This article originally appeared in the April 2003 Women’s Health Watch and is provided courtesy of Harvard Health Publications.

Recovering from an ankle sprain

A sprained ankle is a debilitating and painful injury that can turn into a frustrating recurrent problem. But if you make an up-front investment in proper treatment and rehabilitation, you can increase your chances of a timely return to normal daily activities and exercise.

Types of sprains
An ankle sprain occurs when a ligament connecting the bones of the ankle joint is stretched or torn, often the result of stepping onto an uneven surface. In the most common type of sprain, the foot rolls inward, pulling the ligaments on the ankle’s outer side. The severity of a sprain depends on the degree of damage to the ligaments and how unstable the ankle joint becomes as a result. The more severe the sprain, the longer the recovery (see chart, below).

IImmediate care
Treatment begins with the standard RICE regimen—rest, ice, compression, and elevation. Rest your ankle by staying off it as much as possible for at least the first 24 hours. During that time, intermittently apply ice: Cover your ankle with a towel to protect the skin, then place a bag of ice on top of it. (You may also use a plastic bag of frozen peas or other vegetables.) To reduce swelling, compress the ankle with an elasticized wrap, such as an ACE bandage. Elevating your foot higher than your heart also helps. In the first 24 hours, avoid anything that might increase swelling, such as hot showers, hot packs, or heat rubs.

Rehabilitation
To recover fully, you must restore the normal range of motion to your ankle joint and strengthen the ligaments and supporting muscles. After a sprain, put weight on your ankle only when it feels comfortable to do so. Many people try to wobble around on a sprained ankle sooner than they should, while it’s still painful. This may impede healing. It would be better to use crutches or a brace until weight bearing is pain-free.

Depending upon the severity of the sprain, range-of-motion and stretching exercises can begin within the first week or two of an ankle sprain. In deciding when to start, let pain be your guide. Begin with exercises in which you’re seated or on the floor. As your ankle improves, you can advance to standing exercises. Consult your doctor about when to start these.

Don’t return to full sports activity too early, or you risk re-injuring your ankle and facing potential long-term problems. When you can stand on the toes of your injured foot for 20 seconds and hop 10 times, you’re probably ready to try jogging or fast walking again.