Sprained ankle

Dear Alice,

What is the best home treatment for an apparently badly sprained ankle?

— Limping

Dear Limping,

Badly sprained, huh? Bummer! For this fairly common injury (about 25,000 folks tweak their ankles every day!), the best treatment really depends on the severity of the sprain. A sprained ankle can happen whenever the foot twists, turns, or rolls beyond its normal position. This causes the ligaments — elastic structures that stabilize and hold your joints in place — in the ankle to stretch or even tear. At-home treatment may do the trick and reduce swelling in a few days for minor sprains. However, with the more severe variety, some extra time and perhaps some medical intervention may be in order to help treat and prevent further damage. Moreover, it’s been noted that it can be tough to tell the difference between a severe sprain and a fracture. So, to be sure you know what you’re dealing with, having the ankle evaluated by a medical professional will help inform the appropriate course of treatment.

Once a health care provider has adequately assessed the problematic ankle and determined that your injury is indeed a sprain, they’ll likely give it a grade of either I, II, or III. Grade I sprains are minor and typically benefit from a few do-it-yourself strategies. Folks with this type of sprain may utilize the R.I.C.E. guidelines:

  • Rest: Keep the ankle immobilized and avoid activities that cause pain, discomfort, or more swelling.
  • Ice: Apply ice for 15 to 20-minute increments. Repeat this process every two to three hours throughout the day.
  • Compression: Use elastic wrap bandages on the affected ankle.
  • Elevation: Prop the injured ankle above the heart, especially at night.

R.I.C.E. helps control swelling for a few days until it feels as if the affected ankle can support weight once again. Over-the-counter pain relievers can also help reduce swelling and pain. For grade II sprains, utilizing the R.I.C.E. guidelines is also recommended, but recovery may require extra time. A provider may also try to immobilize the ankle or employ the use of a splint to assist with the healing process. More severe grade III sprains may require further immobilization of the ankle, as these sprains are associated with risk of permanent ankle instability. Ankle immobilization for a grade III sprain usually consists of a short leg cast, walking-boot, or a cast-brace for several weeks. In rare circumstances, surgery may even be required.

When swelling goes down from any type of sprain, seeking out the services of a physical therapist may be in order to help build up the ankle’s strength, balance, range of motion, and flexibility. Then, with a provider’s green light, folks can gradually return to activities that put stress on the ankle, such as playing sports or other types of physical activity. It may help to wear an ankle brace or to wrap/tape the ankle for a while after the injury. This will provide some additional support and help prevent re-injury.

While your mind might be on treatment and recovery at this time, it’s wise to starting thinking ahead as well. To help prevent future sprains, make sure to warm up before getting active, be wary of uneven terrain, wear proper and comfortable footwear, and maintain flexibility and muscle strength.

Hope you make a full rehabilitation and speedy recovery!

Last updated Jan 01, 2021
Originally published Jan 06, 1995