How to deal with ankle sprains
with advice from Kate Chewning, PT, DPT,
Maria Fermoile, PT, DPT, OCS
and Tenille Policastro, PT, DPT
Ankle sprains are a common injury. They can occur during strenuous activity, like playing a sport, or something as simple as missing a step down from a curb.
If you’ve injured your ankle, Kate Chewning, a physical therapist at Allegheny Chesapeake Physical Therapy (a Physiquality member in Pennsylvania) reminds you to R.I.C.E.:
Rest. Kate recommends trying to stay off your feet. She says, “Don’t walk or put too much weight on your affected ankle, as this will only increase the stress to your ligaments,” increasing the time it will take to heal.
Ice. Application of an ice bag, cold gel pack, or similar item will aid in decreasing inflammation while also helping with pain relief. Kate advises making your own ice massager by freezing water in a paper cup. Simply tear back the edges of the cup to apply the ice to the skin in a circular motion.
Compression. Applying a compression wrap, such as an ACE bandage, will help to minimize swelling, she says. But be sure not to wrap it too tightly! Improper bandaging can cut off your circulation, which would make the injury worse.
Elevation. Putting your ankle at heart level, or close to it, can decrease swelling in the ankle and allow the blood to circulate back into your system.
One thing to keep in mind: Be sure to ice for no more than 20 minutes at a time, every 1-2 hours. And some doctors are questioning whether ice should be used on all injuries, as the swelling and inflammation are a part of the healing process. Consider their opinions in our previous post here.
Most ankle sprain symptoms will improve over three to four days, but there are a few signs that you need to see a doctor or physical therapist to treat your ankle, says Tenille Policastro, another physical therapist at Allegheny Chesapeake Physical Therapy. If your foot or leg bends at an abnormal angle, you cannot move your ankle, or you feel severe pain and/or tingling, she says, you should immediately consult a physical therapist or doctor. If you’re still having problems with any combination of pain, swelling, bruising, and the inability to bear weight on the foot after more than four days, this is also a sign to seek assistance.
Maria Fermoile, a physical therapist at Alliance Rehabilitation, a Physiquality network member in Fresno, California, says that a physical therapist can help in a variety of ways after an ankle sprain. She points to a couple of recent studies in the Journal of Orthopedic and Sports Physical Therapy: One concludes that patients who undergo PT after an ankle sprain have far better results than those that simply do exercises at home. Another study, published last fall, concludes that a training program is effective in treating ankle sprains.
Maria advises going to physical therapy to start with gentle range of motion and exercises. The PT will assess the injury to determine whether compression or kinesiology taping are necessary to decrease swelling and assist with pain management. Physical therapy treatment could also include a stretching and strengthening exercise progression, balance exercises, and proprioception training, which helps strengthen all of the muscles within the joint.
||Kate Chewning, PT, DPT, is a staff physical therapist at the Wexford office of Allegheny Chesapeake Physical Therapy, a Physiquality member with 10 locations in Pennsylvania. She completed both her Doctorate of Physical Therapy and her Bachelors of Science at Chatham University. She is a member of the American Physical Therapy Association and has a special interest in manual therapy.
||Maria Fermoile is a doctor of physical therapy at Alliance Rehabilitation, a Physiquality network member in Fresno, Calif. In addition to being an expert clinician, Maria has guest lectured for Fresno State’s PT and Kinesiology programs, has served as a clinical educator for PT students, assisted in the development and accreditation of College of the Sequoias Physical Therapist Assistant Program, and also served as a full-time professor and Academic Coordinator of Clinical Education for PTA students.
||Tenille Policastro, PT, DPT, is a full-time coverage physical therapist at Allegheny Chesapeake Physical Therapy, a Physiquality member with 10 locations in Pennsylvania. She completed both her Doctorate of Physical Therapy and her Bachelors of Science at Slippery Rock University.
For further information, look through our selection of articles on injury prevention and treatment, in addition to the below links:
Quinn, Elizabeth. Balance training and proprioception. About.com: Health, December 15, 2014.
Journal of Orthopedic and Sports Physical Therapy.