Orthopedics Plus

Q: I have an ankle sprain. What is the best way to treat it?

A: Sprains of the lateral aspect or outside ligaments of the ankle are one of the most common reasons for emergency department visits in the United States. Typically initial treatment will include x-ray to rule out fracture followed by rest, ice, compression and elevation (or the acronym RICE).

You may also use crutches for a few days. Exercises may be performed, but treatment usually ceases once the ability to walk normally returns. Unfortunately studies have shown there are a high number of recurrent sprains as well as chronic complications of poor balance, instability, loss of motion and arthritis with traditional ankle sprain treatment.

The best way to treat a lateral ankle sprain is in three or four phases based on the severity of injury and the type of activity to which you want to return. Phase one includes ruling out fracture, the use of the RICE principle, and crutches for mobility as needed. The second phase begins once swelling has subsided and you are able to walk without discomfort. The goal of phase two is to restore ankle range of motion and strength. This is achieved through exercises such as spelling the alphabet with toes, ankle circles, and resistance exercises. Manual techniques may also be used to restore full range of motion.

In phase three, proprioception, or your awareness of where the body is in space, is the focus. Proprioception is restored by use of a balance board, balance foam, or standing on the affected foot while playing catch or brushing your teeth. Phase four progresses from rehab to sport-specific skills such as cutting, pivoting and jumping. Treatment after a fracture is ruled out should be directed by a licensed physical therapist or in a high school setting by your licensed athletic trainer.

Restoration of motion, strength and proprioception are essential in the best treatment of lateral ankle sprains; helping to prevent further injury and chronic complications.

This answer is provided by Stacey Grosnick, Physical Therapist, ThedaCare Orthopedics Plus