I have been doing RICE everyday since then..and it really helps a lot…swollen is quite reduced, just little pain is present in that area.
    I would suggest everyone to go for the RICE method.

  22. Liz says:

    Wow, this page has been getting comments for years! It is helping me recover from a fall down some stairs. Someone told me to use heat as well but I chose not to because I wanted to follow the info here. It has been 5 days and I am doing the rehab exercises, walking with a little pain but I am taking pain killers twice a day. I hope the pain killers aren’t disguising my progress. When should I stop using them?

    • PhysioPrescription says:

      Hi Liz

      It sounds like you are doing well with the rehab, so stick to it!

      I can’t advise on painkillers sorry

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