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The Best Way to Treat a Sprained Ankle

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:

  1. 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.

  2. 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.

  3. 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.

  4. 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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I just happened to findthis article by google searching and this worked amazingly well for my ankle and I always recommend this technique to others now. After this I subscribed to Dr Ben Kim's mailing list and I have been reading his articles regularly.

I learned of the method of using hot and cold therapy for treating ankles many years ago from my barber when I was a kid. His daughter was a very good cheerleader and when an ankle was sprained she had to get up and go again as soon as possible. We started using this method and i still as a father today will use it to treat ankles, bruised knee, and i used it on a sprained wrist after I hurt self snowmobiling.

About 2 hours ago I sprained my ankle jogging for the second time! Sitting in my room in pain I tried to reduce the pain and swelling with the usual RICE method and lots of positive thinking, only just to find the swelling and pain increasing. I started to search for a home remedy and found this web page. I decided to do this hot-cold method as I already had a bag of peas by me and a little fan heater (its winter by us. I did the peas for a few minutes and then removed it and then put my foot in front of the fan heater all the time moving the ankle around. Its only been around 30 min and the swelling is gone and the pain is significantly less. I must say I also used Lavender essential oil in the ankle, but only started to feel better after using the hot-cold method. Thank you Dr Ben!!!

This therapy works wonders thanks Dr kim

This therapy works wonders thanks Dr kim

I had bad sprain in my left ankle almost 6 months back. Then I used the RICE method and used ankle support for 6 weeks. Even after that the discomfort never really went away. Recently, since last few weeks the pain has increased and it is more so on the inside of my left ankle rather than the outside. I presume the ankle never healed completely. Is it still recommended to use this hot/cold method now or any other suggestion?

The hot/cold method wouldn't hurt your ankle, so I think it's worth trying.

Please type "ankle mobility exercises" into the search engine at the top of our site - you will find some exercises that you can do to help facilitate healing and a return to full mobility.

Hello Dr. Ben? With the water contrast therapy, what is the estimated time of full recovery from an ankle sprain?

Hello Emeka,

It depends on the severity of the sprain, as well as your general health. With appropriate rest, exercise, and therapy, the goal is to see steady, gradual improvement. If you don't experience steady, gradual improvement, it is prudent to visit your physician for an evaluation.

Ben Kim

Thank you.

Its been 5 weeks

Thank you Dr Ben Kim
I followed up with the hot and cold water therapy after I sprained my foot. Now almost a week and it's working miracles!

Do you recommend the contrast therapy for sprains on the medial side too?
And if I don't have buckets can hot moist towels and ice suffice?

Yes, I suggest contrast therapy for any type of ankle sprain. Submerging in water is much more effective than using cloth, so if at all possible, I would try to find buckets or simple basins.

The easiest thing to do is sit in the tub with ur foot under the faucet run the cold water on ur foot for 2 mins then turn the knob to hot for 2 mins and just time urself for up to 10 mins recovering from ankle surgery and this has helped me a bunch.

Thank you, dear Ben Kim! We have followed this a few times with success! Right now I'm using the therapy on my sprained ankle, last night and this morning. Incredible improvement! Question: Do you recommend using any kind of cream after soaking, like Deep Blue Rub or DMSO?

I'm glad this has been useful to you, Kristina. By way of creams, you can use anything that brings you relief. To actually help clear congestion, I would suggest something with Arnica in it - we use a blend that includes Arnica plus several other natural compounds here: