How to manage an ankle sprain

[DorianStarbuck]

Yesterday afternoon, I rolled my left ankle and fell during Taekwondo, and it was immediately obvious that I’d done some damage. I felt a pop when it happened, and was unable to put any weight on it at first. I tried to walk it off, and within a few minutes, was able to put my weight on it and walk. For the rest of the day, I walked on it as much as possible (I have a desk job), but by the end of the day, it had become very swollen and was beginning to bruise, so I went to a clinic to have X-rays.

The X-rays showed no break. I was advised to follow the “RICE” method, and was given a brace. I was instructed to not put any weight on my ankle for at least three days, and to use crutches when getting around.

I don’t feel confident in the advice I was given, and am reaching out to you for your thoughts on this. Today (the day after the injury), my ankle is extremely swollen and discolored, and the swelling has moved well up my calf to my knee. But there is almost no pain at all unless I try to bend my ankle beyond a short distance. I can walk on it without pain, as long as I’m careful not to allow it to bend too far.

Based on what I’ve encountered here, I think that I should be walking on this ankle as long as I’m not doing so in a way that causes excessive pain. Complete inactivity feels like the wrong thing to do to treat this injury to me, especially when I am able to walk on it without pain.

I also have an anxiety about the swelling, but have been avoiding icing it, in part because I feel like it probably doesn’t actually help, and in part because it’s unpleasant and uncomfortable, and I just don’t want to do it.

I would love to get your thoughts on how I should manage this situation. I am extremely eager to get back to training, including squats and deadlifts, and although I haven’t tried it yet, I’m fairly sure I could do both with limited weight without pain.

Is three days of immobility really necessary in my case? Do I risk further injury by using my ankle to tolerance? Do I really need to ice it?

Thank you so much for all that you do!

[Michael_Ray]

@DorianStarbuck

Yesterday afternoon, I rolled my left ankle and fell during Taekwondo, and it was immediately obvious that I’d done some damage. I felt a pop when it happened, and was unable to put any weight on it at first. I tried to walk it off, and within a few minutes, was able to put my weight on it and walk. For the rest of the day, I walked on it as much as possible (I have a desk job), but by the end of the day, it had become very swollen and was beginning to bruise, so I went to a clinic to have X-rays.

The X-rays showed no break. I was advised to follow the “RICE” method, and was given a brace. I was instructed to not put any weight on my ankle for at least three days, and to use crutches when getting around.

I don’t feel confident in the advice I was given, and am reaching out to you for your thoughts on this. Today (the day after the injury), my ankle is extremely swollen and discolored, and the swelling has moved well up my calf to my knee. But there is almost no pain at all unless I try to bend my ankle beyond a short distance. I can walk on it without pain, as long as I’m careful not to allow it to bend too far.

Based on what I’ve encountered here, I think that I should be walking on this ankle as long as I’m not doing so in a way that causes excessive pain. Complete inactivity feels like the wrong thing to do to treat this injury to me, especially when I am able to walk on it without pain.

I also have an anxiety about the swelling, but have been avoiding icing it, in part because I feel like it probably doesn’t actually help, and in part because it’s unpleasant and uncomfortable, and I just don’t want to do it.

I would love to get your thoughts on how I should manage this situation. I am extremely eager to get back to training, including squats and deadlifts, and although I haven’t tried it yet, I’m fairly sure I could do both with limited weight without pain.

Is three days of immobility really necessary in my case? Do I risk further injury by using my ankle to tolerance? Do I really need to ice it?

Thank you so much for all that you do!

Hey @DorianStarbuck - sorry to hear about the recent ankle sprain.

My typical approach for ankle sprains is movement to tolerance. If you feel able, try and weight bear to tolerance while walking throughout the day. I also am a fan of doing focused work to the ankle like writing the alphabet with your foot. https://www.youtube.com/watch?v=YTVZUMuEKPA. You can practice the alphabet throughout the day, doesn’t have to be in a single sitting. As you feel more comfortable with walking and bearing weight on the extremity, then you can start squatting and deadlifting to tolerance. Perhaps begin with an air squat, then goblet squat, and sumo kettlebell deadlift then barbell deadlift. You can also dose in single leg work like a split squat to tolerance. The swelling and bruising will likely be a part of the process for a while and isn’t anything to panic about…these can look fairly narly but that’s ok.The RICE protocol is outdated and I don’t recommend it. Ice will numb the area but that’s about it. I don’t typically recommend bracing for ankle sprain situations.

