Ankle > Ankle Sprain > Treatments

   Splints and Bracing

Home Recovery

Physicians generally recommend that you avoid sports and everyday physical activities until your ankle has healed. Continue using crutches as prescribed by your doctor. Household tasks that require you to be on your feet may be difficult for a few weeks after a severe ankle sprain. It can be helpful to arrange for someone to visit you to help with any physical chores. In general, you should continue R.I.C.E. treatment (rest, ice, compression, elevation) as instructed by your doctor until symptoms go away. After 72 hours, your physician may prescribe heat therapy. Only apply heat if the sprain has healed, which may take up to three months for a severe sprain. Heat draws blood to the skin around the ankle, which can increase swelling and internal bleeding if used too soon after a sprain. Many heating treatments are available and physicians generally suggest a specific heat therapy at their discretion. Heating options include heat lamps, hot showers, heating pads, heat ointments, and whirlpool or bath treatments. Massage also may be used to soothe muscle pain. However, massaging an injured ankle can disrupt the healing process and damage injured ligaments right after an injury. Your physician will decide when it is safe to begin ankle massage. Proper nutrition may also help heal an ankle sprain. Your physician may suggest taking vitamin supplements that contain vitamin C, vitamin A, vitamin E, and selenium. However, research has not yet proven how important nutrition is for healing nor which vitamins, minerals, or supplements are the most effective. Your physician will either suggest physical therapy that can be done at home or refer you to a physical therapist within a week after the sprain to help you restore range of motion in your ankle.

Physical therapy usually is prescribed to help ligaments heal after most moderate and severe ankle sprains. As soon as possible after the sprain, your physician may refer you to a physical therapist to begin early motion, which helps circulate fluid out of the ankle. Early motion consists of simple up and down flexion and extension, and progresses to small circles or drawing the alphabet on the floor with your toes. Therapists also may use electrical stimulation to control swelling. Knowing when to start more vigorous rehabilitation exercises is difficult and should be decided by your physician. Physicians generally recommend that you avoid bearing weight and walking in pain after an ankle sprain. Patients tend to heal better in the long-term if they start rehab slowly, instead of rushing to begin painful exercises on an ankle that has not yet healed. When swelling and pain have gone away and you feel comfortable without supportive wrapping, you usually start an exercise program to strengthen all the muscles around your ankle. Elastic bands are often used to provide resistance as you move your ankle in different directions. The amount of resistance increases over time as you regain strength in the muscles around the ankle. You may help your ankle feel better by icing it for 10 minutes both before and after rehab exercises. It is particularly important to strengthen the peroneal muscles, located on the outside of your lower leg around your small lower leg bone (fibula). The peroneals help keep your ankle from turning inward. Arthritis may result from repeated ankle sprains, which can hinder your ability to return to your previous activity level. People with arthritis or who suffer repeated ankle sprains may need to spend extra time in rehab and perform a more elaborate training program. The final steps of rehab help increase coordination, and may include balance beam exercises and running in a figure-eight pattern. When the injured ankle is about 90 to 100 percent as strong as the uninjured ankle, you may be ready to begin returning to activities. Most patients can rehabilitate their ankles with less than three months of physical therapy and return to activities at full strength.

Prevention

To prevent the recurrence of ankle sprains, you should make the stretching and strengthening you learned in physical therapy part of your regular exercise routine. A strong and flexible ankle may be more able to withstand any abnormal positions and strain that occur during sports and recreational activities. Before activities, remember to warm up your ankle muscles by stretching in all directions. Tight ankle muscles and ligaments may be more apt to pull or tear. Replace athletic shoes when the padding or the tread wears out. Avoid participating in activities in old, worn-out shoes because they do not provide good padding or side-to-side support.

In general, you should try to provide extra support to your ankle for at least 12 months after a severe sprain, possibly longer. Taping is a good preventive measure if it is done immediately before participating in the sport and if the person doing the taping is trained in proper techniques. Ankles are usually taped all the way from the midfoot to the lower calf. Physicians generally do not advocate the use of braces for people who have not had ankle injuries. But for people who have had recurrent injuries and those in the early post-injury period, braces may be useful to enhance recovery and prevent further injury. Neoprene sleeves simply provide compression and other lace-up types of braces provide more support using metal or plastic strips on the sides of your ankle.

DEALING WITH PAIN

A small amount of pain is normal during activities, but if you feel so much pain in your ankle to warrant taking a painkiller before an activity, you should consider cutting back or stopping. If you experience significant pain in your foot or ankle, do not continue to run on a sore ankle. Pain after rehabilitation could be a sign that you have excess scar tissue, loose fragments of bone or cartilage that were not seen on the initial X-rays, or other minor foot and ankle injuries that need proper treatment before you can return to activities.

In conjunction with R.I.C.E. (rest, ice, compression, and elevation), moderate or severe ankle sprains may need to be immobilized in a splint or brace for a few weeks immediately after the injury. Simply walking around can aggravate a sprained ankle. Ankle splints or braces help speed recovery and support your ankle. Crutches are usually prescribed, irrespective of the brace, until you are able to walk comfortably. For severe, Grade III sprains, your ankle is often immobilized in a splint. Inflatable splints are often used because they are adjustable depending on the amount of swelling, and removable so that you can begin gentle movement exercises to help circulate fluid in the ankle. When the splint is no longer necessary, your physician may prescribe an ankle brace. Mild to moderate sprains also may require you to wear a neoprene sleeve for compression or a lace-up type brace that has metal or plastic bars on the sides. Removable ankle braces help protect your ankle from further injury. Many braces are designed to limit bending and twisting in the ankle. If you happen to step on an uneven surface or lose your balance, your ankle is held in proper position. Physicians often recommend that you wear a brace during activities for up to 12 months after an ankle sprain. Many variables determine the type of brace you need and how long you need to wear it. Some athletes require repeated bracing for recurrent sprains while others may only need to wear a neoprene sleeve for one to three months. Your physician will probably prescribe a few regular check-up visits if you have a moderate or severe sprain, but most of the treatment can be done at home.