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Emergency Department Discharge Instructions

Ankle sprain

Category

Sprains

Emergency Care Discharge Instructions

Instruction summary

Ankle sprain diagram: Posterior Talofibular Ligament, Calcaneofibular Ligament, Anterior Talofibullar Ligament

An ankle sprain is a very common injury. An ankle sprain means there is damage to one of the ligaments in the ankle. The most common type of ankle sprain occurs on the lateral or outside part of the ankle. In this area, there are three main ligaments, all of which attach to the bone on the outside of your ankle:

  1. The anterior talofibular ligament (in the front)
  2. The posterior talofibular ligament (in the back)
  3. The calcaneofibular ligament (underneath) (see the Figure).

In most ankle sprains, the anterior talofibular ligament is partly torn, usually when the foot rolled inwards during activity.

Unfortunately, ligaments do not have a good blood supply (unlike tendons) and as a result, they can take 4-6 weeks to heal, and up to six months for full strength to return.

There are several ways to reduce swelling and to help the healing process
  1. Elevate the injured ankle. This can be done by putting your leg up on a chair when sitting down (watching TV, reading, eating dinner, etc). Elevating the ankle uses gravity to drain the swelling away from the ankle.
  2. If the ankle is swollen or painful, apply ice wrapped in a towel (or a bag of frozen peas wrapped in a thin towel) on the ankle for ≈10 minutes at a time. Then remove the ice pack and allow the skin to return to normal temperature before re-applying the ice pack (to avoid frostbite). Continue this while the ankle is still swollen; do not apply heat while the ankle is swollen.
  3. A tensor bandage can be wrapped around the ankle to provide more support over the lengthy healing period. This bandage can be removed when applying ice to the ankle.
  4. If the sprain was severe, you may have been provided with a splint during your visit to the ER. Use the splint as directed by the emergency physician.
When can you walk on your ankle?

The answer to this question is to “listen to your ankle.” If you feel pain when you try to put any weight on the injured ankle, then listen to your ankle and use crutches or a cane for a few days instead. After a few days, try to put some weight on your ankle again, starting with a small amount of weight and gradually increasing this amount as you feel comfortable.

If your ankle is not healing in 4-6 weeks, see your family physician.