[DorianStarbuck]

@Michael_Ray

Hey @DorianStarbuck - sorry to hear about the recent ankle sprain.

My typical approach for ankle sprains is movement to tolerance. If you feel able, try and weight bear to tolerance while walking throughout the day. I also am a fan of doing focused work to the ankle like writing the alphabet with your foot. https://www.youtube.com/watch?v=YTVZUMuEKPA. You can practice the alphabet throughout the day, doesn’t have to be in a single sitting. As you feel more comfortable with walking and bearing weight on the extremity, then you can start squatting and deadlifting to tolerance. Perhaps begin with an air squat, then goblet squat, and sumo kettlebell deadlift then barbell deadlift. You can also dose in single leg work like a split squat to tolerance. The swelling and bruising will likely be a part of the process for a while and isn’t anything to panic about…these can look fairly narly but that’s ok.The RICE protocol is outdated and I don’t recommend it. Ice will numb the area but that’s about it. I don’t typically recommend bracing for ankle sprain situations.

Your advice falls right in line with what I’ve experienced with this injury over the weekend. What you recommend is so vastly different from what I was told to do by the doctor (and so much more in line with what, for me, has been genuine relief), that it’s almost hard for me to believe that immobilization and rest was ever the recommended treatment for this sort of injury.

I really appreciate you taking the time to give this advice, and want to say again how much I appreciate the work that you folks are doing. The work that BBM is doing has had a tremendously positive impact on my life, and I’m just so thankful for you all.

I’ll update this just in case anyone else encounters this thread while in a similar situation. I used the brace for the first day, and used crutches to completely avoid putting any weight on the foot, despite, as I say in the original post, feeling like I could have walked on it with almost no pain.

Beginning on the second day, I stopped using the crutches, left the brace on, and walked on it throughout the day. I had an active day, so I was on it all day long. By the second half of the day, I was able to walk with an almost normal gait at an almost normal speed without pain. Near the end of the day, I finally removed the brace, and experienced almost immediate relief. I was able to walk normally without the brace, and the swelling started to go down only after I took the brace off.

Now, three days later, the swelling and bruising is still pretty horrific…even my toes have mostly turned black and blue. But as long as I am careful not to bend the ankle too far in the direction of the initial rolling injury, it’s basically fine. A little stiff, but no real pain. Continuing to move and load the ankle to tolerance has, I’m convinced, turned what might have been a long, drawn-out period of frustration into a minor nuisance.

[Michael_Ray]

@DorianStarbuck

Your advice falls right in line with what I’ve experienced with this injury over the weekend. What you recommend is so vastly different from what I was told to do by the doctor (and so much more in line with what, for me, has been genuine relief), that it’s almost hard for me to believe that immobilization and rest was ever the recommended treatment for this sort of injury.

I really appreciate you taking the time to give this advice, and want to say again how much I appreciate the work that you folks are doing. The work that BBM is doing has had a tremendously positive impact on my life, and I’m just so thankful for you all.

I’ll update this just in case anyone else encounters this thread while in a similar situation. I used the brace for the first day, and used crutches to completely avoid putting any weight on the foot, despite, as I say in the original post, feeling like I could have walked on it with almost no pain.

Beginning on the second day, I stopped using the crutches, left the brace on, and walked on it throughout the day. I had an active day, so I was on it all day long. By the second half of the day, I was able to walk with an almost normal gait at an almost normal speed without pain. Near the end of the day, I finally removed the brace, and experienced almost immediate relief. I was able to walk normally without the brace, and the swelling started to go down only after I took the brace off.

Now, three days later, the swelling and bruising is still pretty horrific…even my toes have mostly turned black and blue. But as long as I am careful not to bend the ankle too far in the direction of the initial rolling injury, it’s basically fine. A little stiff, but no real pain. Continuing to move and load the ankle to tolerance has, I’m convinced, turned what might have been a long, drawn-out period of frustration into a minor nuisance.

Thanks for the kind words, that’s exactly why we are here. Glad to hear you are recovering and managing well!