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The Best Way to Treat a Sprained Ankle
Posted by Dr. Ben Kim on May 11, 2010
Updated on February 6, 2009
For years, the standard protocol for treating a sprained ankle has been the R.I.C.E. method - Rest, Ice, Compression, and Elevation. While this protocol typically prevents further damage and allows for gradual healing of a sprained joint, sports medicine practitioners are finding that sprains tend to heal most effectively when the injured joint is exercised as soon as possible.
What follows are guidelines that I generally recommend when looking to fully recover as quickly as possible from a sprained ankle:
Avoid wrapping or compressing the joint. Often times, wrapping the injured joint can prevent drainage of excess fluid from the area, which can prolong inflammation and discomfort.
Elevate your injured ankle and rest it on a blanket or pillow while on the couch - this can help promote fluid drainage. While your ankle is elevated, spell out the alphabet with your foot as often as you are able to. If the injury is severe, you may not be able to do this at all. Do it as soon as you are able to, as putting the injured joint through its normal range of motion helps with fluid drainage and may help prevent a build-up of scar tissue.
Continue with the alphabet exercise and begin contrast therapy with hot and cold water. Fill two buckets or pans that are large enough to comfortably house your foot and ankle - one with hot water, and one with cold water. The water temperatures should be as hot and as cold as you can tolerate.
Begin by putting your foot and ankle into the hot water for two minutes. Slowly spell out the alphabet, taking the joint through as much range of motion as possible without creating significant pain.
Next, transfer your foot and ankle into the cold water for two minutes. Allow your foot to rest completely.
Go back and forth from hot to cold, taking your ankle through range of motion exercises in the hot water, and resting in the cold water, for a total of three to four cycles. Your final two minutes should be in cold water if you're still at a point where you have noticeable swelling in your ankle. If you've healed to a point where you don't have noticeable swelling, you can end your contrast therapy sessions with hot water.
The hot water and range of motion exercises are meant to increase the size of your blood vessels, while the cold water and rest are meant to narrow your blood vessels. Going back and forth between expansion and contraction of your blood vessels can create a pumping effect, which can help clear fluid out of the injured area.
Repeat this whole process every few hours, up to three or four times per day.
As soon as you are able to, put weight on your injured leg. You can begin by placing weight on your foot while you are seated. This can progress to slow walking, but be careful not to put too much burden on your good leg. If you can walk only by putting the bulk of your weight on your good leg, it's better to stop until you are able to put more weight on your injured leg, or to use crutches or a walker. Putting too much weight on your good leg can cause injury to the ankle, knee, and/or hip joints of that leg.
Walking on your injured leg as soon as possible can activate nerve fibers in the injured area that control your joint-position sense and balance. Repeated activation of these nerve fibers can help restore strength to the surrounding ligaments and muscles, as well as promote better circulation in the area.
The approach described above can be used to effectively facilitate healing of most types of strains and sprains - the idea is to get the injured area moving as soon as possible to restore function to all of the soft tissues involved, and to promote optimal blood flow through the injured area via movement and contrast bath therapy. The key is to refrain from creating significant discomfort as you recover, as this may be a sign that you are aggravating the injured tissues, which can prolong your recovery time.
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