Ankle sprain is a painful injury preventing you from moving any further the second it happens. Sharp pain, usually on the outer side of your ankle will take your breath away and the inability to put your foot down are typical symptoms. The few following rules can help faster healing. If you cannot put any weight on your heel even after several hours or the injury is big, you should get an X-ray. However, in majority of the cases this injury the the ligaments of the ankle does not have to be treated by immobilization in a plaster cast. Despite the sharp pain gentle and careful rehabilitation will reduce the healing time.
Immediately after ankle sprain
RICE -rest, ice, compress and elevate. Avoid weight bearing on your foot and elevate it above your heart level. Use ace wrap for compression and ice to reduce pain and swelling. This applies to any injury, it will reduce bruising and swelling. Protect your ankle.
Injury to three days
Continue with the RICE regimen for at least three days. If you don’t have pain at rest when not weight bearing you can start careful ankle pumps. Do not look for pain, just move within the pain-free range and promote healing by gentle stretching. Do not move your foot to sides yet.
Three days to a week
If the pain continues to reduce and you can start slowly walking around, do not plan to go hiking yet. Continue with the RICE regimen. At this point you want to focus on quality of your gait. Try to avoid limping, use crutches if you have too much pain. You can increase the ankle pumps range of motion, but remember the exercises must not hurt.
One week to two months
If you can walk well on level surface and the ankle is less swollen, gradually add exercises such as heel and toe raises in sitting, single leg stance etc. Continue to focus on quality of your gait, make small but regular steps and do not limp.
Two to six months
Don’t worry, the ankle will heal in way less than 6 months. Especially not, if this is the first time you have injured it. However, the rehabilitation process should continue even after you have returned back to normal to avoid repeated injury. At this stage we have to focus on proprioception or kinesthetics. It is your body’s ability to sense where in the space you are and which way it is moving. Your brain analyses the information from the periphery and without you knowing reacts very fast to this information. This allows us to move in space without focusing on particular muscles or muscle groups. After ankle sprain we need to focus on training this ability to prevent repeated injuries. An example of proprioceptive training is single leg stance. This exercise can be made more challenging by for example closing your eyes.
RICE - what to do right after ankle sprain
Early physical therapy speeds up the healing process. Beside the exercises your physiotherapist can use modalities such as ultrasound to reduce bruising, e-stim for pain control, taping and manual therapy to reduce edema.