Sprained your ankle? Now what
6/24/2024 by Ryan Yennie, P.A.-C.
As the weather gets nicer, summer activities (sand volleyball, hiking and outdoor activities) are ramping up. So can ankle sprains.
An ankle sprain can happen any time the ligaments supporting the ankle are stretched or torn. This most often occurs when you "roll" your ankle and your foot turns inward (inversion injury). This results in injury to one or more of the ligaments on the outside part of your ankle. This is one of the most common injuries among athletes but can happen to anyone — even with a misstep.
After this type of injury it's common to notice swelling, bruising, tenderness to touch or a feeling of instability of the ankle (like the ankle will give out).
When should I be seen?
You should seek professional care if you notice any of the following after the injury:
- Unable to bear weight on the ankle.
- Deformity in how your ankle looks.
- Heard or felt a crack or pop during the injury.
- Notice a loss of sensation in your foot.
- Unable to move your foot in certain directions.
Management after an ankle sprain
Initial management includes RICE.
- Rest: Minimize walking and do not return to the activity that caused the injury.
- Ice: Apply ice to the area, typically for 20 to 30 minutes, three or four times daily Do not apply ice directly to your skin.
- Compression: A compression sleeve, wrap or brace can help reduce swelling and support the injured ankle.
- Elevation: Elevate the extremity at or above the heart level as often as possible for the first 1-2 days to reduce pain and swelling.
Additionally, you may use over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen or aspirin — if you can safely take them — to help reduce swelling and control pain.
After the initial management — and depending on the severity of your symptoms — beginning early pain-free motion (such as drawing each letter of the alphabet with your foot), gradual strengthening exercises and proprioception (balance) training is important to regain normal function to return to desired activities. Generally, discontinue an exercise if it causes pain while doing the activity. This return to motion, strength and balance can often be facilitated in physical therapy. It's important to note, you may progress through these exercises in a couple of weeks with mild sprains but may take 6 to 12 weeks with more severe sprains. After an ankle sprain, you are more likely to have repeat sprains in the future. Using an ankle sleeve or brace can add support and stability. The most important part of your recovery is to complete your rehabilitation to normalize motion, strength and balance. Incomplete rehabilitation is a common cause of continued ankle instability.
While common, if not treated appropriately ankle sprains can lead to chronic issues, such as ankle instability and degenerative arthritis. It's also possible a more severe injury has occurred to a tendon, cartilage (smooth lining of the joint) or even a fracture. If you do not see improvement after the first week of initial treatment, consider following up with a healthcare professional, such as your primary care clinician, sports medicine/orthopedic specialist or physical therapist.
If you experienced a more significant injury and saw a healthcare professional, you may experience a longer recovery with additional treatments that might include:
- A period of immobilization in a boot, splint or cast.
- Protected weight-bearing in a boot or using a gait aid such as crutches.
- Physical therapy to increase stability, strength and balance.
- Surgery.
If your health care professional suspects a more significant injury or there is a lack of improvement with treatment, you will undergo X-rays and possibly an advanced imaging study (MRI) to determine the extent of the injury.
You may be referred to meet with a surgeon or a surgical podiatrist if:
- You fail to improve with the non-operative treatments.
- You demonstrate continued ankle instability.
- You have an associated injury, such as a fracture, damage to the ankle cartilage or a torn tendon.
While ankle sprains are common, proper treatment is important to regain your function and reduce future instability.
Ryan Yennie, P.A.-C., is a certified physician assistant in the Department of Orthopedic Surgery and Director of Advanced Practice Providers. He practices in the adult Integrated Community Specialties — Musculoskeletal Division at Mayo Clinic in Rochester, where he helps patients with hip, knee, shoulder, foot and ankle orthopedic conditions.