Ankle sprain - Treatments

Moving around early, with an ankle support

You need to take it easy for the first few days. This is part of RICE, which stands for rest, ice, compression and elevation. But when the worst of the pain and swelling have gone, you should start getting up and about.

If your ankle ligaments are torn, your ankle needs to be properly supported by an elastic bandage, an ankle support or tape. This is to make sure you don't twist it again. Your doctor will be able to check whether you've ruptured any ligaments after five to seven days, when most of the swelling has gone.

You shouldn't move so much that it hurts a lot. Try doing a little bit more each day.

Getting moving early on with an ankle support should help you get back to normal faster than resting with your foot in a plaster cast.[1] And your ankle will probably be less swollen.[1] Your ankle is less likely to give way again in future if you use an ankle support and start moving around early on.[2] You should also have less lasting pain and stiffness and feel more stable on your feet.[3] [4]

The research shows that it doesn't seem to make much difference whether you have an elastic bandage, tape, a lace-up support or a stiffer ankle support.[5] [6] [7] [8] [9]

But you're more likely to get an allergic reaction or skin rash if you use tape compared with an elastic bandage.[10] Keeping your foot still in plaster increases your risk of getting a deep vein thrombosis (a blood clot).[11] [12]

Surgery

An operation can repair the torn ligaments in your ankle. Most people won't need an operation. Having an ankle support and moving around works just as well for most people.[11]

But one study found that surgery can reduce your chances of having long-term pain or weakness in your ankle. It might also reduce your chances of spraining your ankle again.[13]

Surgery has risks. There's a chance the nerves in your foot could get damaged. There's also a risk of an infection, bleeding or osteoarthritis.[12] [14] [15]

Some people still have a weak and painful ankle some time after their injury, especially after a bad sprain. If you are in pain and your ankle keeps giving way after six months, surgery to repair the torn ligaments can usually help.

Deep heat using electrodes (diathermy)

Physiotherapists sometimes use diathermy to 'deep heat' your swollen ankle with electromagnetic energy. But we don't know if this treatment really reduces swelling.[16] There hasn't been enough research to tell us.

Physiotherapy

Physiotherapists use a variety of treatments for ankle sprains, including heat, ultrasound and exercises. The exercises are aimed at increasing your flexibility and the strength of your muscles.

One small study compared standard physiotherapy with physiotherapy plus a balance exercise.[17] In the balance exercise, people practiced standing on one leg while pointing the other leg in front, behind and to the side of them. The balance exercise seemed to help a bit more than physiotherapy alone. But there's not enough research to say whether physiotherapy alone is helpful.

It's best to ask your doctor or physiotherapist before trying exercises for a sprained ankle. If you try balancing on a sprained ankle too soon, you might cause more damage.

Homeopathic cream

Gently rubbing arnica cream over your sprained ankle might make it less bruised and swollen. One small study (a randomised controlled trial) looked at this homeopathic treatment for a sprained ankle. It found that arnica worked better than a dummy treatment (a placebo).[18] But this study was too small to give reliable results.

Cold treatment

Putting ice on your swollen ankle as part of RICE can help at first. But there's no research to say that continuing to put a cold pack on your ankle will make any difference in the long term.[16]

Ultrasound

Ultrasound probably doesn't help ankle sprains heal.[19] High-frequency sound pulses are often used by physiotherapists treating severe ankle sprains to warm up the soft tissue in your foot. But ultrasound therapy doesn't seem to make your pain or swelling go down any quicker, or help you stand on your foot. Your ankle will be just as able to bear weight after a week if you don't have ultrasound treatment.