From the Guidelines
One week after an ankle sprain, treatment should focus on controlled rehabilitation while protecting the healing ligaments, with functional support preferred over immobilization, as stated in the British Journal of Sports Medicine study 1.
Key Considerations
- Continue RICE (Rest, Ice, Compression, Elevation) as needed for pain and swelling, but begin gentle range-of-motion exercises like ankle circles and alphabet tracing with your foot.
- Start weight-bearing as tolerated with proper support from an ankle brace or elastic wrap, as functional support is effective in preventing recurrent ankle sprains 1.
- Take over-the-counter pain medications like ibuprofen (400-600mg every 6-8 hours with food) or acetaminophen (500-1000mg every 6 hours) as needed for pain control, with NSAIDs shown to reduce pain in the short term without significantly increasing the risk of adverse events 1.
Rehabilitation and Prevention
- Begin gentle strengthening exercises such as towel scrunches with your toes and resisted ankle movements using a resistance band, with exercise therapy shown to be effective in recovering joint functionality and preventing recurrent ankle sprains 1.
- Maintain proper balance between activity and rest, avoiding activities that cause significant pain, and gradually increase activity as pain allows.
- Avoid running, jumping, or pivoting movements until you can walk without pain, typically 2-4 weeks post-injury, to prevent further injury and promote healing.
Additional Recommendations
- Identify and address modifiable risk factors, such as workload and level of sports participation, to minimize the risk of future injury recurrence 1.
- Consider using semirigid supports, which have been shown to be superior to elastic bandages in providing protection against future ankle sprains 1.
- Ankle disk or proprioceptive neuromuscular facilitation exercise regimens may also be helpful in preventing recurrent ankle sprains, although the literature supporting this is limited 1.
From the Research
Treatment Options
- Non-steroidal anti-inflammatory drugs and early mobilisation are strongly recommended for pain, swelling, and function after an acute ankle sprain 2
- Exercise and manual therapy techniques have moderate evidence supporting their use in the treatment of acute ankle sprains 2
- Bracing and neuromuscular training are recommended for preventing recurrence of ankle sprains 2
- Cryotherapy, functional supports, early ambulation, short-term NSAIDs, and rehabilitation are highly recommended for ankle sprain management 3
Rehabilitation and Prevention
- A thorough clinical evaluation is necessary to ensure an accurate diagnosis and appropriate treatment prescription 4
- Rehabilitation strategies, including exercise and manual therapy techniques, can help improve function and reduce the risk of recurrence 2, 4
- Prevention of recurrent sprains is crucial, and strategies such as bracing, neuromuscular training, and ankle strengthening exercises can be effective 2, 4
Current Guidelines
- The Ottawa rules, manual therapy, and early ambulation are recommended for ankle sprain management 3
- Updated clinical practice guidelines emphasize the importance of diagnosing, managing, and preventing acute ankle sprains and chronic ankle instability 5
- Current evidence supports the use of a combination of treatment strategies, including non-steroidal anti-inflammatory drugs, early mobilisation, exercise, and manual therapy techniques, for the treatment of acute ankle sprains 2, 3