An ankle sprain is a common sporting injury. It can be a very painful experience and can significantly affect a patient’s lifestyle. It occurs due to the ankle twisting and causing damage to the soft tissues and ligaments. A ligament consists of several strands of tissue all compacted together to form a strong structure, similar to a rope. An ankle sprain may result in a partial or complete tear of a ligament, which stabilizes the ankle joint. Once the ligament is torn, it becomes weak which in turn affects ankle stability.
The degree in which the ankle stability is affected is dependent upon the level of the tear. When an ankle sprain occurs, the usual scenario involves the athlete “rolling” his ankle while landing from a jump or running followed by a sharp pain on the outside of the ankle. An audible “pop” or “snap” may accompany the injury, which sometimes signals ligament rupture. If the athlete can walk on the injured ankle, the likelihood of a serious injury is less, but athletic participation should be discontinued. Shoes should be kept on until examination and treatment. Symptoms include a swollen, painful ankle with possible bruising due to ruptured blood vessels.
Treatment of Ankle Sprains – RICE
Unless the joint is extremely painful or is obviously deformed (the bones or joints are out of their normal alignment), a sprained ankle can safely be treated by self-care.
Follow the RICE acronym, which stands for: Rest, Ice, Compression, Elevation.
Treatment with “RICE” aims to reduce swelling, and can be continued for as long as swelling is present, and at least for the first 48 hours after the injury.
- Rest the injury by avoiding movement of the affected joint and keeping weight off it for the first 24-48 hours, to prevent further injury. If you need to move around, a crutch may help.
- Ice packs, a bag of frozen peas or a cold compress will cool the injured area to ease the swelling, bruising and pain. Ice should not be applied directly to skin because it can cause frostbite – place a cloth between the ice and skin. Ice can be applied for up to 20 minutes in every hour, every couple of hours.
- Compress the joint by bandaging it with an elasticated support bandage. The bandage should be firm but not so tight that circulation is cut off (if the toes go blue, for example, the bandage is too tight).
- Elevate the joint by raising and supporting it above the level of the heart, especially at night while sleeping. It may be most comfortable to lie down with the feet elevated on pillows.
If you have the following symptoms after the first 24 hours you should see a doctor or visit a hospital:
- the ankle remains extremely painful
- swelling and discolouration do not subside, or they get worse
- it is impossible to bear any weight on the affected leg
- there is any obvious deformity
On the second day after the injury, it may help to bathe the ankle in cold water for one minute, followed by hot water for three minutes. Repeat this cycle for about 15 minutes. If there is no improvement after two or three days, seek medical advice.
For more severe sprains, using a brace or taping to support the ankle will help prevent the ankle being sprained again. This is particularly relevant for people who are returning to sporting activities. Personally, I recommend using Active Ankle T2 whenever you play sports.
The risk of sprains can be reduced by aiming for a steady build up to exercise rather than occasional bouts of vigorous exercise. Consider flatter-soled shoes, especially for walking on uneven ground.