- Sprain recovery plays an important role in long term physical ability, and can take from six weeks to a year for full recovery.
- A significant number of people who sustain an ankle sprain develop long term ankle instability.
- Optimal short term sprain recovery studies are inconclusive.
- The best long term solution for sprain recovery is a combination of a strengthening plan, therapy, and a temporary physical brace.
Why You Should Take Sprain Recovery Seriously
According to research, 40% of people who experience a lateral ankle sprain develop chronic ankle instability. 1)https://www.tandfonline.com/doi/full/10.1080/00913847.2018.1409604?scroll=top&needAccess=true
This results in long term decreased range of motion, strength, posture control, and altered movement when performing normal tasks.
I have to admit that I am reluctantly taking my own sprain recovery advice on this one.
About 15 years ago I was obsessed with skateboarding (come on, the physics are so amazing) – it’s all I did during the summertime.
And, like many skaters, I sustained a severe ankle injury that earned me a hospital visit. Instead of a broken ankle I found I was dealing with a deeply sprained ankle (I can’t decide which I would rather have).
Rather than allowing my body to heal, I went back to skating far too quickly and I re-sprained it at least a dozen times in a short period of time…
….an unbelievably stupid decision that has taken years to overcome.
Fast forward to last week.
Unfortunately, I sustained another nasty lateral sprain playing basketball with some very talented players in Yigo, Guam.
You’d think I’d have learned my lesson last time, but slowing down is something I hate doing. I simply love being active.
After a few days of feeling better I returned to playing basketball and immediately sustained a much worse lateral ankle sprain then the previous week. I should have listened to that little voice in the back of my head that was telling me to go home, rest, and recover.
They say it’s never too late to make the right decision, and that’s where I’m at.
After doing quite a bit of research, I have a lot to report about ankle sprain recovery and how to create successful long term healing.
There Are Multiple Severities Of Sprains
Ankle sprains are broken down into three separate grades.
- Grade 1 is a mild stretching of the ligaments without macroscopic rupture or joint instability.
- Grade 2 is a partial rupture of the ligament with moderate pain and swelling. Functional limitations and minor to medium levels of instability are also a factor.
- Grade 3 is a complete ligament rupture with substantial pain, swelling, and bruising. There is an obvious impairment of function and stability. 2)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718986/
Whichever type of sprain you’re dealing with, it’s unlikely that you’ll have to resort to any kind of surgery.
Most ankle sprains, including all three grades, can be managed without surgery. 3)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718986/
During my hospital visit 15 years ago I distinctly recall that no surgery or medication was suggested or prescribed.
Even though I could barely walk and was using crutches.
The sprain was bad enough so that I was told to keep any weight off it for a week…what a waste of money for that visit, right?
If the hospital can’t do anything other than offer obvious (and expensive) advice, it makes you wonder if there’s anything you can do on your own to facilitate sprain recovery.
Happily, there is.
With surgery (hopefully) out of the question, it’s important to know what practices are most effective to stimulate sprain recovery.
Sprain Recovery Methods
The typical sprain recovery mantra is icing the injured area is your best short term solution.
But multiple studies have are totally inconclusive that the ice method is effective for sprain recover. At best, there is little evidence for its validity. 4)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396304/ 5)https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-017-1777-9
In fact, one randomized trial performed at an emergency room, using 143 patients and ankle wraps, compared the effectiveness of ice therapy with a placebo.
The results showed that…
“Though a trend was found in favor of ice therapy, no statistically significant difference was found in recovery time, as defined by pain relief and ability to bear weight.” 6)https://www.ncbi.nlm.nih.gov/pubmed/27198132
Another randomized study comparing ice and a placebo showed similar results questioning the validity of the RICE method.
They also concluded that …
“No statistical difference was found in recovery time, defined as ability to bear weight with only mild to moderate pain.” 7)https://www.mdedge.com/jfponline/article/60339/pain/heat-or-ice-acute-ankle-sprain#bib2
The information gained from these studies shows that ice is neither helpful or hurtful for long term sprain recovery.
Adding ice is simply to help reduce pain and swelling. So if you want to use it, go for it.
Personally, I’m a bit more of a naturalist. I believe the body is smarter than I am. So with the exception of far more serious conditions, I generally trust my body to heal itself.
Redness, swelling, inflammation, and pain are your body’s first defense responses to injury.
These conditions deter you from incurring further injury and signals the release of chemicals that will begin the healing process. 8)https://www.nationwidechildrens.org/swelling-bodys-reaction-to-injury 9)https://www.medicalnewstoday.com/articles/248423.php 10)https://www.webmd.com/arthritis/about-inflammation
Ankle Braces And Supports
I recently overheard a nurse warning a patient to limit the use of an ankle brace after a sprain.
The nurse went on to explain that the patient shouldn’t develop a dependency on a physical brace or the injury wouldn’t recover as quickly.
But scientific literature shows that there is a more prominent place for braces in the sprain recovery process.
Not only do braces help athletes return to work with less risk of recurring injury, but they also can improve physical sensation.
“Both taping and bracing have been found to reduce the risk of recurrent ankle sprains in athletes…Braces also provide the athlete with proprioceptive stimulation, which implies an improve proprioception and sensory feedback.” 11)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2786815/
This review critiques 19 ankle sprain studies that span over ten years. The conclusion states that the type of brace is dependent on the type of sprain.
