Andrew woke up later than normal on a foggy Monday morning. He darted out the door, gripping his coffee in one hand and his keys in the other. As he raced towards his car he happened to step right where the driveway meets the grass, rolling his ankle and ruining any chance of savoring that cup of coffee. The sudden pain signaled an ankle sprain, prompting him to make a call into work, letting them know he would be late.
Perhaps you have a similar story. But how can you determine if your ankle is sprained? And if it is, what steps should you take to avoid exacerbating the injury?
What exactly is an ankle sprain?
A sprained ankle is an injury that occurs when you roll, twist or turn your ankle in an awkward way that stretches or tears the tough bands of soft tissue (ligaments) within the joint that help hold the ankle bones together. Ligaments help stabilize joints and prevent excessive movement beyond the normal, functional range of motion. Most sprained ankles involve injuries to the ligaments on the outer side of the ankle.
What are the symptoms of an ankle sprain?
Call your doctor if you suspect a sprain. Self-care measures may be all you need; but talk to your doctor to discuss whether you should have your ankle evaluated. If signs and symptoms are severe, you may have significant damage to a ligament or a broken bone in your ankle or lower leg. The symptoms of an ankle sprain vary depending on the magnitude of the injury. Signs of a sprain may include:
- Pain, especially when you bear weight on the affected foot
- Tenderness when you touch the ankle
- Restricted range of motion
- Instability in the ankle
- Popping sensation or sound at the time of injury
Remember that these signs can vary in severity depending on the extent of the sprain. If you experience any of these symptoms, it is advisable to consult a healthcare professional for a proper diagnosis and guidance on the next steps.
What is the RICE method and should I use it if I have a sprained ankle?
The RICE method stands for:
Rest: Avoid putting weight on the injured ankle as much as possible. Use crutches if necessary.
Ice: Apply ice to the ankle for 15-20 minutes every two to three hours for the first two to three days after the injury. This will help reduce swelling and pain.
Compression: Wrap the ankle with an elastic bandage to help control swelling. Make sure the bandage is snug but not too tight.
Elevation: Elevate the ankle above the level of your heart to reduce swelling. You can do this by lying down and placing a pillow under your ankle.
While the RICE method has traditionally been recommended for managing acute injuries like ankle sprains, recent research and expert opinions have evolved. It is important to note that the RICE method alone may not be the most effective approach for treating ankle sprains.
What is the POLICE method and is it better than RICE?
The current consensus among healthcare professionals suggests using the POLICE (Protection, Optimal Loading, Ice, Compression, Elevation) method instead. The POLICE method emphasizes protecting the injured area, promoting optimal loading and movement, and incorporating appropriate rehabilitation exercises.
Here's a breakdown of the POLICE method for managing ankle sprains:
- Protection: Use braces, crutches, or other supportive devices to protect and stabilize the ankle.
- Optimal Loading: Gradually reintroduce controlled weight-bearing and movement to stimulate tissue healing and prevent muscle atrophy.
- Ice: Apply ice to the affected area for 15-20 minutes every 2-3 hours in the initial 48-72 hours to reduce pain and swelling.
- Compression: Use an elastic bandage or compression sleeve to provide gentle compression to the injured ankle, helping control swelling.
- Elevation: Keep the injured ankle elevated above the level of your heart as much as possible to minimize swelling and promote fluid drainage.
It's worth noting again that the best course of action for an ankle sprain may vary depending on the severity of the injury and individual circumstances. It is advisable to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan for your specific situation.
Do you need a boot for a sprained ankle?
You may need physical therapy, a brace, a walking boot, or an aircast brace to provide the necessary support needed for healing. For more severe sprains, you may require a short leg cast or even surgery, depending on the severity of the sprain.
How do you wrap a sprained ankle?
Here's a step-by-step guide on how to wrap a sprained ankle:
Gather the necessary supplies
You'll need a compression bandage (such as an elastic bandage), adhesive tape, and possibly a padding material like foam or gauze.
Prepare the ankle
If possible, clean the ankle area gently with mild soap and water and pat it dry.
Start with a base
Hold the end of the compression bandage against the inside of your foot, just above the arch. Wrap the bandage around the ball of your foot a few times to secure it.
With a slightly tensioned pull, start wrapping the bandage in a figure-eight pattern. Cross the bandage over the top of your foot, around the back of your ankle, and then under your foot, repeating this pattern. Ensure that each wrap partially overlaps the previous one, covering the previous layer by about half.
Secure the wrap
After several figure-eight wraps, continue wrapping the bandage around the ankle and foot, moving upward in a spiral pattern. Make sure the wrap is snug but not too tight, as excessive tightness can impede blood circulation.
Address swelling and padding
If there is significant swelling, you can place some foam or gauze pads around the ankle before continuing the wrap. This helps provide additional support and cushioning.
Secure the end
When you reach the top of the ankle or the end of the bandage, secure it with adhesive tape or fasteners to prevent it from unraveling.
Check circulation and comfort
After wrapping, make sure there is no numbness, tingling, or excessive tightness. Wiggle your toes to ensure proper blood flow and sensation.
Remember, it's crucial not to wrap the ankle too tightly, as this can restrict blood flow and cause further complications.
