How To Recover From a Sprained Ankle
- Jeremy Tarwater PT, DPT
- Apr 10, 2022
- 6 min read
Updated: Jun 4, 2022
Updated February 3rd, 2022
Introduction
When I played youth baseball, our teams would go to see the New York Yankees play against the Blue Jays in Toronto. I only remember one common theme from these games and it had nothing to do with who won or lost. Almost every single game we went to, my mom would roll her ankle. She always said that Derek Jeter was waving to her and distracted her, but I think she may have had (and still has) some ankle instability.
Have you ever “sprained” or “rolled” your ankle? If so, you came to the right place. I’m going to go through the anatomy and how it happens first, since I’m a nerd. If you happen to not be a nerd and want secrets on how to recover from your sprained ankle now, CLICK HERE
Anatomy
The ankle joint involves many ligaments, tendons, muscles, and bones which are all affected by an ankle injury. Ligaments connect muscle to bone and are one of the supporting structures of a joint. During an ankle sprain, one or more ligaments are stretched too far, causing damage to your ankle. The most common ankle sprain is caused by an inversion movement shown below.
Does this picture bring back any bad memories? OOPS. The way I explain it to my patients: since the ligament was damaged, the muscles and tendons around that ligament have to compensate to keep the ankle stable and allow the healing process to begin.
Grades of Ankle Sprains
Grade | Symptoms | Recovery Time |
1 | Mild pain with possible bruising Minimal pain with weight-bearing | 1-2 weeks |
2 | Partial tear of one or more ligaments Moderate pain with weight-bearing Significant swelling and tenderness | 4-6 weeks |
3 | Severe pain and swelling Unable to walk Complete tear of ligaments and possible fracture | 4+ months |
Consulting a Physician
When to see a Physician:
What to expect at the doctor/physician’s office:
A brief history or questionnaire about how you injured your ankle and your current symptoms
A physical examination of your ankle to assess tenderness, swelling, range of motion, and strength
They may use what’s called the Ottawa Ankle Rules to determine if you may have a fracture before imaging (1)
Possible imaging:
X-rays will show if there is any fracture associated with your ankle sprain
MRIs usually are not conducted at the initial evaluation, but could show ligament damage in the future if necessary
Medications:
Your physician may prescribe an anti-inflammatory medication (NSAIDs) such as Naproxen or Meloxicam
They also may have you take Ibuprofen or Tylenol over the counter
All medications should be taken as prescribed by your physician
If you are interested in reducing inflammation and swelling without relying on medication, stay tuned for our future article on this topic!
Self-Treatment
Rest or Movement?
If you have difficulty bearing weight through your injured foot, you should perform PRICE until you have seen a medical provider
If you meet the criteria for the Grade 1 sprain above and do not have pain with bearing weight on your foot, proceed with PRICE and the exercises below
Performing PRICE may help expedite the healing process:
Protection of the ankle as it heals by avoiding excessive weight bearing or movements that cause pain for the first few days
Rest the ankle and avoid painful movements to allow the healing process to begin
Ice the ankle to help reduce swelling and pain
Ice for 10-15 minutes with a pillow case or towel between the ice and your skin
Thinking about using heat instead? CLICK HERE for more information about the use of heat vs. ice after injury
Compression of the ankle with an ACE wrap or brace to help immobilize and prevent excessive swelling
Elevation of the ankle above the heart so gravity can help pull the swelling from your ankle (2)
Exercises (if any of the following exercises cause increased pain, please speak with a medical professional before proceeding)
Movement can begin after the first few days as pain begins to subside. Please view the video below for the ankle alphabet exercise. You can also perform ankle “pumps” or “circles” to help the healing process.
Light Stretching once the pain is more tolerable. Give the calf stretch in the video below a try. You can also try it with your knee bent to feel a stretch further down into your ankle.
Strengthening is usually performed about 3-4 weeks after the injury, when you no longer have pain but do experience weakness.
Balance exercises can also help prevent future injuries. But they should be performed after the ankle has been strengthened and are safest to perform under the supervision of a Physical Therapist.
