Whether you are a pro, a sunday league player or a yoga addict you know that a sprained ankle will have you sitting behind the lines of action for a while. Your foot suddenly plants itself, you get a “stabbing” pain and then comes the swelling. Ice is the first aid against one of the most hated sports injuries.

“A sudden change of direction, a sprint during a race, especially on rough terrain, a click and then a setback can cause a sprained ankle. The sand and uneven terrain from this point of view, can be treacherous to run and jump on”, says Dr. Maria Cristina D’Agostino, orthopedic specialist and Head of the Center of Shockwave Therapy at Humanitas Hospital. The pain is the first alarm bell of this trauma.

What mark does a sprained ankle leave?

“The ankle is swollen, and in some cases, more severe distortion can also occur and as well as hematoma in the hours and days following the trauma”.



What should you do in case of a sprained ankle?

“The therapy of a sprained ankle is broken down into 4 “basic rules” to follow for simplicity, they go under the acronym RICE:

  • Rest and refrain from sports activities
  • Ice: Immediately apply ice
  • Compression, apply a bandage, or guardian, on the injured party
  • Elevation, ie keep the leg and the foot upward to facilitate a reduction of the edema (and possibly hematoma).

“It is necessary to state that in regards to “do it yourself” treatment, its ok to rest-ice-elevate, but the bandage workds best if its tied by a professional to avoid the risk of interfering with blood circulation and/or worse. The ice itself also helps to relieve pain, especially if applied immediately (do not place it in direct contact with the skin because of the risk of a “burn” so always place a thin towel or a piece of cotton between your sking and the ice). Regarding the use of medication, you should consult a doctor as soon as possible”, warns the specialist.


Do not put your foot down

“In the presence of severe pain and swelling, especially if associated with hematoma, it is important not to put your foot down on the ground and visit as soon as possible the emergency room, where an X-ray will be taken to establish or rule out any fractures (can also be small fractures or delamination). Its not necessary that the hematoma is related to a fracture in which case a doctor can assess the possible injury to a ligament and the type of restraint to be implemented (a simple bandage or a brace)”.


What is the course of a sprained ankle?

“There are crucial early weeks, which influence the subsequent evolution. If you respect the rule of RICE mentioned above, and especially if you get a fairly quick resolution to the hematoma/edema and pain, the course will be potentially more favorable and faster, with less risk that the pain becomes chronic. A very important factor in recovery to the best functionality and ankle stability is the rehabilitation process. Subsequently one must resume function and muscle tone, to re-educate the neuromuscular control (proprioception) of the affected part, and prevent further distortions. A first ankle sprain predisposes to the risk of recurrence, especially if there was also a ligament injury. It is therefore advisable to visit a specialist even if the resolution of the distortion was quick and maybe self-managed, to avoid or reduce the risk of long-term issues”.


What if the ankle pain does not go away?

“If the pain tends to be chronic and last for more than two months despite appropriate therapy, it is examined in greater depth and with more diagnostic tools (usually MRI). In some cases, especially serious distortions may have also been bruising a bone and cartilage at the ankle. In these cases patients continue the course of treatment with more specific measures”, concludes Dr. D’Agostino.