Health & Safety Resources

Basics of Ankle Sprain Management

As with any sprain or strain you should first follow the R.I.C.E. principal immediately after an ankle sprain.  R.I.C.E stands for Rest, Ice, Compression, and Elevation.  R.I.C.E. will relieve pain and keep the area from swelling.  The earlier the RICE treatment is started after an injury, the better it works.

REST - If moving the injured area causes pain, this is the body's way of saying stop. Rest the affected area. Sometimes resting an injured area means not participating in any physical activity or just the activity that caused the injury. For example, some walking may be allowed, but no running. If necessary, a health care provider may suggest using crutches or a cane so that less weight is put on the injured foot or leg.  Activities are resumed on a gradual basis and as tolerated evaluated by pain and ability to participate with proper form.

ICE - Ice applied to the injured area will help to prevent or reduce swelling. Swelling causes more pain and can slow healing. Apply a cloth-covered ice pack to the injured area for no more than 20 minutes at a time, 4 to 8 times a day. A one-pound package of frozen corn or peas makes a good ice pack. It is lightweight, conforms to the injured area, and is inexpensive and reusable. 

COMPRESSION - Use an elastic wrap to prevent or reduce swelling. Wrap the injured area with an elastic bandage, but not so tightly that the blood is cut off. It should not hurt or throb. Fingers or toes beyond the bandage should remain pink and not become "tingly." The elastic bandage should be taken off every 4 hours and reapplied. 

ELEVATION - Elevation means raising the injured area above the level of the heart. The affected part should be elevated so it is 12 inches above the heart, to help reduce swelling. Prop up a leg or arm while resting it. It may be necessary to lie down to get the leg above the heart level.  Elevation can be achieved with several pillows placed under the injured area.  Anyone with Raynaud's, diabetes, sensitivity to cold or any medical condition with reduced blood flow to the arms or legs should not use R.I.C.E. therapy. These people need to see their provider for care of minor and more serious injuries. 

As pain and swelling subside begin ankle range of motion (ROM) exercises, pumping the ankle up and down and side to side.  Progress to calf stretches if ankle ROM is well tolerated.  When ROM becomes pain free, a light resistance band can be used to begin strengthening the ankle muscles.  Use the band to resist side-to-side and up and down ankle motions. Progress to more difficult bands as strength increases and if the exercises can be done pain free.  Heel raises and wall squats can generally be tolerated as you become proficient at moderate resistance band exercises.  Progress your ankle program to simple walking and single leg balancing exercises when these activities can be done pain free.  Begin hopping exercises when walking and SLB become pain free.  Start with hopping on two legs straight up and down.  Progress hopping to side to side and front to back hops.  When this can be done proficiently and pain free progress to single leg hops.  The next step is running.  Begin with straight-ahead light jogging and progressing to sprints as pain and function allow.  When this can be done proficiently and without pain progress to cutting side to side, slowly at first, working up to sprint speeds as you become proficient.

Remember all exercises should be pain free.  Do not perform any exercises that you can not accomplish pain free and with out substitution or a limp.  This article is not intended to replace medical care from your health care provider about your specific complaint.  If you are unsure of the severity of your injury, if your condition does not improve, if you have considerable pain or if the pain worsens, it is recommended that you seek medical care.

For further information on this article or for priority appointments for sports injuries please contact Henry Ford Center for Athletic Medicine at 313-972-4216.

Henry Ford Health System’s Center for Athletic Medicine offers a comprehensive approach to sports medicine, including surgical and non-surgical care, sports rehabilitation, injury prevention, and performance enhancement programs.  The HFHS treatment team includes sports medicine fellowship trained orthopedic surgeons, sports medicine fellowship trained primary care physicians, as well as certified athletic trainers and physical therapists.  These health care professionals are supported by the HFHS nationally recognized bone and joint research facility, including the prestigious Herrick Davis Motion Analysis Lab.  HFHS is proud to be health care providers to the Detroit area’s premier sports programs including professional, collegiate, and high school athletes.