Sprained Ankle / Foot
Date issued: December 2022
Review date: December 2024
Ref: A-531/NB/ED/Sprained Ankle / Foot
PDF: Sprained Ankle Foot final December 2022.pdf [pdf] 115KB
What is a sprain?
A sprain is an injury to the ligaments near a joint. Ligaments are strong bands of tissue that connect one bone to another. They help hold joints together. A minor sprain means the ligaments may have been overstretched. In more serious sprains the ligament may be partially or completely torn.
What is the treatment?
Protect Avoid overstretching the joint.
Rest For the first 24 hours, when the pain typically gets slightly worse, avoid putting full weight on the affected leg.
Ice Either crushed ice or a bag of frozen peas. Don’t apply ice directly to skin, place it over a tea towel
Compression Support bandages sometimes work if applied very soon (i.e. minutes) after the injury. They are rarely used outside this timeframe as they do not work
Elevation Raise the joint and support it above the level of the heart.
Exercises
These may be uncomfortable at the beginning but will prevent stiffness and weakness.
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Pull the foot up and then point the foot down.
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Turn the foot in then turn the foot out (keeping the knee still).
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Circle the ankle in both directions.
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It is important to start walking on the ankle as soon as possible and so crutches are best avoided. However, if you cannot walk on the ankle, you may need crutches for a short period.
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A supporting bandage is not medically necessary but may make some patients feel more comfortable.
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Severe sprains may benefit from physiotherapy
Should I take painkillers?
Paracetamol is useful to ease pain. It is best to take it regularly for a few days or so, rather than every now and then. An adult dose is two 500 mg tablets, four times a day. A doctor may prescribe additional painkillers such as codeine if the pain is more severe. If you are prescribed a combination of paracetamol and codeine (e.g. cocodamol or codydramol) then it is important not to take additional paracetamol as you will accidentally overdose.
Anti-inflammatory medication can be used with paracetamol or as an alternative. There are many types and brands. They relieve pain and reduce inflammation and swelling (often the cause of the pain). You can buy ibuprofen at pharmacies or supermarkets without a prescription. The dose varies depending on your age and other medical problems. Side-effects sometimes occur with anti-inflammatory painkillers. Ask your doctor or pharmacist for advice regarding them
If pain is not controlled by these simple painkillers, do not exceed the recommended dose but see your general practitioner to discuss the possibility of stronger painkillers.
What do I do if my symptoms are not improving?
Sprains of the ankle/foot normally take at least a few days to start improving. They may take weeks to heal properly.
Self-Referral to Physiotherapy
You have the option of a delayed referral to physiotherapy should your injury not settle with the advice given during your time in ED. If you feel you require physiotherapy then please use the link below to self-refer. This is also available via your General Practitioner.
https://www.plymouthhospitals.nhs.uk/physio-self-referral
Please be Aware: it is very important that you see your doctor immediately if you notice that the calf becomes increasingly tender, red and hot to touch
DVT (deep vein thrombosis) is a rare complication following any injury which may limit your mobility. Symptoms to be aware of and to report include:
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throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh
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swelling in 1 leg (rarely both legs)
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warm skin around the painful area
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red or darkened skin around the painful area
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swollen veins that are hard or sore when you touch them
Call 999 or attend the Emergency Department if you develop chest pain or breathlessness.
