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Ankle Sprains

An overview from the Women's Sports Medicine Center at HSS

Women's Sports Medicine Center,
Hospital for Special Surgery

Ankle sprains are one of the most common sports injuries. They often occur when playing sports that call for quick changes of direction, trying to keep your balance on an uneven surface or landing on another player’s foot. Your foot may roll over and you feel a sharp pain on the outside of your ankle. Ankle sprains occur when the ligaments around the ankle get stretched or torn. They commonly occur on the lateral (outside) ankle and are accompanied by pain, swelling, bruising, and stiffness.

Diagnosis and Treatment

Your doctor will diagnose the severity of your ankle sprain and recommend a treatment plan. This might include ankle support, medication, and physical therapy. During the first 24-48 hours, you will be asked to:

Rest: Stay off your ankle and avoid painful movements. Walk with an assistive device such as crutches or a cane.

Ice: Apply ice to the injured area several times/day. Use a bag of ice or frozen peas and leave on for 15-20 minutes. You can apply cold therapy every hour if necessary. It is a good idea to wrap the ice onto the ankle with an elastic bandage to provide compression.

Compression: Use some kind of elastic wrap to keep the swelling down. It should be snug, but not too tight. Wrap more tightly around your ankle and get looser as you work your way up the calf. If your toes are blue or numb, it’s too tight!

Elevation: Whenever you can, keep your foot elevated above the level of your heart on a sofa, bed, or chair. Make sure your foot is up high enough and your knee is supported! Try putting a sofa cushion under the foot of your mattress for elevation while in bed.

Regain Your Flexibility

After a few days, gradually begin to restore your range of motion by gently flexing your foot and pointing your toes. You may perform a calf stretch by wrapping a towel around the ball of your foot and pulling your toes toward you. After about a week, gently begin to trace the alphabet with your foot in the air. As with any exercise, STOP IF YOU FEEL PAIN.

Regain Your Strength

When your ankle is pain-free, you should begin doing some strengthening exercises.

  • Riding a stationery bike for 10-15 minutes is a good way to start without putting all your weight on your ankle.
  • With your foot flat on the floor, scrunch a towel with your toes.
  • Loop an elastic band around the ball of your foot and point your toes against resistance (or move your foot in and out). Then progress to calf raises.
  • Calf raises: Stand with both feet flat on the ground and rise up on your toes. Hold for a few seconds and then slowly lower. When you get comfortable, try this using just your injured foot.

Regain Your Balance

Once you’ve regained your strength, you’ll want to train your ankle to maintain balance by standing on your injured leg with hands out to the side. Try to keep your balance for 30 seconds. Progress to doing this while wiggling your "air" leg around or keeping your eyes closed.

When Can I Return to Sports?

Check with your doctor about when you’re ready to begin play. In general you should not return to sports activity until:

  • You have complete range of motion (in and out, up and down, side to side)
  • You have full weight bearing, good balance and strength in the muscles around your ankle
  • Your ankle doesn’t hurt or swell up during exercise or daily activity. You can run pain-free.

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