Sprained ankle

Sprained ankle injuries are quite common, usually painful, and, in most cases, simple to treat at home using the RICE protocol:

• Rest your ankle by not walking on it.
• Ice should be immediately applied to keep the swelling down. It can be used for 20 to 30 minutes, three or four times daily. Do not apply ice directly to your skin, protect your skin with a towel.
• Compression dressings, bandages or ace-wraps will immobilize and support your injured ankle.
• Elevate your ankle above the level of your heart as often as possible during the first 48 hours.

It is the ankle ligaments that are injured in a sprained ankle, usually the lateral ligaments on the outside of the ankle. They can range from tiny tears in the fibers that make up the ligaments to complete tears. Ankle sprains are graded according to how much damage has occurred to the ligaments, from mild to moderate to severe.

A mildly sprained ankle will usually respond well to the RICE protocol described above, along with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. These over the counter medicines can help control pain and swelling.

Nonsurgical treatment of a sprained ankle

In addition to the RICE protocol and medications, you may need to use crutches for the first few days. A Grade 2 sprained ankle may require the use of a removable plastic device such as a cast-boot or air stirrup-type brace to provide additional support. For a Grade 3 sprained ankle, a short leg cast, or cast-brace may be applied for 2 to 3 weeks.

Your physician may recommend rehabilitation exercises for your sprained ankle. These are used to prevent stiffness, increase ankle strength, and prevent chronic ankle problems.

Surgical treatment for a sprained ankle

Ankle sprains rarely require surgical treatment. However, if you experience persistent ankle instability after several months of nonsurgical treatment and rehabilitation, your physician may recommend arthroscopic surgery to reconstruct the torn ligaments.