Managing Ankle Sprains: Recovery Tips and When to Return to Sports

After an ankle sprain?

After spraining my ankle, I visited a doctor but did not get an X-ray.
Here’s a brief description of my condition: After the injury, I was still able to walk, but my ankle gradually swelled.
After seeing the doctor, the pain increased, and pain relievers were ineffective; even without touching it, I felt pain.
The next day, I could walk slowly upon waking, and I noticed three bruises on my ankle: one above the outer protrusion about 1x1 cm, one below the outer protrusion also about 1x1 cm, and one near the sole measuring about 1x4 cm.
Currently, only the bruise at the bottom has not yet resolved.
Pressing on the ankle joint is painful, and upon closer inspection, it seems that the swelling has not completely subsided.
It has been over two weeks since my ankle sprain.
A couple of days ago, I went out shopping with friends and walked a lot.
Sometimes, halfway through walking, the injured ankle feels sharp pain, and now it is more prone to pain than before.
Standing on one foot causes some discomfort.
Is this due to the ligaments not having fully healed and walking a long distance? After the New Year (which will mark one month since the injury), school will start, and I will begin practicing basketball.
Should I start practicing with everyone right away, or should I rest a bit longer?

Ballet, 10~19 year old female. Ask Date: 2018/02/10

Dr. Shi Guozheng reply Orthopedics

Based on your description, it is likely that there is no fracture, but rather an ankle sprain affecting the ligaments.
The most common site of injury is the anterolateral aspect, just below the fibula, where bruising is typically visible due to bleeding.
Ligament injuries usually take about six weeks to heal, and it is best to allow for complete recovery before engaging in vigorous activities.
If not fully healed, there is a risk of re-injury, which can lead to ligament laxity and joint instability.

Reply Date: 2018/02/10

More Info

Managing an ankle sprain effectively is crucial for a successful recovery and a safe return to sports. Based on your description, it seems you have experienced a moderate ankle sprain, which is characterized by pain, swelling, bruising, and tenderness around the ankle joint. Here’s a comprehensive guide on how to manage your recovery and determine when it’s safe to return to sports.

Understanding Ankle Sprains
Ankle sprains occur when the ligaments that support the ankle stretch beyond their limits and tear. The severity of the sprain can range from mild (Grade I) to severe (Grade III), with Grade I involving minor stretching and microscopic tears, while Grade III involves a complete tear of the ligament. Your symptoms suggest that you may be dealing with at least a Grade II sprain, which involves partial tearing of the ligament.

Recovery Tips
1. Rest and Protection: It’s essential to give your ankle time to heal. Avoid putting weight on the injured ankle, and consider using crutches if necessary. A brace or splint can provide additional support and protection during the healing process.

2. Ice Therapy: Apply ice to the injured area for 15-20 minutes every 1-2 hours during the first 48 hours post-injury. This helps reduce swelling and numbs the pain. Make sure to wrap the ice in a cloth to avoid direct contact with the skin.

3. Compression: Use an elastic bandage or compression wrap to help control swelling. Be careful not to wrap it too tightly, as this can impede circulation.

4. Elevation: Keep your ankle elevated above the level of your heart as much as possible. This helps reduce swelling and promotes blood flow to the area.

5. Gentle Range of Motion Exercises: Once the acute pain and swelling have subsided (usually after a few days), you can begin gentle range of motion exercises. This may include moving your foot up and down and side to side to maintain flexibility.

6. Strengthening Exercises: As you progress, incorporate strengthening exercises for the ankle and surrounding muscles. This can include resistance band exercises, toe raises, and balance exercises to improve stability.

7. Gradual Return to Activity: After about 2-4 weeks, if your pain has significantly decreased and you have regained a good range of motion and strength, you can start to gradually return to sports. Begin with low-impact activities and progress to more demanding exercises as tolerated.

When to Return to Sports
Returning to sports too soon can lead to re-injury. Here are some indicators that you may be ready to return:
- Pain-Free Movement: You should be able to perform daily activities without pain.

- Full Range of Motion: You should regain full range of motion in your ankle.

- Strength: Your ankle should be as strong as the uninjured side. Consider using strength tests or functional tests to assess this.

- Balance and Stability: You should be able to perform balance exercises without discomfort.

If you plan to return to basketball after one month, ensure that you have completed a rehabilitation program that includes strength and balance training. It’s advisable to consult with a physical therapist or sports medicine specialist who can assess your readiness and provide tailored exercises.

Conclusion
In summary, managing an ankle sprain requires a combination of rest, ice, compression, elevation, and gradual rehabilitation. Listen to your body and avoid rushing back into sports. If you experience persistent pain, swelling, or instability, it may be wise to seek further evaluation from a healthcare professional. Remember, a thorough recovery will not only help prevent re-injury but also enhance your performance when you return to the court.

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