From the Guidelines
Ankle sprains should be treated with functional treatment, including exercise and functional support, rather than immobilization, to promote healing and prevent chronic ankle instability and recurrent sprains. This approach is supported by the most recent and highest quality study, which found that functional treatment is the preferred method for treating ankle sprains 1. The study also recommends using the Ottawa Ankle and Foot Rules to exclude fractures and to use a semirigid brace as a cost-effective option for functional treatment 1.
Some key points to consider when treating ankle sprains include:
- Using the RICE protocol (Rest, Ice, Compression, and Elevation) to manage pain and swelling in the initial stages 1
- Gradually reintroducing weight-bearing activities and beginning gentle range-of-motion exercises to prevent stiffness 1
- Using physical therapy exercises, such as ankle circles and calf stretches, to promote healing and restore strength 1
- Considering the use of nonsteroidal anti-inflammatory drugs to reduce pain and swelling, and to decrease the time it takes for the patient to return to usual activities 1
- Addressing prognostic factors, such as pain, workload, and level of sports participation, to prevent future injury recurrence and promote recovery 1
It's also important to note that surgery should be reserved for patients with lateral ligament ruptures, and that functional support, such as bracing or taping, can be effective in preventing recurrent ankle sprains 1. Overall, a comprehensive treatment plan that includes functional treatment, physical therapy, and addressing prognostic factors can help promote healing, prevent chronic ankle instability, and reduce the risk of recurrent sprains.
From the Research
Ankle Sprain Overview
- Ankle sprains are a common injury, frequently appearing in emergency services 2
- The lateral sprain of the ankle is a very frequent injury in the general population 2
Treatment and Management
- Clinical practice guidelines recommend the use of Ottawa rules, manual therapy, cryotherapy, functional supports, early ambulation, short-term NSAIDs, and rehabilitation for ankle sprain management 2
- There is insufficient evidence to determine the relative effectiveness of RICE therapy for acute ankle sprains in adults 3
- Supervised physical therapy is the recommended care for an ankle sprain, but some patients may not receive this care and instead be prescribed medication 4
- Non-steroidal anti-inflammatory drugs and early mobilisation have strong evidence for treating acute ankle sprains, while exercise and manual therapy techniques have moderate evidence 5
Prevention and Rehabilitation
- Bracing and neuromuscular training have strong evidence for preventing recurrence of ankle sprains 5
- Exercise therapy and bracing are supported in the prevention of chronic ankle instability (CAI) 5
- A thorough clinical evaluation is necessary to ensure an accurate diagnosis and appropriate treatment prescription for ankle sprains 6
- Strategies for prevention of recurrent sprains and return to play considerations are important for athletes who have suffered an ankle sprain 6