Ankle sprains are one of the most common injuries we experience in daily life and sports. Whether it's from misstepping or tripping during everyday activities, or from changing direction or landing awkwardly in sports, ankle sprains can happen to anyone. As someone who loves exercise and playing sports, I know the temptation to jump right back into things after an injury. But rushing back too soon can lead to further irritation, tissue damage, or even a re-injury. The severity of your ankle sprain will determine the timeline for healing, and understanding that process is key to a smooth recovery.
Healing Rates
Grade I Sprain (mild pain, swelling, tenderness, able to bear weight): 1-3 weeks
Grade II Sprain (moderate pain, swelling, tenderness, bruising, mild to moderate joint instability, some loss of range of motion and function, pain with weight-bearing): 4-6 weeks
Grade III Sprain (severe pain, swelling, tenderness, bruising, considerable instability, loss of function and range of motion, unable to bear weight): 6-12 weeks
You might be thinking, “What am I supposed to do for 6 weeks?!” Unfortunately, biological timelines can’t be rushed, but here’s the good news: You don’t need to completely limit yourself during the healing process. While you’ll need to adjust your activities, you can still stay active in ways that won’t hinder healing.
RICE: The OLD APPROACH
You’ve probably heard of the RICE protocol for treating an ankle sprain:
Rest
Ice
Compression
Elevation
However, in 2014, Dr. Mirkin, the creator of RICE, revised his stance, stating that ice and complete rest might actually delay healing rather than helping. Cooling may reduce swelling, but it doesn't speed up muscle recovery. That’s where the new, improved protocol PEACE and LOVE comes in.
PEACE and LOVE: A Better Approach
Protection: Avoid painful activities that could further damage the injury. A brace or immobilizer may help initially to promote stability and weight-bearing, but long-term use can limit ankle range of motion and reduce muscle activation.
Elevation: Elevate the injured area to help reduce swelling.
Avoid Anti-Inflammatories: Non-steroidal anti-inflammatory drugs (NSAIDs) and other anti-inflammatory treatments, like ice, can slow healing. Use them only if the pain is severe.
Compression: Apply compression to reduce swelling.
Education: Understand the injury and healing process.
Load: Begin weight-bearing activities as soon as possible. Research shows that weight-bearing as tolerated is far more beneficial than non-weight-bearing immobilization. Early mobilization helps improve ankle range of motion and reduce swelling. Therapeutic exercise in combination with early mobilization also improves single-leg stabilization, balance, and squatting ability after an ankle injury.
Optimism: Stay positive! Injuries are frustrating, but maintaining a hopeful attitude and focusing on daily improvements can make a big difference in your recovery.
Vascularization: Get moving! Activities that promote blood flow, such as massage, cupping, dry needling, biking, and rowing, help speed up recovery.
Exercise: Gradually increase activity as your pain and function improve. Focus on ankle mobility and therapeutic exercise, as a lack of mobility increases your risk of re-injury—not just to your ankle, but also to your knee. Instead of relying on a brace long-term, focus on retraining the muscles of your foot and ankle for better support. As your ankle becomes more stable and mobile, you can begin to gradually return to your usual exercise or sport.
Early Ankle Sprain Suggestions and Exercises
While the exercises below can be helpful, remember that this is just a starting point. For a tailored rehab program, it's always a good idea to consult with a physical therapist or movement specialist who can guide you based on your specific needs.
Ankle Alphabet
Banded Ankle Dorsiflexion
4-Way Ankle (Dorsiflexion, Plantarflexion, Inversion, and Eversion)
Heel Raise Progression
Single Leg Dead Lift Progression
🤝 If you need some assistance with your ankle sprain we are here to help at Process Physical Therapy and Performance! Schedule a free 30-minute consultation TODAY. E-mail admin@processptandperformance.com or call us at 301-531-5347.
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