Lateral Ankle sprain management.
The current management of an ankle sprain typically involves a combination of self-care measures, conservative treatments, and, in some cases, medical intervention. Here are the general steps involved in the management of an ankle sprain:
Protection: Protect the injured ankle from further damage by avoiding activities that cause pain or stress to the affected area. You may need to limit weight-bearing and use crutches or a brace for support.
Rest: Allow the ankle to rest to promote healing. Avoid putting weight on the injured ankle and reduce activities that exacerbate pain.
Ice: Apply ice to the affected area for 15-20 minutes every 2-3 hours for the first 48-72 hours after the injury. Ice helps reduce pain, swelling, and inflammation.
Compression: Use an elastic compression bandage to wrap the ankle firmly, but not too tightly, to help reduce swelling. Make sure not to impede circulation.
Elevation: Elevate the injured ankle above heart level whenever possible to reduce swelling. Prop it up on pillows or use a cushioned footrest.
Pain management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can help alleviate pain and reduce inflammation. Follow the recommended dosage and precautions or chat to your pharmacist.
Rehabilitation exercises: Once the initial pain and swelling have subsided, you can start performing gentle range-of-motion exercises, such as ankle circles and toe curls, to improve flexibility and strength. Gradually progress to more challenging exercises as directed by a healthcare professional or physical therapist.
Manual therapy: If the sprain is severe or recovery is not progressing as expected, your doctor may refer you to a physical therapist. They can guide you through a personalized rehabilitation program, including exercises, stretches, and hands-on treatments to restore strength, balance, and function to the ankle.
Bracing or taping: Depending on the severity of the sprain and your level of activity, your healthcare provider may recommend using an ankle brace or taping the ankle to provide stability and support during the healing process.
Follow-up and monitoring: Regularly follow up with your healthcare provider to monitor your progress. They can assess the healing process, make adjustments to the treatment plan if necessary, and provide guidance on returning to normal activities or sports.
It's important to note that the above steps are general recommendations and may vary depending on the severity of the sprain and individual circumstances. It's always advisable to consult with a healthcare professional for an accurate diagnosis and appropriate management plan for your specific situation.
What Does The Evidence Say?
Predisposing factors should be identified and if possible addressed, such as instability.
RICE is not advised as treatment modality after a lateral ankle sprain
NSAID’s may be used to reduce pain and swelling
Immobilisation should not be used in the treatment of Lateral Ankle Sprains
Functional support if preferable over immobilisation, such as compression or a brace.
Exercises therapy should be commenced as soon as possible to assist in restoring joint range of motion
Manual Therapy is only advised in combination with other treatment modalities such as exercise and proprioception, to enhance the treatment effect.
NO recommendations can be made with regards to footwear due to inconclusive evidence.
Work resumption should be immediate where possible
Sport resumption can gradually occur, with a focus on proprioception, strength, coordination and function.
(Vuurberg et al, 2018)
References:Vuurberg, G., Hoorntje, A., Wink, L. M., van der Doelen, B. F. W., van den Bekerom, M. P., Dekker, R., van Dijk, C. N., Krips, R., Loogman, M. C. M., Ridderikhof, M. L., Smithuis, F. F., Stufkens, S. A. S., Verhagen, E. A. L. M., de Bie, R. A., & Kerkhoffs, G. M. M. J. (2018). Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. British journal of sports medicine, 52(15), 956. https://doi.org/10.1136/bjsports-2017-098106