How to Treat a Sprained Ankle - Your Complete Guide

How to Treat a Sprained Ankle - Your Complete Guide

If you just twisted your ankle, there are probably a couple things running through your mind:

Did I sprain it? 
What do I do now? 
How do I make it stop hurting??

Your ankle has ligaments that help keep it stable, holding the bones in your ankle together. Ligaments are like thick elastic bands. An ankle sprain can happen when you roll or twist your ankle, stretching the ligaments past their natural position. The pain is caused by those ligaments stretching or tearing. Your ankle will start feeling better as the tears repair and the ligaments return to their natural position.

How to Tell if it’s a Sprain

There are a few dead giveaways of a sprain. It’s probably going to hurt a lot, and it will be painful to move or put weight on your ankle right after you twist it. Other symptoms include:

  • Swelling
  • Bruising or redness
  • Stiffness
  • Tenderness 
  • Itching
  • Cold or numb feet

Types of Sprains

The amount of damage to the ligament determines the sprain's grade. The three grades are:

Grade one sprains: the fibers of the ligament are stretched but not torn. These sprains are accompanied by some tenderness, swelling and stiffness but the ankle will still be stable. You will usually be able to walk with minimal pain once the initial swelling goes down.
Grade two sprains: the ligament is partially torn, causing moderate pain, swelling, bruising, tenderness, and difficulty walking for about a week. 
Grade three sprains: the ligament is completely torn or ruptured, preventing your ability to walk or weight bear. Grade 3 sprains are extremely painful, causing severe swelling and bruising.

If you are concerned about the severity of your sprain, you can go to your doctor for an assessment. You may also need to get an X-ray, CT scan or MRI to confirm the extent of the injury.

The RICE Method

The body is generally pretty good at healing itself from injuries like sprains. However, we can help it heal faster - or make it take longer to heal - depending on how we treat the sprain.

The general medical consensus is to follow the RICE method after the injury:

Rest - protect your sprained ankle and refrain from moving it for the first 24-48 hours after the sprain. If it’s too painful to walk on it, don’t try to push through the pain. The pain you feel is your body telling you “something is wrong, stop using the injured body part!” 
Ice - wrap an ice pack, a back of ice, or a bag of frozen peas in a towel. Apply this to the injury for 15-20 minutes every few hours during the first 24 hours after the sprain. This will help reduce excessive swelling. Don’t let your skin become numb or burned while icing.
Compression - wrap the sprain with a compression bandage to keep the ankle warm and maintain blood flow to the area. This helps promote healing.
Elevation - keep the injured ankle elevated above your chest as much as possible for the first day or two after the sprain.

Treatments for Grade One Sprains

If you have a grade one sprain, the RICE method will be sufficient treatment. Your ankle should be feeling much better after a few days. You can begin walking as soon as it isn’t too painful to do so.

The CoolXChange wrap helps with rest, ice and compression. This wrap works like a regular tensor bandage, letting you adjust the compression and support depending on how tightly you wrap it. It also has a cooling effect that brings the temperature of the skin down to reduce swelling. No need for ziplock bags with ice cubes and towels or bags of peas melting on your ankle. These are reusable and mess-free.

Treatment for Grade Two Sprains 

If you have a grade two sprain, it’s best to follow the RICE method as well. Then use a brace to provide extra support as your ankle heals after the injury. As soon as you can tolerate putting weight on your ankle, you can begin to carefully walk on it. Gradually increasing movement will help your ankle recover faster.

The best support to help you heal from a more severe sprain is the Swede-O Ankle Lok. This brace holds your ankle in a neutral position to prevent it from moving too much. Too much movement right after the injury can further damage the sprained ligaments. This brace isn’t too bulky so you can wear it in a shoe.

Treatment for Grade Three Sprains 

Since a grade three sprain involves a complete ligament tear, your body may not be able to completely heal by itself. If you suspect you’ve injured yourself to this extent, it’s best to get checked out by a doctor. You might need to use crutches and fully immobilize your ankle after the injury. Once you can put weight on your ankle, we recommend using a walking boot for a few weeks to help you get around. 

The Ultralight Air Walking Boot is a great option for those who need a high level of support. It has an inflatable liner so you can adjust the compression and keep your ankle really secure.

If you are a younger athlete who hopes to keep playing sports, you may need to consider surgery. Your doctor may also suggest you go to a physiotherapist. Physios will give you a professional assessment and treatment.

