What should I do if I sprain my ankle?

Most ankle sprains are will improve with simple measures:

• Rest – take the weight off the injured joint as much as possible for a day or two. For most mild sprains, it is best to start taking some weight on the injured ankle within 2-3 days to stop the muscles from weakening.
• Ice – apply an ice pack (a small bag of frozen peas wrapped in a towel is ideal) three times a day for 15 minutes to reduce swelling.
• Compression – consider strap the ankle with a snug bandage to help reduce swelling.
• Elevation – ideally rest your ankle above the height of your chest since gravity can then help fluid to drain away  from the injury to reduce swelling (and pain) more effectively.

Normally a sprained ankle will recover within 6-8 weeks, although swelling tends to take a few weeks longer.

Do I need physiotherapy or an operation? 

Most simple sprains will get better without any special treatment. However, if you have a severe injury or the initial injury does not recover normally, it is usually best to see a physiotherapist initially. They will help to re-train your ankle to respond to various movements by doing different exercises and activities; this is known as proprioceptive physiotherapy. If your ankle or Achilles tendon are stiff, you will also be shown exercises to stretch these, and the strength of the muscles around the ankle will be increased by exercises. If your foot shape makes you prone to extra stress on the ankle ligaments, a moulded insole may be advised for your shoe to reduce these stresses.

You cannot absolutely prevent another injury, but there are things you can do to reduce the risk. This includes taking care when walking to avoid twisting your foot on uneven pavements, cobbles etc. High-heeled shoes put extra stress on your ankle and should be avoided. If your ankle or Achilles tendon are stiff this puts extra stress on your ankle ligaments when you walk or run, and exercises would probably improve this.

In some people, going over on the ankle can persist despite physiotherapy. At this point, the opinion of an orthopaedic foot and ankle surgeon would be helpful. They will examine your ankle and might organise an x-ray or scan of it. Depending upon the findings, the surgeon may suggest an exploratory operation on your ankle (arthroscopy) to check on the state of the ankle joint and possible repair of the damaged ligaments.