Ankle Sprain

Ankle Sprain

This page describes the condition of Ankle Sprain and the approach to this condition adopted by Mr Bowyer. Other surgeons may use variations on the techniques, for instance with regard to post-operative management. It is important that you understand what your own surgeon intends to do, and how you will be treated after the procedure.


Gavin BowyerAnkle sprains account for about 25% of all sports injuries. Most ankle sprains occur when the foot rolls to the inside or the ankle twists, tearing or stretching the ligaments on the outer side of ankle. The ankle is painful, swollen and there may be an inability to weight-bear. Bruising, usually around the outer part of the ankle and foot, becomes apparent within a day or so.

The position of the ligaments around the outer border of the right foot and ankle are shown in the illustarion to the right.

Common Signs and Symptoms

  • Sharp, immediate pain as the injury occurs.
  • Continued throbbing pain (sometimes even once rested)
  • Swelling
  • Tenderness to the touch

If there is tenderness over the bones of the foot and ankle, and persistent difficulty with weight-bearing then you ought to be assessed by a doctor, or through the NHS Direct advice line.


Rest, Ice, Compression and Elevation (the so-called RICE regime) form the most important factors in early treatment. The use of an “NSAID” (non-steroidal anti-inflammatory such as the Ibuprofen gel) may be considered. Early physiotherapy can also be helpful.

Once the condition has begun to improve, mobilisation (movement) exercises, followed by a strengthening regime, can begin. In more serious cases the use of an ankle brace might be useful, with compression initially, and then support during the rehabilitation phase.

The RICE Regime

Rest: It is essential that the ankle is rested following a sprain, particularly in the early phase of treatment. With more serious sprains, you should avoid putting too much weight on the ankle (the use of a crutch/crutches may be recommended by your doctor or physiotherapist). Further exercise or participation in sport should stop or be modified until the sprain has healed.

Ice: Traditionally the Ice stage has involved just that! Putting either crushed ice or an ice-pack (even a bag of frozen peas) directly on to the injured area. There are some problems with this approach though: It can be a messy and ultimately wet procedure and there is a risk of “ice burns” from excessively cold packs kept in domestic freezers.

Compression: In addition to drawing heat away from the ankle sprain, a properly applied elasticated or crepe-type bandage will also provide the necessary support and compression of the ankle.

Elevation: The ankle should be elevated whilst using the bandage to avoid fluid accumulating in the ankle and causing further swelling/pain. Sitting on a sofa with your leg up on the sofa, is appropriate elevation.

Continuing Treatment

Continue treating your sprained ankle 2-3 times a day with the RICE regime. A physiotherapist will be able to advise you on returning to sports and activities, and on the support your ankle needs in this rehabilitation phase. If your ankle is not improving within a week to ten days you should consider consulting a doctor, physiotherapist or NHS Direct.

Ankle Sprain Exercises and Rehabilitation

A physiotherapy may be helpful in rehabilitation and in getting you back to activity. The exercises you do will vary as the condition improves and you make progress. At first, whilst you may still be using RICE and not fully able to bear weight on the ankle, the exercises are aimed at improving the range of movement and early strengthening. These exercises are key.

Notify a doctor if pain increases, despite treatment.

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