Caring for Your Sprained Ankle A sprain is an injury to the ligaments and tissues around a joint. Sprains usually cause swelling and eventual bruising. Ligaments, tendons, and small blood vessels are stretched and sometimes torn when a joint is sprained. The goals of treating an ankle sprain are to decrease swelling, control pain, and allow you to return to full activity as soon as possible. The following recovery timeline is approximate and will vary according to your injury, age, and prior level of activity. PHASE 1. Treatment of the Acute Injury (1-3 days) Phase 1 will last approximately 1-3 days following your injury. Treatment goals in this phase are to minimize swelling and allow you to begin walking. 1.Ice Alternate 20 minutes on and 40 minutes off for the first 24-72 hours following the injury, or until the swelling goes down. 2.Elevation Keep your ankle elevated to reduce swelling and allow fluids to flow back toward your heart. Elevate your foot higher than the level of your heart as often as possible. This is often easiest while lying down with your foot propped up on pillows. 3.Compression/Support Wrap the ankle with an Ace wrap. The wrap should be snug but not tight. 4.Exercises Begin flexibility (range of motion) exercises as soon as you can do them without pain. Move your foot up and down as though pressing on a gas pedal. Make circles with your foot, both clockwise and counterclockwise. As tolerated, begin bearing weight on your foot. In either a sitting or standing position, shift your weight from front to back and from the inside to the outside of your foot. 5.Shoes High-top, lace-up shoes such as hiking boots provide the best support. PHASE 2. Ongoing Treatment and Rehabilitation (3 days to 2 weeks) Phase 2 starts around the third day following your injury and generally lasts up to two weeks. The goal during this period is to enable you to walk without a limp. 1.Continued use of ice and elevation If swelling persists, elevate your foot and place ice your ankle twice a day. 2.Exercises Do all exercises slowly and stop if the pain increases. Flexibility exercises. Continue the flexibility exercises from Phase 1 throughout the day for circulation and to regain normal range of motion. Strengthening exercises. Once you can walk without pain, try rising up on your toes, then try walking on your heels and on your toes for 10-20 feet two or three times a day. Balance exercises. You may also begin balancing on the injured leg. When you can do this comfortably for 30 seconds, challenge yourself by reaching forward and to either side while balancing on the injured leg. Try 5-10 repetitions for 30 seconds each, two or three times a day. PHASE 3. Rehabilitation for Return to Prior Activity Level (2-6 weeks) After Phase 2 you should be able to do your usual amount of walking without a limp. Phase 3 usually lasts from two to six weeks and will enable you to resume your usual level of activity, at which point your rehabilitation will be complete. The first set of exercises helps you resume day-to-day activities; the second, optional set of exercises is for those who regularly engage in sports or other athletics. You should complete as many of these exercises as necessary to resume your previous level of activity. Progress from one exercise to the next only when you can perform the exercise painlessly and with good control. SERIES 1: Rehabilitation for day-to-day activity Step-ups and step-downs: Do these 10 times, twice a day. Once you are comfortable with the exercises, try doing them without hand support. Step-ups. Stand on a flight of stairs. Hold onto a railing or wall for balance. With the injured leg, step up onto the next step. Keeping your weight on the injured leg, bring the "good" leg up to the step. Lower the "good" leg to the step below. Do not shift your weight onto the "good" leg. Return to starting position. Step-downs. Stand on a flight of stairs, facing the stairs and holding onto a railing. Standing on the injured leg, slowly lower the "good" leg down to the step below. Do not shift your weight onto the "good" leg. Return to full upright stance on the injured leg. SERIES 2: Rehabilitation for athletic activity Hop up and down and side to side with feet together. Do this 10 times, twice a day. Progress to hopping only on the affected leg, up and down, side to side, and turning in clockwise and counterclockwise circles. Do this 10 times, twice a day. Progress to jogging in a straight line on level ground. Take one mile every other day, alternating between jogging and walking every quarter mile. Slowly increase the proportion of the mile that you jog. After you can jog the whole mile, begin increasing the distance to two miles. When you reach two miles, you may add 10% of the distance or time per week until you have reached your target distance. When you can jog one mile without pain, progress to sprinting in a straight line, running in large circles decreasing into small (both clockwise and counterclockwise circles), running figure eights, and cutting back and forth at 45 and 90 degree angles. Sport-specific activity: Return to structured team practice or individual sport, starting with a limited practice. For example, a soccer player would start in a game at 5 to 10 minutes each "half" and slowly increase playing time. A tennis player might begin by hitting balls against a wall and progressing first to doubles play, then to singles. Call your doctor’s office if: The sprain does not improve as expected. You are unable to bear weight on the affected foot within three days after the injury. You experience increased pain and swelling after the first three days. You have any questions regarding the care of your ankle.
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