What are the recommendations for light duty after an ankle sprain?

Recommendations for Light Duty After an Ankle Sprain

For ankle sprains, patients with a distortion should return to light duty work after 2 weeks with restrictions, while those with partial or total ligament rupture should return after 3-6 weeks with similar restrictions. 1

Return to Work Timeline

Distortion (Grade I Sprain)

• Return to light duty: 2 weeks 1
• Full return to former work: 3-4 weeks (depending on job requirements) 1
• Restrictions during light duty period:
  • Mostly sitting work 1
  • Not exceeding 10 kg of lifting 1
  • Limited standing and walking on uneven surfaces 1

Partial or Total Ligament Rupture (Grade II-III Sprain)

• Return to light duty: 3-6 weeks 1
• Full return to former work: 6-8 weeks (depending on job requirements and physiotherapy results) 1
• Restrictions during light duty period:
  • Mostly sitting work 1
  • Not exceeding 10 kg of lifting 1
  • Limited standing and walking on uneven surfaces 1

Treatment During Recovery Period

Acute Phase Management

• Avoid activities that cause pain and seek medical attention 1
• Apply cold therapy (ice and water in a damp cloth) for 20-30 minutes, 3-4 times daily to reduce pain and swelling 1
• Consider compression wrap for comfort, ensuring it doesn't compromise circulation 1
• Use functional support (brace or tape) rather than immobilization 1
  • Ankle braces show greater effects compared to other types of functional support 1
  • Workers using semi-rigid ankle braces resume work faster than those using elastic bandages (4.2 days sooner) 1

Rehabilitation Phase

• Begin exercise therapy as soon as possible to improve outcomes and prevent recurrence 1, 2
• Exercise therapy should focus on:
  • Balance and coordination training 1
  • Proprioceptive exercises 1
  • Functional rehabilitation 3
• Continue using functional support (brace or tape) to prevent recurrence, especially in patients with history of ankle sprains 1

Special Considerations

Severity Assessment

• The degree of injury (distortion vs. ligament rupture) should be determined to guide treatment and work return timeline 1
• Key physical examination findings associated with more severe sprains include:
  • Swelling and hematoma 1
  • Pain on palpation 1
  • Positive anterior drawer test 1

Monitoring Progress

• Re-examine 3-5 days after injury to distinguish partial tears from frank ligament ruptures 1
• Monitor for persistent pain (lasting 6+ weeks), which may indicate complications requiring additional treatment 4

Common Pitfalls to Avoid

• Inadequate rehabilitation is a common cause of persistent pain and delayed return to work 4
• Returning to full duty too soon increases risk of reinjury 1, 3
• Overreliance on passive treatments (like Kinesio tape) without proper exercise therapy 5
• Prolonged immobilization (>10 days) leads to worse outcomes than functional treatment 1

By following these evidence-based guidelines for light duty after ankle sprains, healthcare providers can optimize recovery and facilitate appropriate return to work while minimizing the risk of reinjury and chronic instability.