“This systematic review supports a phase adapted non-surgical treatment of acute ankle sprains with a short-term immobilization for grade III injuries followed by a semi-rigid brace. Types I and II injuries might best be treated with a semi-rigid brace.” 12)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718986/
In other words, the use of an ankle brace or tape can allow you to return back to your normal activities with less risk of injury.
A brace should prove helpful alongside your recovery priorities, which are:
- Paying attention to inflammation.
- Reestablishing a range of motion.
- Becoming pain-free.
- Gaining strength.
- Weight bearing.
- Balance training exercise. 13)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164373/
But even when using a brace, be very cautious when you begin returning to your normal movement patterns, because full recovery takes a very long term (more on that in a bit).
Simple Therapy At Home Can Accelerate Sprain Recovery
You don’t have to cringe at the word therapy. It’s just simple movement and exercise that can help you recovery fully.
The benefits of movement therapy are less pain, improved ability to perform daily activities, and return to sport. 14)https://www.jospt.org/doi/full/10.2519/jospt.2013.0504
An interesting study of ankle sprain recovery compares two methods of therapy: manual therapy and supervised exercise, and a home exercise program.
The comparison shows quite a bit of information, which concludes that both methods can both be effective.
But the manual therapy and supervised exercise group has an edge in pain reduction and overall function.
“The patients who received the manual therapy and supervised exercise program experienced about a 70% reduction in pain at 4 weeks and more than a 92% reduction in pain at 6 months. By contrast, patients who received the home exercise program only had a 39% reduction in pain at 4 weeks and an 80% reduction at 6 months.” 15)https://www.jospt.org/doi/full/10.2519/jospt.2013.0504
The biggest difference here is at the four month marker – a 31% decrease in pain after sustaining an ankle sprain.
In the end your total recovery and ability to get back to what you love is the most important factor.
Again, the manual therapy and supervised exercise program group showed a significant advantage of the home therapy group.
“For those in the manual therapy and supervised exercise program, the ability to perform daily activities improved from 66% at the initial exam to 87% at 4 weeks and 97% at 6 months (100% is full function). Meanwhile, those doing just the home exercise program only saw improved function to 73% at 4 weeks and 88% at 6 months.” 16)https://www.jospt.org/doi/full/10.2519/jospt.2013.0504
The study concludes with a difference of 9% in total function at the six month mark. As an active person, 9% sounds like a whole lot of missing strength.
Another study confirms that restrictions to range of motion can last at least six months, maybe longer. 17)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396304/
The study also shows that long term decreased range of motion can cause chronic ankle instability.
This is further evidence that a primary goal of full sprain recovery should be increasing range of motion by movement and therapy techniques. 18)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396304/
Wasting six months on an ineffective recovery strategy is obviously a poor choice. Particularly when you consider exactly how long an ankle sprain takes to completely heal.
Full Sprain Recovery Takes A Long Time
Even though your ankle may feel relatively normal in just a few days, there’s still a lot of repair that needs to happen.
I can tell you from experience that jumping back into an active lifestyle and allowing re-injury is foolhardy, discouraging, and a complete waste of weeks – maybe even months.
Take the time to completely heal. It’s worth every moment of yearning for activity.
An analysis of several studies between 1964 and 2007 reveals two crucial facts to reach full sprain recovery.
- Mechanical stability did not occur until somewhere between six weeks and three months.That one sentence, as someone facing an ankle sprain recovery, is one of the most frustrating things I’ve ever read.
- Even between six weeks to a whole year, a moderate percentage of participants had “objective mechanical laxity and subjective ankle instability.”19)http://natajournals.org/doi/full/10.4085/1062-6050-43.5.523
A year is a long time to wait and still have an unstable ankle.
I’d like to think that with the use of a brace and the right type of movement therapy, that moderate percentage of participants might have had better results.
It’s a strong possibility, considering all the studies we’ve covered so far in this article.
This long and tedious process of waiting and doing very little is very frustrating to me.
But the good news is that now, armed with science and knowledge, I can definitely look forward to a full recovery with a low risk of re-injury…unlike my skateboarding days.
Sprain Recovery – Summary
If you only take away one thing from this article, let it be this: don’t rush the sprain recovery process.
Even if your ankle begins feeling normal, there’s still a lot of recovery that needs to happen.
Learn from my mistakes (I’m still kicking myself…not with my right foot, it’s still a little swollen) and remember the science that shows how you can stimulate effective recovery for long term health and vitality.
In addition to playing the long game of sprain recovery, I’m also taking preventative measures to make sure this never happens to me again. Spending a hundred dollars on a pair of NBA athlete-endorsed ankle braces seems like a small investment to remain active.
Remember these key points if you’re facing the process of sprain recovery:
- Sprain recovery plays an important role in long term physical ability, and can take from six weeks to a year for full recovery.
- Optimal short term sprain recovery studies are inconclusive, so focus on rest as much as you can.
- The best long term solution for sprain recovery is a combination of simple, supervised therapy, and a temporary physical brace.
- Once you’re back to your normal activities, it makes sense to prevent further injury. Invest in a high-end brace or two. Particularly if you’re still inside a year from your initial injury. Full stability takes a long time.
Help me out a little as I spend some quality time recovering from my sprain in front of the computer – leave a comment or send me an email at firstname.lastname@example.org
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References [ + ]
|2, 3, 12.||↑||https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718986/|
|4, 17, 18.||↑||https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396304/|
|14, 15, 16.||↑||https://www.jospt.org/doi/full/10.2519/jospt.2013.0504|