Sprained ankles are the most common form of injury a podiatrist sees. Some estimate as many as 25,000 happen every day in the U.S. And one of the most common questions a podiatrist gets is, “How long will I take to recover?” Your doctor can only answer, “It depends on how severe the injury is.” It also depends on the treatment the injury gets and whether the patient does the physiotherapy and exercises required.
An ankle sprain is defined as stretching, tearing or otherwise damaging ligaments around the ankle joint. It’s often caused when you step on uneven ground, which makes your ankle roll inward or outward. Rolling the ankle inward, called inversion, causes pain along the outside of the ankle. It’s not necessarily severe—often the pain goes away after a few minutes. Rolling outward, or eversion, causes pain on the inner side and can be a more severe injury. If you experience pain on the inside of your ankle, you should see a podiatrist.
The most common cause of a sprain is called plantar flexion: this means your heel is raised while your toes are on the ground. This puts the ankle ligaments under tension, making them vulnerable. Uneven ground or a twisting force can cause that rolling motion, leading to ligament damage. Most sprains are minor, but if you cannot bear weight on your ankle or if there’s significant swelling, seek medical attention from your emergency department or podiatrist.
How severe is your sprain?
A poodiatrist will put an ankle sprain into one of three classes:
- A Grade 1 sprain means there is some stretching and slight damage to ankle ligaments. You might feel some instability in the joint, slight swelling and joint stiffness and have trouble walking. Full recovery can take five days to two weeks.
- A Grade 2 sprain involves partial tearing of one or more ligaments around the ankle. Symptoms include instability in the ankle, moderate to severe pain, swelling, stiffness and possible bruising. Recovery can take four to six weeks.
- A Grade 3 sprain means the complete tearing of a ligament. You’ll know it because you’ll feel severe pain at the moment of injury but no pain in the ankle afterward. You might even hear a popping sound. The ankle will be very unstable, with extensive swelling and bruising. Recovery can take eight to 12 weeks.
Without an x-ray, it’s almost impossible to tell the difference between a severe sprain and a bone fracture. Yet most sprains don’t require surgery. The best treatment for minor sprains is rehabilitation—physiotherapy and exercise.
The RICE treatment
You might have heard a podiatrist or doctor talk about the RICE treatment for ankle sprains. This acronym stands for:
- Rest: Do not walk or bear weight on your injured ankle after a sprain. Depending on the severity, you might need an ankle brace or crutches.
- Ice: Apply an ice pack or cold pack to the sprain to reduce swelling and pain. Don’t put the ice directly on the skin—separate it with at least a thin cloth. To avoid frostbite, don’t hold the ice for more than 20 minutes at a time.
- Compression: Squeezing the injury slightly with a brace or bandage immobilizes it and helps reduce swelling.
- Elevation: Raise your ankle and rest it on something so it is higher than your waist or heart.
Some doctors add a “P” to this list to make it the “PRICE” treatment. In such cases, the first step is Protection, which means avoiding sprains in the first place by wearing the appropriate footwear for every activity.
Following an injury, you should also avoid certain factors and activities, collectively known as HARM, for 72 hours:
- Heat: No hot baths, heat packs or saunas, which can increase swelling and bleeding
- Alcohol: Drinking alcohol increases bleeding and swelling, and slows healing
- Running: This and other exercise can lead to further injury
- Massage: This can increase bleeding and swelling
A Grade III sprain might also require surgery or necessitate that you put the injured ankle in a cast or immobilizing boot.
Full recovery from an ankle sprain always requires rehabilitation. Your podiatrist will probably describe three phases of rehab:
- Rest and protect the ankle with a brace or compression bandage until the swelling goes down.
- Restore flexibility, range of motion and strength with physiotherapy and stretching exercises.
- Gradually return to normal activity through exercise and, when safe, sports once your full range of motion has been restored without pain.
If you suffer an ankle sprain, see a Heiden Orthopedics podiatrist in Park City for the right treatment to restore your full strength and range of motion as quickly as healthy.