Ankle Sprain Treatment Options

Conservative Ankle Sprain Treatment Options

Conservative treatment for an ankle sprain focuses on stabilizing the joint and reducing pain and swelling. Mild sprains benefit from a lace-up brace, while moderate to severe cases may require a walking boot and, in some cases, crutches for initial support. Pain and swelling typically last two to three days, with ice therapy and NSAIDs recommended during the first two weeks. Healing takes about four to eight weeks, during which early motion exercises may help prevent stiffness and improve proprioception. Even complete ligament tears can heal without surgery if properly immobilized, as surrounding tendons contribute to stability and function.

Grade 1 Sprain: R.I.C.E.

• Rest your ankle by not walking on it and using a brace.
• Ice should be applied immediately to reduce swelling. Use it for 20–30 minutes, three to four times daily. Combining ice with wrapping helps decrease swelling, pain, and dysfunction.
• Compression dressings, bandages, or Ace wraps immobilize and support the injured ankle.
• Elevate your ankle above heart level for 48 hours.

Grade 2 Sprain

For a Grade 2 sprain, follow the R.I.C.E. guidelines. A walking boot may be recommended to immobilize or splint the ankle.

Grade 3 Sprain

A Grade 3 sprain can lead to permanent instability. Surgery is rarely needed unless left untreated. A short leg cast or walking boot may be used for two to three weeks.

Physical therapy and rehabilitation help reduce pain, swelling, and the risk of chronic ankle problems. Treatment may include ultrasound, electrical stimulation, and controlled range-of-motion exercises, with water therapy as an alternative if land-based movements are too painful. Strength and endurance exercises are introduced gradually, with proprioception training to prevent repeat sprains. As pain decreases, agility drills and balance exercises are added to improve stability. Ankle sprains take months to fully heal, and returning to activity too soon can lead to recurrent sprains and chronic instability, sometimes requiring surgical correction.

Platelet Rich Plasma Therapy For Ankle Sprains

Platelet-rich plasma (PRP) therapy is a non-invasive treatment for ankle sprains that have not healed properly. By injecting a high concentration of the patient’s own platelets, PRP stimulates blood flow and triggers the body’s natural healing response. Dr. Soomekh performs PRP therapy for ankle sprains in Los Angeles at our Beverly Hills office, drawing the patient’s blood, processing it in a centrifuge, and using ultrasound guidance to inject the PRP into the ankle ligaments. Patients follow a post-treatment protocol, including wearing a walking boot to protect the ligaments, and some may benefit from additional PRP sessions based on their progress.

Chronic Lateral Ankle Instability

If an ankle sprain is not recognized or treated with the necessary attention and care, chronic pain and instability may result. Patients who sustain many ankle sprains over short periods of time can also experience chronic pain and an unstable ankle. The ankle will feel loose and unstable. You may feel insecure about its strength, so be cautious about how you use your “weak ankle.”

The Ankle Sprain Triad

Some untreated ankle sprains, or those that have multiple sprains over time, can develop added problems around the ankle joint. This leads to what can be called a “Triad” of damage from ankle sprains:

1. Chronic tearing and loosening of the ankle ligaments
2. The cartilage of the ankle can become disrupted, causing cartilage loss over time
3. Inflammation and scar tissue within the joint will develop, increasing pain and disability
4. Damage to the peroneal tendons on the outside of the ankle

Continued use of the damaged tendon can develop into tearing of the tendons, which leads to increased pain and lack of function.

Surgical Treatment For Lateral Ankle Instability

Dr. Soomekh will always recommend and attempt conservative treatment when appropriate. However, when ankle instability becomes painful, contributes to more damage, daily activities become a struggle, and conservative treatments have failed, surgical repair may be indicated.

Ankle Arthroscopy

Ankle arthroscopy is a minimally invasive procedure involving two small incisions—one for a camera to visualize the joint and another for instruments to perform repairs. This procedure helps “clean out” the joint, remove inflammation, scar tissue, bone spurs, and loose cartilage, and stimulate new cartilage growth when possible. The earlier it's performed, the better the outcome. Stretched ligaments can also be tightened using specialized instruments to improve joint stability.

Lateral Ankle Stabilization