A sprained ankle happens when the ligaments, the tissues that connect bone to bone, are stretched and torn. The number of fibers of the ligament that are torn will help determine the degree or grade of the sprain. Some sprains involve the compete tearing of the ligament and the only option to treat it is with surgery. Other than surgery cases, treatment for the other grades of sprain are treated in the same way and can take a few days to several weeks to heal.
Protect
A general acronym to remember when treating a sprain is P.R.I.C.E. "P" refers to Protecting the joint. This means the ankle should be in a brace of some sort when there is weight being put on it. It is most important to protect the ankle within the first 48 to 72 hours of the sprain to prevent re-injury. A brace can be bought in a local grocery store or pharmacy.
Rest
The more the sprained area can be rested initially, the more the time body has to repair the injury. The body starts to repair the injured tissues by laying down scar tissue, often in different directions, which helps the tissue stay strong in the future.
A sprained ankle should be rested immediately, and no weight should be put on it. Pain-free ranges of motion are encouraged, but any movements that cause pain should be avoided
Ice/ Inflammation
Icing is important to keep the swelling down. After a sprain occurs, the body starts a healing cascade that leads to swelling and heat production. The ice helps with the pain caused by swelling; it also and keeps the swelling in check, so that circulation to the foot is not cut off . Icing has its own stages, known as CBAN. First the area will get Cold, then start to Burn and Ache and finally go Numb. When the area has gone numb the ice has been on long enough. This takes about 10 to 20 minutes. The ice should not be placed directly on skin, nor should it be left on for more than 20 minutes, both of which may cause an ice burn. Allow the skin to warm back up to room temperature before reapplying ice. In addition to ice, over the counter anti-inflammatories will also help with the pain and swelling. Follow dosing instructions on the bottle.
Compression
The ankle sprain should be compressed to help move fluid out, thus keeping swelling down. This treatment can be combined with the protect stage of treatment since an elastic compression bandage can provide both protection and compression. White athletic tape also works to protect and compress, but takes some skill to put on and takes more time to remove than a compression bandage. These items can be found in the grocery or pharmacy as well.
Elevation
In the first 48 to 72 hours of injury, it is important to elevate the ankle as often as possible to the level of the heart or higher, which allows the extra fluid to move away from the ankle.
In Office Care
If the bruising, swelling and pain are severe, make an appointment with a health professional to rule out fracture.
References
- "Emergency Care and Transport for the Sick and Injured, Ninth Edition"; American Academy of Orthopedic Surgeons; 2005
- "Quick Reference Conditions Manual"; Nikita Vizniak and Michael Carnes; 2004
