A Simple Twisted Ankle – What Can You Do?

It’s so easy to sprain the ankle stepping off a footpath without watching, or running to catch a train or bus, let alone injuring it on the sports field. Do you know what to do with a simple, straightforward ankle sprain?

First, you need some idea of how to self assess the amount of injury. Most ankle sprains involve the soft tissues only: muscle and ligaments. These cases respond well to home management in the first few days. Signs that suggest more significant damage include the fact that the fall was accompanied by a strong sensation of something tearing or snapping apart in the outer ankle. Complete inability to take any weight on the foot may be significant, as is the immediate onset of swelling within minutes of the fall. The only way to categorically confirm bone injury is an x-ray.

Thankfully, soft tissue damage is far more common than broken bone in an ankle sprain. If you can take some weight on the foot, and walk or limp a little after the injury, it is fairly safe to assume you have not broken a bone. The following advice is applicable to every acute or recent injury. The rule to remember is RICE: Rest, Ice, Compression, and Elevation.

Rest is obvious. If it is sore to take weight or use the injured part, rest it. Put it up for the evening. Give up activities such as going to the gym or dancing class for a few days to allow symptoms to subside.

Ice next. At the time of injury, the body was in action, working muscles were pumping blood around the leg, even if the injury only occurred walking along a footpath.

When the sprain occurred, small blood vessels were overstretched and torn. Bleeding occurred in the area. Cooling the damaged part is just like turning off the hot tap. Blood vessels in the area respond to cooling by tightening up, reducing blood pumping into the damaged region.

Pure ice, wrapped in a cloth, applied for 15 minutes an hour, every hour for the first 3-4 hours post injury works best.

Compression. Just as we put manual pressure on a skin cut to stop bleeding, compression reduces bleeding under the skin and reduces swelling. An easy way to compress a damaged ankle is to tie on the ice with a bandage or scarf.

Finally, elevation. In normal daily life, the leg is down at the floor most of the day. In this position, gravity pushes everything downwards. If you leave an injured ankle down, it will swell more. It makes sense to use gravity’s effects to your advantage, so sit with the ankle raised higher than the level of the hip, to allow any extra fluid in the limb to drain away. If possible sleep with a pillow under the ankle to assist this process.

How long to recover? If the ligaments were just momentarily overstretched, take it easy for 5-10 days, let all symptoms subside and within 2-3 weeks everything will have settled and recovered. With more damage it can take up to 12 weeks to fully recover.

A really easy exercise from day two onwards is simply to balance on the sore leg. Count to 10 seconds, then 20, with the other leg off the floor. This exercise works all the muscles around the ankle, using your own body weight as resistance.

Some light gym work (non-impact) can begin from 3-4 days post injury. Until you can walk without pain running or contact sports should be avoided.