Ligaments are the tissues that connect muscle to bone. An ankle sprain is a stretching or tearing of the ligaments in the ankle (Picture 1). Signs of an ankle injury include pain, swelling or trouble walking. Often this happens after an injury that involves twisting or rolling of the ankle.
Home Care and Treatment
During the first few days after injury or onset of pain, protect the ankle against further injury. Use the word “P R I C E” to remember the key points of care:
P - Protect the ankle by using bandages or supports. If there is no broken bone, your child may put weight on the ankle.
R - Rest the ankle as much as possible for the first two to three days. To make the ligaments stronger, do range of motion exercises 3 times a day. Have your child write the alphabet in the air with his toes (Picture 2). Your health care provider may prescribe crutches depending on your child’s ability to walk on the ankle. (See Crutch Walking, HH-II-6.)
I - Ice in a bag may be applied for 15 to 20 minutes every few hours to the ankle for two to three days. Do not use heat. To relieve swelling and pain, you may give ibuprofen (Motrin®, Advil®). Follow the directions on the bottle.
C – Compression. Use the ankle support advised by the doctor or nurse. Elastic bandages, splints, ankle braces and crutches can help to rest the ankle. While using any ankle support, watch for changes in circulation (See the Helping Hand, Circulation Checks, HH-II-60.)
E – Elevation. Keep the ankle elevated (raised up) above the level of the heart whenever possible, to decrease ankle swelling. This is best done by lying down and propping the foot on pillows.
To Restore Ankle Use
Your child should start exercises as soon as he or she is able bear weight on the foot and walk. Here are some exercises that should be done to restore ankle use:
Toe raises: Hold the toes on the edge of a step for 10 seconds. Do this exercise 10 to 12 times, twice each day (Picture 3).
Stretching exercises: Wrap a towel around the foot. Push down, up and side to side holding the ends of the towel or band (Picture 4). Do this for ____ (minutes), ____ (number of times per day). Put ice on the ankle after each exercise session.
To Regain Ankle Strength
After your child is walking around and is able to move his joints with little pain, have him start to work on balance:
Stand on the injured leg for up to 30 seconds. Practice with the hands held out to the sides or onto a table if needed. Try the exercise with eyes open or closed (Picture 5).
If your child is active in sports, talk with your child’s coach or gym teacher about exercises for specific sports. Once your child has full range of motion of the ankle and is pain-free, he may go back to full activity.
When to Call the Doctor
Call your child’s doctor if you notice any of the following:
- Pain or swelling gets worse instead of better
- Foot is cold or numb
- Pain is not going away as expected
Call your health care provider and make a follow-up appointment for one to two weeks after the ankle sprain.
If you have any questions, be sure to ask your child’s doctor or nurse.
HH-I-265 10/08 Copyright 2008, Nationwide Children’s Hospital