How do I manage my ankle sprain?

What's more common than an ankle sprain, right? Yet, many people experience long-term effects from their ankle sprain. This could be because people don't know exactly what to do to optimize healing.

Here's how to manage your ankle sprain in the best way possible.

What to do immediately after the sprain?

The initial pain tends to paralyze us and scare us, which is normal. First, take the time to calm down, and then try the following:

• Gently move your toes a little
• Touch your toes and foot with your fingers to see if you still have good sensation
• Try to make small movements with your ankle gently

If all goes well, then you can be more reassured.
You can try putting your foot on the ground without putting weight on it and see how it goes. Just being able to put your foot on the ground is a good sign, even if only 10-20% of your weight is tolerable. If you are able to limp 3-4 steps, it is an even better sign.
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*If you are unable to put any weight on your foot (not even a tiny bit), you should consult a physiotherapist or your doctor to make sure there is no fracture.

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*Note that the fear of pain or injury on the spot can make us very apprehensive and unwilling to put weight on the foot. It is important to take the necessary time to calm down before attempting to put a little weight on it.

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The acute phase 0-48 hours:

For this phase, here are the important elements:

• Avoid doing what hurts
• Continue to do anything that doesn't hurt (even with a large swelling, if walking doesn't hurt, you can walk on the foot)
• Avoid taking anti-inflammatory drugs (see the blog article on the management of sprains – Link to Blog #3)
• Use a compression bandage on the ankle to help reduce swelling
• Elevate your foot in the air whenever you are resting sitting or lying down

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The subacute phase from day 2:

From day 2, it is important to start stimulating the ankle very gradually and without increasing the pain. Here's what to do:

• Practice putting weight on the foot (standing facing the counter)
• Walk with small steps around a table or counter (to have support if needed)
• When resting, move the foot in all directions (foot up, foot pointed, foot inward and foot outward)
• Do a pain-free cardio activity to promote good blood circulation for up to 20 minutes, twice a day. For example:
  • Do stationary cycling (if it is painful, put the ankle on a bench to the side and pedal with the healthy leg)
  • Swim without using your legs (use a float to keep your legs on the surface).

During this phase, use pain as an indicator to know if you're overdoing it. There should be no increase in pain. It's important to listen to your body.

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Days 2 to 7:

Gradually increase weight-bearing and walking as tolerated. Here are some exercises to do without increasing pain, while holding onto a counter for support:

• Balance on one leg on the injured ankle.
• Rise up onto your toes.
• Do small squats.
• Practice walking without limping (take smaller steps if needed).

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Days 7 to 14:

After 7 days, there should already be significant improvement. Here are some exercises you can practice, again without increasing pain:

• If you are no longer limping, you can increase your walking distance. Otherwise, continue with short distances.
• Go up and down stairs without limping, using a handrail for support. Gradually reduce your reliance on the handrail.
• Balance on your injured ankle and turn your head from side to side to increase the difficulty of the exercise.

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Weeks 2 to 8:

Depending on the severity of the sprain, ligaments can take up to 8 weeks (and sometimes longer) to regenerate. Therefore, it's important to do exercises throughout this healing process to optimize the quality of the new tissue that will be formed.

At this stage, exercises should be more specific to each person's condition and functional needs. The following elements should be gradually incorporated:

• Walking on uneven surfaces.
• Jumping (with two legs first, then with one leg).
• Running.
• Squatting or kneeling.
• Exercises specific to your sport or work.

Throughout this process, if you can't control the level of pain, you're afraid to do exercises, or your condition isn't improving day by day, you should consult a physiotherapist.

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Sources

• Petersen W, Rembitzki IV, Koppenburg AG, Ellermann A, Liebau C, Brüggemann GP, Best R. Treatment of acute ankle ligament injuries: a systematic review. Archives of orthopaedic and trauma surgery. 2013 Aug;133(8):1129-41.
• Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE.