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Top tips to manage an ankle sprain

Ankle sprains are an extremely common injury, with over 300,000 accident and emergency attendances involving an ankle sprain. In clinical practice, I have been seeing many more during the lockdown period and after as people take up more outdoor exercise.

What I often find is that patients are ill informed on the way to manage and ankle sprain. Many of the patients who I encounter feel they have very little guidance and are therefore anxious during the recovery. It can be a worrying time. Ankle sprains are painful. They swell and the swelling takes weeks and evens months to eventually subside. There is often extensive bruising, which can be very worrying for patients. And they can take weeks to recover from. An ankle sprain can take anything from 2 weeks to 6 weeks to recover, depending on the severity of the injury. In some cases it can even take months.

I would therefore just like to give a few tips and guidance on managing an injury to your ankle:

Can you weight bear? If the answer is no new cannot put weight on the injured ankle, then it is advised to get x-ray to check if there are any fractures.

Do you have bruising at the sole of your foot? If the answer is yes then I would strongly advise you seek a specialist foot and ankle orthopaedic consultant to check whether there is a significant, but subtle, injury to the foot.

RICE - This stands for rest, ice, compression, and elevation. This is the initial management to relieve the pain and inflammation when an ankle is injured. It is advisable to rest the ankle for a week or two. Ice can be applied in the form of a bag of frozen peas wrapped in a cloth. Compression may be in the form of a tubigrip compression stocking that will help with the swelling. It is not usually necessary to require any ankle braces at this stage. Whenever you can, elevate the ankle to reduce the swelling. Swelling can be persistent and most people will notice ankle to be swollen even up to 6 weeks since the injury. It will however eventually subside and it is important to follow the advice to reduce the swelling. Don’t forget to take regular painkillers if needed.

Exercise the ankle – it is important to maintain motion within the ankle joint. The ankle will feel stiff for at least a few weeks. It may be difficult to do this for the first week, but by the second week you should be able to start pointing your foot upwards and downwards to start off with. By the end of the second week you can start writing the alphabet letters with your foot which will help maintain as much motion in your ankle. With general activity, this should exercise and strengthen the ankle sufficiently in most cases.

Reassess at 6 weeks - if you’re ankle still feels weak, continues to give way, or you have symptoms of clicking, locking, or popping around the ankle joint then it is worth seeking medical help in case there are any more subtle injuries to the ankle. The majority of the time, all that is required is maybe course of physiotherapy. Most of the time ankle sprains do eventually settle. It can take anything between 2 to 6 weeks to fully recover from an ankle sprain, depending on the severity of the injury. Only a minority of patients may continue to have problems and symptoms following an ankle injury. However if you do have persistent symptoms that are troubling, then there is no harm in seeking medical advice.

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