What Should You Do If You Roll Your Ankle?

1. RICE: Rest, Ice, Compression and Elevation

• Rest. Rest your ankle and do not walk or stand on it. Use crutches until you are able to walk without pain.
• Ice. Ice will help keep the swelling down. Press the ice pack on the area for 20 minutes at a time. Avoid placing ice directly on the skin and use a thin cloth or towel to form a barrier between the ice and your skin.
• Compression. Compression will help alleviate swelling and immobilize your ankle to avoid further injury. Use a compression wrap for the first few days.
• Elevate. Elevate your foot by placing it on a pillow so that your ankle is higher than your waist. This will also help keep the swelling down.

Give your injured ankle at least 48 hours to recover after the initial injury. If your sprain is mild, follow the RICE method until the pain goes away. Grade II or higher sprains may require ankle splints or braces for at least 15-20 days. 

2. Restore motion and flexibility

• With your toes on the floor, gently move your heel up and down.
• One week after your injury, begin turning your heel in and out.
• To start restoring flexibility to the calf muscles, face a wall with one foot in front of the other and place both hands on the wall. Lean forward, bending your front leg but keeping your back leg straight, until you feel a gentle stretch. Hold for 10 seconds, switch legs and repeat.

3. Restore strength

• When about 70% of your normal ankle motion has returned, begin strengthening your legs with resistance exercises.
• Sit on the floor with your knees bent, heels on floor and a resistance band looped around both feet.
• Slowly extend one leg outward, moving your knee as little as possible.
• Return slowly to the starting position and repeat with the other foot.

4. Restore balance

• After you have regained sufficient strength, you can start working on your balance
• Stand on your injured foot with the other foot in the air.
• Keep both arms stretched out to the sides.

5. Nonsteroidal anti-inflammatory drugs (NSAIDs) and painkillers

• Ibuprofen helps reduce swelling, pain, and fever.
• Acetaminophen reduces pain and fever. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in a day.

• Common ankle sprain: Occurs when the anterior talofibular ligament (ligament on the outside of the ankle) becomes injured. There is typically short rehabilitation time for this type of injury.
• High ankle sprain: Occurs when a ligament above the ankle joint, a set called the syndesmosis, is injured.
• Grade I sprain: Occurs when there is slight stretching and some damage to the fibers of the ligament can be considered grade I sprain. There is minimal tenderness and swelling and minimal inability to move the joint. Walking may be painful but possible.
• Grade II sprain: Occurs when there is partial tearing of the ligament. If the ankle joint is moved in certain ways, you may feel an abnormal looseness of the ankle joint. There will be moderate swelling and tenderness, decreased range of motion, and possible instability. Walking may be painful but not impossible.
• Grade III sprain: Occurs when there is a complete tear of the ligament. If the ankle joint is pulled or pushed in certain movements, you may feel severe looseness of the joint. There will be significant swelling and pain and significant instability of the joint. Walking on it may be impossible.

It may take as long as 10 days for a mild sprain to heal and as long as several weeks for a severe sprain to heal. Although surgery to treat a sprained ankle is rare, it may be necessary to repair severe ligament damage if the joint appears unstable. 

If surgery is recommended, your doctor will evaluate your case to determine the most appropriate surgical treatment.