Professional Opinion
You can recover from a Grade 1 or 2 ankle sprain rather quickly if the above steps are followed. I believe the most important steps in the first few days after spraining or rolling your ankle are:
PRICE - protect, rest, ice, compression, and elevation
Light movement to progress the healing process
Methods to reduce inflammation
If you are seeking ways to reduce inflammation without adding more pills to your regimen, stay tuned for our future article on this topic!
I promote pain-free movement without excessive weight bearing within the first week with my patients. Although ice may not cure your ankle sprain, I believe that it helps to relax my patients after working through some movements. It also gives you an excuse to take a few minutes out of your busy day and put your feet up to give them a break from carrying you around all day.
It is important to consult with a Physical Therapist following an ankle sprain, regardless of severity. When you have sprained or rolled your ankle once, you are vulnerable to it happening again in the future.
In order to see a Physical Therapist in most states:
You need a script for Physical Therapy from a Licensed Physician
Search “Physical Therapy Clinic near me” on google
The Physician may also suggest a common clinic
If you would like to learn more about Physical Therapy, the process of scheduling an evaluation, and the typical course of treatment; please CLICK HERE
Frequently Asked Questions (FAQs)
Should I use ice or heat on my sprained ankle?
Immediately following an ankle sprain, ice will be more effective at reducing inflammation than heat. After a few weeks have past and swelling has subsided, many people believe heat helps to relax them both before and after exercise. If you would like more information on heat vs. ice, CLICK HERE (3)
Why do I need to see a Physical Therapist?
A Physical Therapist (PT) can help you recover from your ankle sprain faster, as we are trained in helping heal the body through movement.
A PT will teach you exercises beyond the ones above and may use other modalities such as massage, stretching, heat, or ice to help you recover from your injury AND prevent another ankle sprain in the future.
How do I get in to see a Physical Therapist?
You need a script for Physical Therapy from a Licensed Physician
Search “Physical Therapy Clinic near me” on google
The Physician may also suggest a common clinic
If you would like to learn more about Physical Therapy, the process of scheduling an evaluation, and the typical course of treatment; please CLICK HERE
What is the difference between an ankle sprain and a strain?
Ankle sprains involve damage to a ligament as shown above. The damage can be minor with a small tear or it can be large with a complete rupture of the ligament. Strains refer to muscle or tendon damage, which tends to heal much quicker than ligaments due to more blood flow to these structures.
Why do I keep spraining my ankle every year?
Recurrent ankle sprains are very common. They are mostly due to the lack of mobility and stability of the ankle joint. Once a ligament is damaged, the surrounding ligaments and muscles must compensate to help keep you balanced while standing and walking.
How can I improve my balance?
Many of the exercises shown above will help your balance immediately following the injury. A Physical Therapist can teach you these exercises with correct form to improve your balance and avoid future injuries.
My Doctor prescribed me crutches, how do I use them properly?
You may need to use crutches to keep weight off of your foot
If you have difficulty using crutches or poor balance, the physician can also prescribe you a walker
Stay tuned for videos and blog posts in the future about using an assistive device!
How long will I (or my child) be out of sports following an ankle sprain?
Return to sport will depend on the grade of injury. Most athletes follow the time-frames shown above and can be screened by a Physical Therapist prior to athletic competition to ensure proper healing and form. Many athletes return to the playing field or gym too early, leaving them vulnerable to recurrent ankle sprains
Conclusion
Thank you for reading this article. We strive to make this website a place where you can ask questions and learn about various injuries, improve your movement, and achieve better health! Please contact us below with any questions or suggestions for articles that you would like to read in the future!
References
1. Ottawa Ankle Rules. Physiopedia. https://www.physio-pedia.com/Ottawa_Ankle_Rules. Published 2022. Accessed February 27, 2022.
2. Brotzman, S. and Wilk, K., 2007. Handbook of orthopaedic rehabilitation. Edinburgh: Elsevier Mosby.
3. Miranda JP, Silva WT, Silva HJ, Mascarenhas RO, Oliveira VC. Effectiveness of cryotherapy on pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain: A systematic review of randomized controlled trials. Phys Ther Sport. 2021;49:243-249. doi:10.1016/j.ptsp.2021.03.011
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Last updated April 24, 2022
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