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How to Manage an Ankle Sprain

By Laura Henn, ATC, PTA, CSCS

A sprained ankle is the most common injury in sports requiring quick stops, sudden changes in direction and jumping. It can also happen when you awkwardly step on an uneven surface or step down at an angle.

How It Happens
Ankle sprains occur when the foot twists, rolls or turns beyond its normal motions, causing the ligaments to stretch and tear. Top of page

When excessive force is applied to the ankle’s soft tissue structures, you may even hear a “pop”. That’s when pain and swelling set in.

The amount of force from a turned ankle determines the grade of the sprain. A mild sprain is a Grade 1. A moderate sprain with partial ligament tearing is a Grade 2. A severe sprain is a Grade 3 with significant instability or looseness.

Early Treatment

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Remember R.I.C.E (rest, ice, compression and elevation):

  • Rest your ankle by not walking on it.
  • Ice should be applied immediately. It’s crucial to control swelling. Ice should be used for 20 to 30 minutes, three or four times daily. If you don’t have ice, frozen vegetables or snow also work well. If using a chemical ice pack, apply a cloth between the skin and pack to avoid freezer burn to the skin. Avoid any kind of heat or hot tubs since this will increase swelling.
  • Compression dressings, stockings, or ace-wraps support the injured ankle and further control swelling. This should be worn continually except when applying ice.
  • Elevate the ankle above the level of the heart as much as possible for 24 hours after the injury.

Tylenol or other pain relievers may be used for pain. Controlling swelling in the early stages is key to quick recovery. Use crutches if walking with a notable limp. Usually swelling and pain last for a few days. If the ankle is significantly tender in one spot, excessively swollen or unusually painful, see your doctor for further evaluation and possible x-rays to rule out a broken bone. The doctor may suggest a removable cast boot or air splint to immobilize the joint for proper healing.

Continued Management

Wearing a lace-up ankle brace will help support the ankle while walking during the day and also offer necessary stability for return to sport. A recovering ankle should be taped or braced for 4-8 weeks after injury while the ligament heals to prevent recurrent sprains.

To prevent further injury and for peak performance, the injured ankle must regain normal strength and balance.

For more information about physical therapy and athletic training services, call the Institute for Athletic Medicine (IAM) at 612-672-7100 or the 24-hour Injury Hotline at 952-920-8850. Visit us online at

About the author

Laura Henn, ATC, PTA, CSCS, sees patients at IAM-Roseville and is the athletic trainer for
Hill-Murray High School. To schedule an appointment for physical therapy at any of our
over 30 Twin Cities locations, call 612-672-7100.