What is the treatment timeline for an ankle sprain (lateral ankle ligament sprain)?

From the Guidelines

The treatment timeline for an ankle sprain typically spans 4-6 weeks, with specific interventions for each phase, as recommended by the most recent and highest quality study 1.

Initial Treatment (0-72 hours)

• Follow the RICE protocol (Rest, Ice, Compression, Elevation) for the first 24-72 hours, as suggested by 1 and 1
• Apply ice for 15-20 minutes every 2-3 hours
• Use a compression bandage or ankle brace
• Keep the ankle elevated above heart level when possible
• Take over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) as needed for pain and swelling, but with caution due to potential complications 1

Progressive Rehabilitation (after 72 hours)

• Begin gentle range-of-motion exercises around day 3-5, such as ankle circles and alphabet tracing with your foot
• By week 2, start progressive weight-bearing as tolerated with supportive footwear or an ankle brace, as recommended by 1 and 1
• Weeks 2-4 should include strengthening exercises like resistance band work and balance training
• Return to normal activities gradually between weeks 4-6, continuing to wear supportive footwear or bracing during physical activity

Prevention of Recurrent Sprains

• Consider using ankle braces as an efficacious option for preventing recurrent lateral ankle sprains, as suggested by 1
• Supervised exercise-based programs are preferred over passive modalities to stimulate the recovery of functional joint stability, as recommended by 1

Severe Sprains

• Severe sprains with complete ligament tears may require longer recovery periods of 8-12 weeks or possibly surgical intervention, as noted by 1 and 1

From the Research

Ankle Sprain Treatment Timeline

The treatment timeline for ankle sprains can vary depending on the severity of the injury. Here are some general guidelines:

• For grade I and II sprains, the focus is on accurate diagnosis, early use of RICE (rest, ice, compression, and elevation), maintenance of range of motion, and use of an ankle support 2.
• For grade III sprains with complete ligament tears, surgical intervention may be required 2.
• Early motion and mobility are recommended, but ligamentous strength does not return until months after an ankle sprain 2.

Treatment Options

Some treatment options for ankle sprains include:

• Non-steroidal anti-inflammatory drugs (NSAIDs) for pain, swelling, and function 3.
• Early mobilization for pain, swelling, and function 3.
• Exercise and manual therapy techniques for pain, swelling, and function 3.
• Bracing and neuromuscular training for preventing recurrence of ankle sprains 3.
• Cryotherapy, functional supports, and short-term NSAIDs for ankle sprain management 4.
• Rehabilitation and prevention strategies to reduce the risk of recurrent sprains 5.

Clinical Practice Guidelines

Clinical practice guidelines recommend the following for ankle sprain management:

• Use of the Ottawa rules 4.
• Manual therapy 4.
• Cryotherapy 4.
• Functional supports 4.
• Early ambulation 4.
• Short-term NSAIDs 4.
• Rehabilitation 4.

These guidelines are based on the best available evidence and can help guide treatment decisions for ankle sprains 6, 3, 4.