How long will pain last after ankle sprain?
Mild ankle sprains may result in shorter durations of pain, typically lasting for a few days. Moderate ankle sprains may cause pain for about one to three weeks. However, more severe sprains or complex injuries may result in pain lasting several weeks or even months. It's important to note that pain levels can also fluctuate during the healing process.
During the initial stages of recovery, the pain is typically most intense and may gradually decrease as the injured ligaments and tissues heal. Over-the-counter pain medication like acetaminophen or ibuprofen can help relieve pain and reduce swelling. Once the swelling and pain have subsided, you may be able to start doing rehabilitation exercises to strengthen the ankle and improve its range of motion. For mild sprains you may be able to begin exercises after three to four days. This can include gentle stretching, range-of-motion exercises, and balance training, such as the following.
What exercises can I do to help recover from an ankle sprain?
This gentle exercise helps you to move your ankle in all directions:
Sit on a comfortable chair and extend your leg out. ‘Trace’ the letters of the alphabet in the air with your big toe. If there’s no pain, you can repeat this 2 or 3 times.
These exercises stretch and relax the ligaments around your ankle.
Sit in a chair keeping your foot flat on the floor. Slowly move your knee from side to side for 2 to 3 minutes.
Place a small towel on the floor in front of you while you sit in a hard chair. With your bare feet, gently grab the towel with your toes, scrunch it up, and count to 5. Then release the towel and repeat. Do this 8 to 10 time, unless if you feel pain. You can also try this with a tissue.
Sit on the floor with your leg stretched out in front of you with towel or strap wrapped around the ball of your foot. Pull back on the towel so your toes move toward you. Hold the stretch for 15 to 30 seconds. You only need to feel a mild to moderate stretch on your calf muscle.
Stand facing a wall or in front of a countertop, placing your hands on it for support. Place your injured ankle about one step back and your good foot forward. While you keep your back heel flat on the floor, slowly bend the knee of your good leg until you feel a moderate stretch in the calf on your injured side. Repeat this 3 times, holding for 30 seconds.
Stand with your hands in front of you, resting against a wall, countertop, or chair back for support. With your feet shoulder width apart, slowly raise your heels up and come back down. Do about 10 of these heel-rises at first and work up to 20 or more. You only want a moderate stretch and no pain.
With your hands on a wall, countertop, or chair back for support, lift up your good leg behind you so that your weight rests on the leg with the injured ankle. Try to hold this for 20 to 30 seconds. As you get stronger, try doing it only with the support of one or two fingers, and then do this without holding on as you get stronger.
These following resistance stretches should be done after mastering the aforementioned exercises, using an elastic, resistance band. If you experience any pain, stop the exercise.
This is a variation of the towel stretch, but with resistance. Sit on the floor and prop up your ankle with a rolled-up towel to keep your heel off the floor. Place the elastic, resistance band around the ball of your foot and hold the two ends. Slowly push your ankle forward like you’re pointing your toe, and then slowly bring it back. Repeat this 10 times. Stop the exercise if there is any pain, or if your ankle feels wobbly.
Tie the resistance band around a sturdy object such as a desk or table leg or doorknob. While sitting on the floor, hook your toes and upper foot into the band and slowly pull your foot back towards you and return it to vertical position. Repeat this 10 times.
Tie the resistance band around a heavy object. Hook the inside of your foot into the end of the band while sitting or standing. Slowly move your foot to the outside and back. Repeat 10 times and build up to 20 times. You can also do this while sitting down with your ankle propped up on a rolled towel. Tie a loop in the end of the resistance band and hook it around your foot. Now arrange the band to also go around your good foot. Your good foot acts as a pivot. Holding on to the end of the band, turn your ankle out. Repeat 10 times and build up to 20 times.
With the resistance band tied around a heavy object, hook the inside of your foot into the band. Now slowly move your foot inward against the resistance band and bring it back. Repeat 10 times and build up to 20 times.
These exercises are designed to restore basic balance:
Stand on your injured foot, lift the other foot off the floor behind you, and try to maintain your balance. If you feel unsteady, use a countertop or chair back for support. Try to hold this for a few seconds and build up to 30 seconds and 1 minute, if you can.
Repeat the first basic balance exercise with your eyes closed. This is much harder, because you don’t have visual points of reference to help you balance. Be sure to use something for support. Again, try to work up to 30 seconds and 1 minute, if you can.
Do the same basic balance exercise while standing on a pillow. Even if your ankle isn’t sprained, your foot will wobble around a lot and you’ll constantly need to correct your balance. Try to do this for 30 seconds to 1 minute. As with all the exercises, stop if you begin to feel pain in your ankle.
Should I consult a doctor before doing exercises after spraining my ankle?
It's always a good idea to consult a doctor when you injure yourself. Ankle sprains are very common, but the severity can vary greatly. Sometimes you may not know that you sprained your ankle until a few hours later when you see swelling or bruising and feel increased pain. Your doctor will determine the best type of brace to use and prescribe an exercise program to suit your specific needs. Recovery time depends on the severity of the sprain, your age, and your general physical health. Be patient with yourself and your recovery and make sure you get some good sturdy shoes like the ones we sell here at Gatsby. Your feet and ankles will thank you.