What is the recommended duration for wearing a walking boot for a Grade 3 (severe) ankle sprain?

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From the Guidelines

For a Grade 3 ankle sprain, the recommended duration for wearing a walking boot is 4-6 weeks, as functional support for this period is preferred over immobilisation, according to the most recent evidence 1. This duration allows for the complete tear of the ligament to heal and reconnect properly, reducing the risk of chronic ankle instability. The use of a walking boot provides the necessary immobilization to prevent further damage while the ligament heals. Initially, it is essential to follow the RICE protocol (Rest, Ice, Compression, Elevation) for the first 48-72 hours alongside the boot, and your doctor may recommend a non-weight bearing period for 1-2 weeks before progressing to partial and full weight bearing while still in the boot. After the boot period, physical therapy for another 4-8 weeks is likely necessary to restore strength, balance, and range of motion. Key points to consider include:

  • The importance of immobilization to prevent further damage and promote proper healing of the ligament
  • The need for gradual progression from non-weight bearing to full weight bearing
  • The role of physical therapy in restoring function and reducing the risk of long-term instability
  • The preference for functional support, such as an ankle brace, over immobilisation, as shown in the study 1.

From the Research

Recommended Duration for Wearing a Walking Boot

The recommended duration for wearing a walking boot for a Grade 3 (severe) ankle sprain is not explicitly stated in the provided studies. However, some studies provide information on the use of walking boots in the treatment of ankle sprains:

  • A study published in 2020 2 discusses the management of acute ankle sprains, but does not provide specific guidance on the duration of walking boot use.
  • A study published in 2011 3 mentions that a period of immobilization and ambulating with crutches in a nonweightbearing gait may be necessary to allow for proper ligament healing, but does not specify the use of a walking boot.
  • A study published in 2012 4 recommends the use of a lace-up ankle support or an air stirrup brace combined with an elastic compression wrap to reduce swelling and pain, but does not discuss the use of a walking boot.
  • A study published in 2024 5 found that participants with a recurrent lateral ankle sprain had a lower walking boot use, suggesting that walking boot use may be beneficial in preventing recurrent ankle sprains.

Key Points

  • The use of a walking boot may be beneficial in preventing recurrent ankle sprains 5.
  • Immobilization and nonweightbearing gait may be necessary to allow for proper ligament healing 3.
  • Ankle supports and braces can reduce swelling and pain, and protect the injured ligaments 4.
  • Early mobilization can speed healing and reduce pain 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Update on acute ankle sprains.

American family physician, 2012

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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