What is the recommended treatment for an ankle sprain?

From the Guidelines

The recommended treatment for an ankle sprain is functional treatment in the form of exercise and functional support, such as a brace or tape, which is preferred over immobilization. This approach is supported by the most recent and highest quality study, which found that functional treatment leads to the fastest resumption of work and daily life activities compared to other treatment strategies 1.

Key Components of Treatment

• Rest the ankle by avoiding weight-bearing activities for 24-72 hours depending on severity
• Apply ice packs for 15-20 minutes every 2-3 hours during the first 48-72 hours to reduce swelling and pain
• Use an elastic compression bandage wrapped snugly but not too tightly around the ankle to minimize swelling
• Elevate the ankle above heart level whenever possible
• For pain management, take over-the-counter medications like ibuprofen (Advil, Motrin) 400-800mg every 6-8 hours or naproxen (Aleve) 220-440mg every 12 hours with food, which also help reduce inflammation
• Acetaminophen (Tylenol) 500-1000mg every 6 hours can be used for pain relief without anti-inflammatory effects

Rehabilitation and Prevention

After the initial rest period, gradually reintroduce movement with gentle range-of-motion exercises and progressive weight-bearing as tolerated. Physical therapy focusing on balance, strength, and proprioception exercises helps prevent recurrent sprains by restoring ankle stability 1. Coordination and balance training have been shown to prevent recurrent ankle sprains, and exercise therapy, such as neuromuscular training, has a positive effect towards prevention of lateral ankle sprains (LAS) and especially recurrent LAS.

Prognostic Factors

It is essential to consider prognostic factors that may influence recovery and increase the risk of future injury recurrence, such as the patient's current level of pain, their workload, and level of sports participation 1. Addressing these factors early in the treatment process can help improve outcomes and prevent chronic ankle instability (CAI).

Most ankle sprains heal within 2-6 weeks, but severe sprains may take longer and benefit from professional evaluation. Surgery should be reserved for patients with lateral ligament ruptures to avoid unnecessary invasive treatment and risk of complications 1.

From the Research

Ankle Sprain Treatment

The recommended treatment for an ankle sprain can vary depending on the severity of the injury.

• The PRICE method (protection, rest, ice, compression, and elevation) is often recommended for treating ankle sprains 2.
• Early mobilization may be more effective than immobilization in allowing patients to return to work and reducing pain 3.
• Functional treatment, which includes early mobilization and rehabilitation, may be more effective than immobilization in treating acute ankle sprains 4.
• The use of cold compress in the treatment of acute ankle sprain may not have significant benefits 5.
• A study found that the acute treatment of ankle sprains in Danish emergency rooms was not in accordance with international consensus, and that the instruction in rehabilitation should be improved 6.

Treatment Options

• Immobilization: This involves using a cast, splint, or brace to keep the ankle still and allow it to heal.
• Functional treatment: This involves early mobilization and rehabilitation to help the ankle heal and regain strength and mobility.
• PRICE method: This involves protecting the ankle from further injury, resting it, applying ice to reduce pain and swelling, compressing it to reduce swelling, and elevating it to reduce swelling.
• Physiotherapy: This involves exercises and other treatments to help the ankle heal and regain strength and mobility.

Recovery Time

• The recovery time for an ankle sprain can vary depending on the severity of the injury.
• A study found that patients who received early mobilization treatment were more likely to be back to full work 10 days after injury than those who received immobilization treatment 3.
• Another study found that functional treatment was associated with a shorter time to return to work and sport 4.