Ankle sprains are common sports injuries. If there is clear injury to the ligaments, swelling and bruising will also appear. If pain prevents you from putting weight on your foot or if the bone is painful when you touch the ankle, bone injury is possible. If these symptoms are absent, the likelihood of a fracture is very small. Signs of healing include painlessness, and recovery of the range of movement and strength.
- In first aid, remember RICE: Rest, Ice, Compress and Elevate.
- Compress: Compress (wrap) the injured area as soon as possible, using your hands, a scarf, or gauze.
- Ice: Treat the injured area with something cold such as ice cubes, snow, frozen vegetables, or a cold pack. Alternatively, you can place the foot in cold water. Continue the cold therapy for 15 to 20 minutes and repeat every 2 hours if necessary. You should place a cloth such as a towel between the cold pack and the skin in order to reduce the risk of cold burn to the skin. During the first 24 hours, you should repeat the cold therapy often.
- Elevate: Support the limb in a raised position above the level of the heart, at an angle of 45 degrees. Keep the limb in this position as much as possible during the first 24 hours.
- Cold therapy and elevation should be repeated for 2–3 days if the swelling is severe. If necessary, apply more cold therapy later on if there is swelling after exercising the foot.
- Use crutches for 2–4 days if necessary. After this, you should continue to use a support bandage that prevents sideways movement of the ankle for a couple of weeks.
- Rehabilitation of the ankle should be progressive so that the exercises become gradually more demanding.
When should I seek treatment?
- If the sprain injury is associated with considerable swelling, subcutaneous bleeding, or pain on weight-bearing, or if the bone is painful when touched, the ankle should be examined by a healthcare professional.
- In some situations, physiotherapy might be needed to ensure proper recovery. In this case, it is important to decide the right time to start the physiotherapy exercises together with healthcare professionals. In some cases, starting physiotherapy might only be possible when weight-bearing is painless or almost painless.
Information source: The Finnish Medical Society Duodecim
FSHS Physiotherapist / 4 October 2019