The basic plan behind a muscle or ligament pull or strain is RICE. Rest, Ice, Compression and Elevation. These components are the mainstay of immediate treatment while the rehabilitation will be structured around a more individualized plan to help you return to your normal activities. For instance, if your injury happened while running the quarter mile you may undergo a significantly more intense physical therapy routine than if your normal activities included daily living skills such as stair climbing and walking.
But let’s start with Rest – probably the hardest factor for all involved. This means – Do No Walk On It! It doesn’t mean limp, or hop on the good foot or even walk slowly off the heel or toe. It means to rest the ligaments and muscles that were stretched and torn and let your body start to heal. While resting you should have your ankle elevated above the level of your heart. This will help the swelling to stay down and will then help your ankle to heal faster. The larger the amount of swelling the harder it is for the muscles and ligament to rebuild themselves and the longer your rehabilitation and recovery period.
While your foot is resting, elevated above the level of your heart, place ice packs on it for 15 minutes every hour. The ice also helps to decrease the swelling in the soft tissue and decreases the time you’ll need to recover. Even if you are only able to put your foot up for 24 hours before needing to return to work or school that 24 hours will give your body time to recover that you can never replace.
And, because you can’t stay seated, with your foot elevated, for 24 hours you’ll want to use compression to keep the swelling down and help to support the joint. Compression can be accomplished using a standard ace wrap or ankle brace sold specifically for this reason. Don’t ignore any of these first four steps or you’ll find your rehabilitation time has just doubled in time. The more you can rest the ankle and keep the swelling to a minimum the less time you’ll spend on crutches, in braces or in rehabilitation.
If you had a Grade 2 sprain then you may require an immobility device for 2 –3 weeks to allow for proper healing and treatment for sprained ankle. In a Grade 3 sprain you may need a short leg cast for several weeks to allow for proper healing before you are able to begin strengthening exercises and physical therapy. During physical therapy your practitioner will evaluate how unstable and weak your ankle is compared to your other ankle. If you leave this instability or weakness you will actually increase your risk of reinjury to the injured ankle as well as injury to the knee or hip of the good leg as it attempts to compensate for the weakness.
Therapists will give you exercises to perform at home 2-3 times per day, depending upon the type of exercise, as well as icing or heat depending upon your injury. Follow the rehabilitation and you’ll be back to work, school and athletics quickly. For a Grade 1 injury that time may be 1-3 weeks; a Grade 2 or 3 injury may take a month or slightly more before walking, swimming, running or rowing is allowed. For sports that require lateral support and twisting such as basketball, soccer or football, it may be a couple of months before the ankle is ready to work – even with a strong brace.
