UW Health's Sports Medicine doctors in Madison, Wisconsin, treat a wide range of common athletic injuries, including ankle sprains.
About Ankle Sprains
An ankle sprain occurs when fibers of the ligaments, which support the ankle, are stretched or torn.
- In a first-degree sprain the fibers are stretched.
- A second-degree ankle sprain is one in which portions of the ligament(s) are torn.
- A third-degree sprain is defined as a complete tearing of the ligament(s) supporting the ankle.
Ligaments on the lateral, or outside aspect of the ankle are more frequently sprained than the medial ligaments, or inside aspect of the ankle. The severity of injury will determine the amount of time lost from activity, the type of treatment and rehabilitation. Although injury severity varies greatly, some general treatment and rehabilitation guidelines are appropriate for all ankle sprains.
Immediately after the injury occurs, ice should be applied to the ankle and the leg should be elevated above the level of the heart for 15 to 20 minutes. After icing, an elastic bandage should be applied to the ankle to provide compression to minimize swelling. The combination of rest, ice, compression and elevation (R.I.C.E.) should continue for a minimum of 48 to 72 hours.
- Rest: Decrease, modify or eliminate weight-bearing and other painful activities
- Ice: Apply ice for 15 to 20 minutes several times a day
- Compression: Wrap the injured ankle with an elastic bandage
- Elevation: It is difficult for the leg vessels (veins) to remove swelling from the foot and ankle, therefore, elevate the limb higher than the level of the heart
X-rays may be needed when there is tenderness over the ankle bones to rule out a fracture.
After the initial inflammation phase is over (usually 48 to 72 hours), moist heat may be used to treat an ankle sprain. However, heat should not be used when swelling is present. Compression and elevation should continue as long as swelling is present.
Return to Activity
Return to activity may be attempted once there is minimal pain and swelling. The athlete should be able to perform a series of functional testing before returning to activity or sports:
- Single leg toe raises with full weight on the injured ankle
- Jumping up and down
- Jogging, running and sprinting both straight ahead and with cutting (change of direction)
Rehabilitation of ankle sprains consists of regaining range of motion, strengthening muscles surrounding the ankle joint, and balance and coordination exercises. Strengthening exercises such as toe raises, calf press and the use of rubber tubing or a towel to resist side-to-side ankle movements should be performed. Balance exercises should not be overlooked. Activities such as tilt board exercises, one legged standing and jumping rope also improve coordination and balance after injury. Consultation with an athletic trainer or physical therapist may be needed in order to develop the right rehabilitation program for an ankle sprain.
Preventing Ankle Sprains
Prevention of ankle sprains includes the use of ankle braces and/or ankle taping. A consistent program of lower leg stretching and strengthening, as well as agility drills, will also help decrease the incidence of ankle sprains. A consistent program for ankle stretching, strengthening and balance exercises may help decrease the incidence of ankle sprains.