You play basketball, I play basketball.  You jump and grab rebounds, I jump and grab rebounds…and land on someone’s foot…and sprain my ankle.  Court sports, basketball especially, see a very high rate of ankle sprains.  Whether it’s due to weakness of structures within your ankles, or if it’s an external cause (i.e. landing on someone’s foot), it’s possible you have experienced an ankle sprain, or at least know someone who has.  To show the prevalence of this injury, Hubbard & Hicks-Little estimated that approximately more than 23,000 ankle sprains occur daily within the American population.1  And of those who have suffered an ankle sprain, as many as 70% of those people re-injure that same ankle.1

First and foremost, if this happens at a school function, or any event with medical coverage, consult an athletic trainer (AT) immediately.  Athletic trainers study for years to know how to respond to any injury, trust them.  If no AT or physician is readily available, here is your plan B.

If you experience an ankle sprain, it is import to understand what is being damaged.  When you suffer a sprain, it means you have damaged a ligament (strains are damaged muscles or tendons).  The lateral ankle sprain is the most common type of sprain which is cause by foot inversion (inward motion).2  Typically the anterior talofibular ligament (ATFL) is the first to be injured, followed by the calcaneofibular ligament (CFL), and finally by the posterior talofibular ligament (PTFL).

You can damage more than one ligament at a time, which all has to do with the severity of the injury.  Often times, you may hear/feel a “pop,” which may also be indicative of severity.3  To know how bad your ankle sprain, you will need to seek out an Allied Health Professional for an evaluation.

With NO AT available to tell you otherwise, here is an acronym to remember: RICE.

Rest: No unnecessary walking – body parts heal faster when trauma is reduced. Use crutches if necessary to avoid stressing the ankle.

Ice: 20 minutes on / 1 hour off – then repeat several times a day. Ice buckets work very well for ankles – complete submersion of the ankle

Compression: Utilize an ACE wrap or compression sleeve to minimize swelling. If using an ACE wrap be sure to start at the toes and wrap up, you want to push all the swelling proximally (towards the center of the body). Use compression during the day, and take it off at night.

Elevation: Allow gravity to assist in minimizing the swelling by propping the foot up between 45-90 degrees. Combine this step with ice to enhance inflammation reduction.

If you follow these four principles, you are already well on your way back to recovery.

There are several general guidelines you want to remember when you are trying to manage an acute ankle sprain:

Minimize the swelling following the RICE protocol. The inflammation phase generally lasts anywhere from 48-72 hours post injury – do not use any thermal (heat) treatments during this time as it will increase the swelling. The “no pain, no gain” slogan does not apply to injuries.  If it hurts, don’t do it.  Pain is the body’s natural alarm system to tell you to stop doing something.

Ankle sprains can be very debilitating, and for the athlete, it is hard to justify riding the bench to recover from an ankle sprain.  Follow these guidelines and you will be in much better shape and return to the court quicker.  If you suffered from an ankle sprain, there are a few things you should know going forward.

First, you are now more prone to re-injury of the same ankle.  The reason for this is because scar tissue has formed over the tears within the ligament.  Scar tissue is made of a different, more rigid, fiber structure than that of ligament fibers and will not have as much elasticity.  Secondly, not all ankle sprains will be the same grade of severity; do not assume it is the same as the last.  Finally, to reduce the risk of re-injury, rehabilitation of the ankle is a priority (refer to the article entitled Prevention & Rehabilitation of Ankle Sprains).

Hubbard, T.J., & Hicks-Little, C.A. (2008).  Ankle ligament healing after an acute ankle sprain: An evidence-based approach.  Journal of Athletic Training, 43(5), 523-529.
Clark, M.A., & Lucett, S.C. (2011).  NASM essentials of corrective exercise training.  Baltimore, MD: Lippincott Williams & Wilkins, a Wolters Kluwer Business.
Starkey, C., Brown, S.D., & Ryan, J.L. (2010). Examination of orthopedic and athletic injuries.  Philadelphia, PA: F.A. Davis Company

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