How long should I wear an ankle boot for an ankle sprain?

Duration of Ankle Boot Wear for Ankle Sprains

For ankle sprains, an ankle boot should be worn for 4-6 weeks, with the exact duration depending on injury severity, with partial/total ligament ruptures requiring the longer timeframe of 6-8 weeks. 1

Duration Based on Injury Severity

Distortion/Mild Sprain

• Duration: 2 weeks
• Return to light work: After 2 weeks (mostly sitting work)
• Full return to work: 3-4 weeks depending on task requirements 1

Partial or Total Ligament Rupture

• Duration: 4-6 weeks
• Return to light work: After 3-6 weeks (mostly sitting work)
• Full return to work: 6-8 weeks depending on task requirements 1

Post-Surgical Cases

• Non-weight bearing cast and crutches: First 2 weeks
• Weight bearing as tolerated: 3-6 weeks
• Cast replaced by brace: After 6 weeks
• Return to physically demanding job/sports: 12-16 weeks 1

Type of Support Recommended

The use of functional support (brace) is preferred over immobilization for ankle sprains, as it provides better outcomes 1:

• Ankle brace: Shows greatest effects compared to other types of functional support
• Semi-rigid brace: Enables faster return to work compared to elastic bandage (4.2 days faster) 1
• Below-knee cast: May be beneficial for a short period (<10 days) to decrease pain and edema in severe cases 1

Evidence for Effectiveness

Research shows that mechanical supports improve recovery compared to simple compression bandages:

• Below-knee cast resulted in 9% better ankle function at 3 months
• Aircast brace showed 8% improvement in ankle function compared to tubular compression bandage 2

Rehabilitation During Boot Use

While wearing the boot, supervised rehabilitation should include:

1. Early mobilization: Begin as soon as possible to prevent recurrent sprains 1
2. Exercise therapy: Focus on proprioception, strength, coordination, and function 1
3. Supervised exercises: Lead to faster return to sport than non-supervised training 1

Return to Work Strategy

Phase	Activities	Restrictions
During boot use	Mostly sitting work	Not exceeding 10 kg lifting, limit standing/walking on uneven surfaces
Transition phase	Phased rehabilitation	Focus on work-specific tasks with scheduled progression
Full return	Normal activities	Based on task requirements and physiotherapy results

Common Pitfalls to Avoid

1. Premature discontinuation: Removing the boot too early can lead to reinjury and prolonged recovery
2. Complete immobilization: Avoid prolonged immobilization (>10 days) as it leads to poorer outcomes than functional treatment 1
3. Inadequate rehabilitation: Over 70% of people continue to have problems and up to 80% resprain their ankles without proper rehabilitation 3
4. Ignoring pain: Continued activity despite pain can worsen the injury and delay healing 1

After Boot Removal

1. Continue using a brace or tape: Recommended to prevent relapses, gradually phasing out use 1
2. Exercise therapy: Continue balance and coordination training for at least 12 months to prevent recurrences 1
3. Manual therapy: Combined with exercise therapy provides better outcomes than exercise alone 1

Following these guidelines will optimize recovery from ankle sprains while minimizing the risk of chronic instability and recurrent injury.