From the Guidelines
The management of an ankle sprain should focus on functional treatment, including the use of a brace or tape, and an exercise program, rather than immobilization or the RICE protocol, as it has been shown to be more effective in promoting recovery and preventing future injuries. According to the most recent and highest quality study 1, functional support is preferred over immobilisation, especially the use of a brace, and exercise therapy should be started as soon as possible to recover joint functionality.
Key Components of Ankle Sprain Management
- Functional treatment: Use of a brace or tape to provide support and stability to the ankle, allowing for early mobilization and weight-bearing activities.
- Exercise program: A structured program focusing on range of motion, strength, and balance exercises, such as ankle circles, calf stretches, and single-leg balance training, to promote recovery and prevent future injuries.
- Pain management: Over-the-counter pain medications like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help manage pain and reduce inflammation.
- Gradual return to activity: Avoid weight-bearing activities initially, then gradually reintroduce movement as pain allows, to prevent further injury and promote proper healing.
Importance of Early Mobilization and Exercise
Early mobilization and exercise are crucial for promoting recovery and preventing future injuries, as they help to restore joint functionality, improve strength and balance, and reduce the risk of chronic ankle instability 1.
Role of Healthcare Provider
A healthcare provider should be consulted to rule out fractures or complete ligament tears, especially in cases of severe sprains with significant instability or inability to bear weight 1.
Prevention of Future Injuries
The use of functional support devices, such as a brace or tape, and exercise therapy can help prevent future ankle sprains, especially in individuals with a history of recurrent sprains 1.
From the Research
Ankle Exam with Sprain Injury
The management and treatment of an ankle sprain typically involve a combination of rest, ice, compression, and elevation (RICE) therapy, as well as protection and pain management.
- The RICE therapy is commonly used to reduce pain, swelling, and inflammation in the affected area 2.
- Cryotherapy, or the application of ice, is also a common treatment modality for acute ankle sprains, with intermittent ice applications showing promise in reducing pain and improving function 3, 4.
- Compression is another important aspect of ankle sprain management, with various forms of compression, such as elastic bandages and intermittent pneumatic compression, being evaluated for their effectiveness in reducing swelling and improving recovery 5.
Treatment Options
- Nonsurgical treatment with PRICE (protection, rest, ice, compression, and elevation) is often recommended for most ankle sprains, with a detailed examination and hands-on grading of the injury dictating treatment and forecasting recovery time 6.
- In cases where patients experience chronic pain or instability from an ankle sprain, a directed approach may be necessary to fine-tune nonsurgical treatments or suggest a surgical referral 6.
- The effectiveness of different cryotherapy protocols, such as standard ice application versus intermittent ice application, has been compared in studies, with intermittent applications showing potential benefits in pain relief 3, 4.
Management Strategies
- A systematic review of compression in the management of soft tissue ankle injuries found that compression may be an effective tool in reducing swelling and improving quality of life, but definitive conclusions are hampered by the poor quality of evidence and the variety of treatments used 5.
- The use of compression bandaging, elastic tubular bandages, and intermittent pneumatic compression has been evaluated in studies, with some showing positive effects on recovery after ankle injury 5.
- Further research is needed to determine the most effective form of compression to treat ankle sprains and to establish evidence-based management strategies for this common injury 2, 5.