Ankle Sprain Treatment

Author: Chloe Wilson - BSc(Hons) Physiotherapy

Ankle sprain treatment is vital to prevent ongoing problems of pain and instability after an ankle ligament injury. Ankle sprains are common and approximately thirty five percent of people who sustain them will have recurrent problems in the future, making effective rehab vital. 

An ankle sprain is the over-stretching of one or more of the ligaments supporting the ankle joint

A sprain is where one of the ligaments around the ankle is overstretched, often resulting in damage and tearing of the fibres.  They usually result in pain, swelling and bruising around the foot and in severe cases there may be difficulty walking and instability. 

There are three grades of ankle sprain, grade 1 (minor damage), grade 2 (moderate damage) and grade 3 (complete rupture). The severity of the sprain will determine the best course of treatment and the recovery process.

Here, we will look at the different ankle sprain treatment options for the different grades of injury as well as how to prevent long term problems and re-injury. If you want to know more about the causes, diagnosis and symptoms of this type of injury, visit the ankle sprain overview.

Treatment for All Grades of Sprain

The following ideas for ankle sprain treatment are suitable for all grades of sprain. 

Initial ankle sprain treatment aims to reduce pain and swelling

The best ankle sprain treatment to start with is PRICE: Protect, Rest, Ice, Compression and Elevation.  This aims to reduce the bleeding, swelling and pain around the injured ligament which helps to speed up healing. 

1)  Protect

Sprained ankle first aid starts with protecting the ankle from further injury.  In severe cases, a plaster cast may be applied to limit all ankle movement.  In less severe cases an ankle brace may help to support the foot.

2)  Rest

Avoid activities that aggravate your symptoms, but don’t rest completely – the key is relative rest.  You can still do other exercises to keep other body parts strong.  You may need to use crutches initially to help you walk if you are having difficulty taking weight through your foot.  As the ligament heals, you will gradually be able to take more weight through your foot.

3)  Ice

Applying ice regularly is a vital part of ankle sprain treatment.  It is particularly effective in the early stages after an ankle sprain, but only if used appropriately.  Find out how to safely and effectively use ice as part of your ankle sprain treatment in the Cold Therapy section.

Tubigrip elasticated bandage is a great way to apply compression as an ankle sprain treatment

4)  Compression

A compression bandage such as tubigrip helps to reduce swelling and provides minimal support.  It should be worn double thickness from just below your knee down to your toes.  Tubigrip should not be worn at night.  Tubigrip is generally safer and more effective than a normal bandage. You can find out more about Tubigrip on our sister site.

5)  Elevation

Keeping the foot elevated higher than the level of your heart will help to reduce swelling.  Swelling tends to pool around the ankle due to gravity, so keeping the foot elevated can really make a difference as it drains excess fluid away.

6)  Exercises

Exercises are an important part of ankle sprain treatment.  Approved use by

Exercises are a really important part of ankle sprain treatment.  They help mobilise the joint and work the muscles help to prevent stiffness and weakness.  Movement also helps to speed up the healing process by improving circulation. 

As well as doing a range of movement exercises and strengthening exercises, balance and proprioception exercises are really important to regain stability around your ankle as part of your ankle sprain treatment.  The level and type of exercises will depend on the severity of your injury.  Visit the foot and ankle exercises section to find out more.

7)  Medication

Non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen and naproxen can be used to help reduce pain and inflammation, but always talk to your doctor before taking them as they can have side effects.

Grade 1 ankle sprains, where just a few ligament fibres have been damaged, will usually settle down in a few weeks by following these treatment methods.  However, if you have suffered a grade 2 or 3 ankle sprain treatment will need to be more targeted and continued for longer. It usually takes a few weeks to a few months to recover completely

Grade 2 & 3 Ankle Sprain Treatment

With severe ankle sprains, more input is likely to be required to ensure a full recovery.

1) Physiotherapy

Effective physiotherapy is a vital part of ankle sprain treatment with severe sprains.  As well as an exercise programme, your physiotherapist may also do some manual therapy to reduce any stiffness in the joints of the foot.  Stiffness around the talus bone is a common problem associated with ankle sprains, as is dislocation of the small foot bones, known as cuboid syndrome, often leading to long term problems, so manual therapy should be done to restore the normal gliding movements of the bones. 

Deep transverse friction massage can help reduce the build-up of scar tissue.  You may also be given ultrasound to help reduce inflammation and promote healing, although the evidence behind ultrasound is somewhat lacking.

With severe ankle sprains, you may be placed in a walking boot to prevent further injury

2) Brace/Support

If there is instability around the ankle, you may need to wear a brace or ankle support as part of your ankle sprain treatment to prevent further injury. In severe cases, you may be given a cast or walking boot to immobilise the joint temporarily while the ligament heals

3)  Footwear

It can help to wear high-top shoes such as walking boots for extra support.  They should be tight but should not cause discomfort.   Avoid high heels to reduce the risk of re-injury.

4)  Surgery

Surgery is not a common ankle sprain treatment, but in some cases of severe ankle sprains, it may be necessary to repair the torn ligament surgically. If rehab has failed to resolve persistent instability, surgery will also be considered.

Most sprains will respond well to these ankle sprain treatment methods, but if they are not done properly, or if rehab stops too soon, long term problems can ensue.  Do not return to sports until you can hop on your injured foot without any problems.

Preventing Further Injuries

It goes without saying, prevention is better than cure.  With more severe ankle sprains, it is really important to fully rehab to prevent long term problems. The recurrence rates for lateral ligaments sprains have been reported to be as high as eighty percent.  This is most commonly due to persistent weakness around the ankle, stiffness in the joint and reduced proprioception.

Ankle sprain treatment needs to be carried out effectively and completely to avoid these and prevent recurrence.  Here are some things you can do to help reduce your risk of further problems.

1)  Appropriate Footwear

Wear appropriate foot wear for the activity you are doing.  Shoes/boots should provide sufficient support without being too tight.  Be aware that you are at increased risk of a rolled ankle if you wear high heels.

A wobble board is a great way to improve proprioception and reduce the risk of ankle sprains

2)  Balance/ Proprioception Exercises

Your ankle plays a vital role in proprioception, the body’s awareness of body position.  It helps make rapid adjustments to your position without you even thinking about it, reducing your risk of injury.  A good quick test is to see if you can stand on one leg with your eyes closed for one minute.  If you can’t, you need to do balance challenging exercises.

3)  Take Care On Uneven Surfaces

You are much more likely to sprain your ankle on uneven surfaces, so take extra care.  Watch where you are putting your feet, especially on mountains, fields, snow, building sites and even pavements and go slowly.

4)  Warm Up

Get your body ready for action and warm up properly before doing exercise.

5)  Braces/Taping

Wearing an ankle brace or taping the ankle can help provide stability and reduce the risk of injury.  Taping should only be carried out by a trained professional.

What Next?

To find out more about ankle sprains and their causes and symptoms, visit the ankle sprain overview.

If this is not sounding quite like your pain, visit the foot pain diagnosis section for help working out what is wrong.

Go to Ankle Sprain Overview or Foot Pain Treatment

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