Returning to Sports After a Sprain

If you play sports, you’ll probably be eager to get back to training, playing, or competing! However, you don’t want to return to activity until you have full range of motion in your ankle, because you may be more likely to re-injure yourself. 

Stiffness and lingering pain can be a sign your ankle is not fully healed. The ligaments in your ankle are probably not strong enough to withstand the forces it did before the injury - especially while playing sports that require jumping, running, or zig-zag movements which put extra pressure on the sides of your ankle. You are likely to re-sprain your ankle if you return to sports before your ankle is fully recovered.

Ok, we know what you’re thinking. 

You’re losing precious time practicing, training, and building strength for game time while you’re waiting around for your ankle to heal. 

If you can handle walking or jogging but you still experience a bit of pain or instability, we recommend the Active Ankle Trainer II. This brace is great for those who play high-impact sports like volleyball, basketball, softball, and football. 

It is a lightweight, rigid brace that prevents the ankle from rolling. It also allows full range of motion with a hinge at the bottom. It will hold the ligaments in your ankle up until they are fully recovered.

Stretches to Improve Ankle Mobility

Once you can comfortably put weight on your ankle, you should begin walking and gently stretching your ankle. 

Resting your ankle will help prevent further injury while the ligaments are still weak, but it will also cause the muscles around the ankle to tighten up, since you aren't moving or stretching them. This tightening will make it harder to move your ankle, which can also cause injuries if you try to jump right back into regular movement. 

Gentle stretches as soon as your doctor gives you the go-ahead will help reduce this tightness and help you get back to feeling 100%.

There are lots of different stretches you can do. Here are a few that work well:

Plantar Flexion Stretch

Think of what your foot does when you step on a gas pedal - this stretch helps you improve your ability to do that motion.

  1. Sit on the ground with your legs straight in front of you.
  2. Push your foot forward away from you, towards the floor, by bending your foot the ankle. You should push your foot down until you feel pain or discomfort, or you physically can’t go any farther.
  3. Hold this position for 10-15 seconds.
  4. Return your foot back to a neutral position, pointing up to the ceiling.
  5. Do this 10 times.
  6. Stop and do not continue if you feel sharp or extreme pain.

Dorsiflexion Stretch

Dorsiflexion flexion is the motion of pulling your foot up towards your face. This stretch helps improve dorsiflexion after a sprain:

  1. Kneel in front of a wall on your non-injured leg and keep your other leg bent in front of you with your foot flat on the floor. It’s best to start with the toes of your front foot against the wall. 
  2. Keep your front foot flat on the floor and bring your knee forward to touch the wall, bending at your ankle.
  3. Hold for 10-15 seconds
  4. Move back 2-3 inches and repeat.
  5. Keep moving back until you can no longer touch your knee to the wall without your heel coming off the ground. 
  6. Do a total of 10 stretches.
  7. Stop and do not continue if you feel sharp or extreme pain.

Inversion Stretch

Inversion is when you move your ankle inward. This is usually the direction you sprained your ankle in, but sprains can cause overall tightness so it’s still a good idea to do this stretch.

  1. Sit on the floor with your legs flat on the floor in front of you, your toes pointed to the ceiling.
  2. Moving only your ankle and keeping your toes pointed up, turn your foot inward, so the sole is facing your other leg. 
  3. Keep turning your foot inward until you experience discomfort or you no longer can.
  4. Hold this position for 15 seconds.
  5. Return to a neutral position.
  6. Repeat these steps 10 times
  7. Stop and do not continue if you feel sharp or extreme pain.

Eversion Stretch

Eversion ROM is the act of moving your foot outwards. This stretch works the muscles on the side of the sprain if you rolled your ankle inward.

  1. Sit on the floor with your legs flat on the floor in front of you, your toes pointed to the ceiling.
  2. Turn your foot outward by moving only your ankle. Try to keep your leg in the same position. 
  3. Keep turning your foot outward until you experience discomfort or you no longer can.
  4. Hold this position for 15 seconds.
  5. Return to a neutral position.
  6. Repeat above steps 10 times.
  7. Stop and do not continue if you feel sharp or extreme pain.

You can do these stretches two or three times throughout the day to help you improve mobility. If your physical therapist or doctor recommends other stretches, do those instead. 

Follow these steps after you sprain your ankle and you’ll be back on your feet as soon as possible.