What are the treatment options for ankle sprains?

Photo of a physical therapist treating a sprained ankle

If someone sprains their ankle, the ankle is first immobilized (kept still) for a while using an ankle brace or bandage. But it's usually possible to start doing rehabilitation exercises quite early on. Painkillers can be used to relieve pain. Surgery is only rarely needed.

Sometimes one awkward step is all it takes for your foot to twist sideways, resulting in an ankle sprain. This is an injury where the ligaments around the ankle are overstretched or torn. Severe sprains can make the ankle joint chronically unstable.

Ankle sprain: What can you do?

In the first few days after an ankle injury, people are usually advised to rest their foot, keep it elevated (raised), cool their ankle and use a compression bandage. Resting your foot for a while at first can help reduce the swelling and pain. But if the ankle sprain isn't severe, there are good reasons to already start doing suitable exercises very early on.

Cooling your ankle with an ice pack may provide some pain relief. There isn't much research on how effective cooling the ankle is. If you feel that cooling helps, there is little reason not to. But ice cubes or ice packs shouldn't be placed directly on your skin because that could lead to a cold burn.

According to studies, compression bandages can help in the healing process. Compression bandages are elastic bandages that are wrapped around the foot, from the tips of the toes to above the ankle, to apply gentle pressure. This is best done by a medical professional, to make sure it isn't too loose or too tight.

“Kinesio tape” hasn’t yet been proven to help. This stretchy sticky tape moves with your body, and is thought to stimulate the muscles and nerves while moving.

When can you put weight on your foot again?

If the ligaments in a sprained ankle have only been overstretched, the ankle usually gets better within a few days: Immobilizing your ankle with a bandage or ankle brace and resting your foot will then be enough. You can soon carefully put weight on the foot again. If it's a mild sprain, you should be able to walk normally again after about one week.

If ligaments are torn or partially torn, it can take weeks before you are able to use your foot normally again. Then you will probably have to wear an ankle brace or orthotic (device for aligning your ankle) for at least five weeks, to stop you from moving your ankle too much. The idea is to allow the ligaments to rest, so that they can grow back together again. If there is a lot of swelling, a cast and crutches may be necessary to reduce the strain. Injections to prevent blood clots may be a good idea if mobility is very restricted, or limited for a long time.

Does physical therapy help?

If you have a torn or partially torn ligament, doing strengthening exercises can help to stabilize your foot before you start walking again. Many of these exercises are done to strengthen the muscles and improve coordination. They involve things like stretching and bending the foot in different directions. The earliest time to start physical therapy will vary from person to person. But it's often possible to start after about two or three weeks.

People who do mobilization exercises can often get back on their feet again faster than people who keep their foot immobilized in an ankle brace for a long period of time. They can start doing sports again sooner too. Starting exercises earlier probably doesn't have any influence on the long-term stability of the ankle, though.

Sometimes physical therapists or doctors offer ultrasound therapy or electrotherapy in addition to conventional treatments. These are meant to speed up the healing process. But studies haven't shown that they have any additional benefits.

What helps to relieve the pain?

At first, it helps to rest the foot for a few days and – depending on how severe the injury is – put no or only a little weight on it. If this isn't enough, painkillers can help. These include non-steroidal (NSAIDs) such as ibuprofen, diclofenac and ASA (the drug in medicines like Aspirin). Some medications can be used in the form of ointments or tablets, both of which have been shown to temporarily reduce pain and swelling.

One advantage of ointments is that they don't pass through the stomach. Painkillers that are taken as tablets can damage the lining of the stomach. The longer you take them and the higher the dose, the more likely this is to happen. But people who have a sprained ankle usually only need to take painkillers for a short time.

There are also herbal ointments for pain relief, but they haven't been proven to help.

What are the advantages or disadvantages of surgery?

Torn ligaments can be sewn back together again. But this operation doesn't usually help people get back on their feet again any sooner than if they start doing mobilization exercises early on. And it is associated with particular risks, including nerve damage and – like after any operation – infections, bleeding and wound healing problems.

People who do competitive sports sometimes choose to have surgery in the hope that it will help them recover fully sooner. But there is no scientific that this is actually the case. Instead, research suggests that people who have physical therapy and do strengthening exercises are able to do sports again sooner.

Surgery can sometimes be a good idea for people with particularly severe ankle injuries, though. If the ankle is still unstable six months after it was sprained, doctors might suggest surgery. This involves shortening the ligaments to stabilize the ankle. Ligaments that are operated on for this reason are probably more stable in the long term.

Starting to do exercises and coordination training sooner rather than later is also a good idea after surgery for an unstable ankle. This will probably allow you to return to your usual everyday activities sooner than if you keep your ankle immobilized in a brace for a long period of time.

Bleakley CM, McDonough SM, MacAuley DC. Some conservative strategies are effective when added to controlled mobilisation with external support after acute ankle sprain: a systematic review. Aust J Physiother 2008; 54(1): 7-20.

De Vries JS, Krips R, Sierevelt IN et al. Interventions for treating chronic ankle instability. Cochrane Database Syst Rev 2011; (8): CD004124.

Derry S, Moore RA, Gaskell H et al. Topical NSAIDs for acute musculoskeletal pain in adults. Cochrane Database Syst Rev 2015; (6): CD007402.

Feger MA, Herb CC, Fraser JJ et al. Supervised rehabilitation versus home exercise in the treatment of acute ankle sprains: a systematic review. Clin Sports Med 2015; 34(2): 329-346.

Hansrani V, Khanbhai M, Bhandari S et al. The role of compression in the management of soft tissue ankle injuries: a systematic review. Eur J Orthop Surg Traumatol 2015; 25(6): 987-995.

Kerkhoffs GM, Handoll HH, de Bie R et al. Surgical versus conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults. Cochrane Database Syst Rev 2007; (2): CD000380.

Miranda JP, Silva WT, Silva HJ et al. Effectiveness of cryotherapy on pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain: A systematic review of randomized controlled trials. Phys Ther Sport 2021; 49: 243-249.

Nunes GS, Feldkircher JM, Tessarin BM et al. Kinesio taping does not improve ankle functional or performance in people with or without ankle injuries: Systematic review and meta-analysis. Clin Rehabil 2021; 35(2): 182-199.

Southerst D, Yu H, Randhawa K et al. The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Chiropr Man Therap 2015; 23: 30.

Struijs PA, Kerkhoffs GM. Ankle sprain. BMJ Clin Evid 2010.

Struijs PA, Kerkhoffs GM. Ankle sprain: the effects of non-steroidal anti-inflammatory drugs. BMJ Clin Evid 2015: pii: 1115.

Van den Bekerom MP, van der Windt DA, Ter Riet G et al. Therapeutic ultrasound for acute ankle sprains. Cochrane Database Syst Rev 2011; (6): CD001250.

Woitzik E, Jacobs C, Wong JJ et al. The effectiveness of exercise on recovery and clinical outcomes of soft tissue injuries of the leg, ankle, and foot: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Manual Ther 2015; 20(5): 633-645.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on June 24, 2022

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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