It is estimated that over half of ankle sprains are not evaluated by a medical professional, so proper self-management is very important. Repeat ankle sprains occur in greater than 70% of basketball players, but early, proper management has been shown to reduce repeat ankle sprain rates. Once an ankle sprain has occurred, it is important to know what the most effective treatment is. Knowledge is power.
The first step is to determine the severity of the injury. As mentioned in Part I of this column, the majority of symptoms from a Grade one sprain will resolve within a week and do not produce significant swelling or bruising. The Grade two and three injuries are more severe and should be evaluated by a medical professional.
The next step is to move into rehabilitation. Evidence supports the use of non-steroidal anti-inflammatory drugs (NSAIDs) to decrease pain and swelling and improve short term function after ankle sprains. Like any drug, there are risks associated with NSAIDs that should be discussed with your physician or pharmacist. Functional (moving) rehabilitation is more effective than immobilization (cast and bed rest) in Grade one and two injuries. A Grade three injury should be protected by a rigid ankle brace for at least 10 days and then progressed into functional rehabilitation.
Comprehensive rehabilitation that involves balance training will maximize recovery and minimize the risk of repeat injuries. A balance training program can be effective in preventing sprains but is most effective at reducing repeat ankle sprain rates. Testing your own balance is incredibly important. Start with a static test. Can you stand still on the injured leg only and maintain your balance for at least 30 seconds? If so, progress that test to the next level. While standing on the injured leg, try to reach down to the floor and back up overhead 10 times without losing your balance. If you cannot complete either of these two tests, then you would benefit from balance training exercises.
The final step of the recovery process is the frequently discussed and well-studied question: Should I tape it or brace it? Hundreds of studies have been completed on this topic and the evidence shows that traditional ankle taping and lace-up /semi-rigid ankle braces are all equally effective at reducing repeat ankle sprain rates. Therefore, I do recommend that post-sprain athletes wear a comfortable lace-up or semi-rigid brace, unless consistent ankle taping by an athletic trainer is available. The evidence does not support taping or bracing to prevent the first sprain. Prevention of ankle injuries should focus on pre-season preparation with a diverse fitness program that involves stretching, strengthening, balance and endurance training.
There are many additional treatments that can help you recover from an ankle sprain, and your local physical therapists and athletic trainers are very qualified to help you recover from your current sprain and prevent future ones.