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Ankle Sprains - Tips For Early Management

That dreaded injury that most of us have experienced and which can take a long time to recover from. However, with good early management, your road to recovery can be much shorter than often required!

What is it?

Acute ankle sprains are characterised by a tear in one or more of the ligaments on the inner and/or outer side of the ankle. Ligaments help join bone to bone and so a tear can create weakness and instability, as well as pain. Swelling and bruising is commonly present soon after injury but not always. In sports like football and rugby, they often occur as a result of direct contact but can follow a non-contact mechanism like when running on uneven ground or planting and twisting on a wet boggy surface.

What to do (0-72 hours)

Tip 1 - Get checked?

Whilst the vast majority of acute ankle injuries do not result in a fracture, it is difficult to rule this out in the initial stages post injury. There can be a lot of swelling, bruising, limited movement and pain. This makes an accurate diagnosis quite difficult! If you are in a lot of pain and struggling to weight-bear then a trip to A&E enables you to (hopefully) rule out a fracture.

Tip 2 - Pain does not equal injury!

Once you have been able to rule out a fracture, this does not make the pain better but it does make the pain less of a concern! The pain you experience when weight-bearing is your body telling you that you are using something that is injured but not that you are making your injury worse. The amount of force required to make a ligament tear bigger is so large that light weight-bearing simply cannot achieve that. Use crutches to take some of the weight when walking if necessary.

Tip 3 - Avoid anti-inflammatories

As previously touched upon, ankle sprains are often followed by large amounts of swelling and we often want to reduce this by taking ibuprofen or other similar anti-inflammatory drugs. However, inflammation is our body's natural response to an injury and is designed to start the healing process. If we take this natural response away, then we are also delaying the start of the healing process.

Tip 4 - Don't follow the acronym RICE

Rest, Ice, Compression & Elevation has been a commonly prescribed method for early treatment of acute injuries for decades. However this is outdated. Some compression and elevation throughout the day can be helpful but too much won't be. Rather than resting, we want to exercise as tolerable. This can take the form of walking (with or without crutches) little and often. We can even start some targeted exercises like seated calf raises or active ankle movements in sitting.

Tip 5 - Be optimistic

Being injured can be a very frustrating time and pessimistic thoughts can enter your head when you are unable to do the things you love. However, you will get better and you will get back to your sport! Believe it or not, research shows that having a positive outlook on your injury reduces your time of recovery.


Acute ankle sprains can be painful and debilitating injuries as well as frustratingly keeping you from your sport. It can take some patience and you should not rush your recovery as re-injury rates are high without optimal rehabilitation. Early loading and avoiding too much rest are key to accelerating your recovery in the initial stages. Once through this first stage, sports therapists can help get you back to full fitness with optimal loading and exercise programmes individualised to your needs and goals.

If you are struggling with an acute ankle sprain and need some advice, please drop me a message or book an appointment online.

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