How to Treat an Ankle Sprain

Ouch! You just stepped on a tennis ball or stumbled over an uneven surface, and now your ankle hurts. Or maybe your child twisted her ankle during soccer practice. How bad is the sprain?

Ankle sprains are common in both children and adults. While most can be treated at home, some require medical care and even physical therapy for complete recovery.

What Is an Ankle Sprain?

Ligaments are strong, fibrous tissues that stabilize the ankle, but still allow for flexibility and movement. Lateral ligaments are on the outwardly facing side of your ankle, and medial ligaments are on the inwardly facing side. Most ankle sprains affect the lateral ligaments.

When a sprain occurs, your ligaments stretch more than they are supposed to. In the more serious sprains, the ligament doesn’t just stretch, but also gets tiny tears in the tissue. In severe cases, the entire ligament may tear completely, causing instability.

How to Tell If Your Ankle Is Sprained

Ankle sprains are assessed on a scale of 1 to 3, from mild to severe.

A mild sprain (Grade 1) may cause short-term discomfort, but you can still walk; swelling is minimal and there is no bruising. Mild sprains can usually be treated at home with ice and rest. Ibuprofen can be effective for pain and to minimize swelling. If needed, you can use an over-the-counter device or wrap to create compression and support.

A medium or Grade 2 sprain may involve some tearing of the ligament. You may have moderate swelling or tenderness around the ankle and may notice some instability when you move your ankle in certain positions. Particularly if you notice instability, you should consult with your doctor rather than treating only at home.

A severe or Grade 3 sprain is very swollen, probably is bruised and is very painful to walk on. The complete ligament may be torn, and it’s important to see your doctor for care. The doctor will examine your ankle, perhaps do some gentle manipulations to determine flexibility, and may do an X-ray to check for physical damage and to ensure there is no fracture. Your doctor may immobilize your ankle with a walking boot or air cast and will refer you to a physical therapist for continued recovery. Rarely is there a need for surgery, even to repair a torn ligament.

Benefits of Physical Therapy After a Sprain

Even before your severe sprain has healed, it’s helpful to see a physical therapist. They can use different techniques to help reduce excess swelling, improve range of motion and help you get your balance back.

If you’ve had ankle sprains before, or want to reduce the likelihood of having one in the future, a physical therapist can help. They can teach you exercises to strengthen the muscles and ligaments surrounding your ankle. While many athletes may think they should wear a brace to support the ankle after an injury, when used long-term, that brace actually discourages the muscles and ligaments from getting stronger.

In addition to helping you develop strength to avoid future injuries, a physical therapist can help you with attaining better balance and proprioception—the sense you have of where your body parts are. Scientists believe that you may be more prone to misstep, perhaps twisting your ankle, if your sense of where your feet or ankles are is a little off. Fortunately, a physical therapist can provide exercises to help you re-establish that connection between your brain and your limbs.

Ankle injuries can vary in severity, and knowing which ones need attention from your doctor is helpful. For severe or repeated ankle sprains, physical therapy can provide numerous benefits to get you back on your feet and steady once again.