About an ankle sprain

An ankle sprain is an injury that happens when your child rolls, twists or turns their ankle in an awkward way. Doing this can stretch or damage their ligaments. Ligaments are bands of tissue that help to hold the ankle bones together.

Treatment

It is important for your child to rest, but also to keep their ankle moving and reduce pain and swelling. For the first few days after the sprain, follow the PRICE guidelines (below).

P Protect
  • Protect the injury from further damage. Try using a support or splint.
R Rest
  • Rest the injury for the first 2 to 3 days.
  • Your child may need to use crutches.
  • Introduce movement gradually so they do not delay recovery by losing muscle strength.
I Ice
  • Ice the painful area with an ice pack (bag of ice or bag of frozen peas). Wrap the ice in a tea towel first, to avoid placing it directly onto bare skin.
  • Do not apply ice directly to bare skin, as this can damage the skin.
  • This will help stop the swelling and bruising.
  • Do this for 15 to 20 minutes every 3 hours.
C Compress
  • Compress (put pressure on) the injured area with an elastic bandage or elasticated tube bandage. This will help with swelling and movement.
  • Take the bandage off when they sleep.
E Elevate
  • Elevate (raise) their injury by resting it above the level of their heart. Keep it supported.
  • For example they can lie on the sofa with their foot on some cushions.
  • They do not need to keep it raised during the night.

Recovery

An ankle sprain usually takes 6 to 8 weeks to heal, depending on how serious it is.

Weeks since injury Goals and expectations
0 to 2 weeks
  • If we have given your child a boot and/or crutches in A&E, use these as instructed.
  • Your child should use the crutches to walk as normally as possible. They should not try to ‘swing’ on the crutches.
  • It is safe for them to move and put as much weight on their foot as they comfortably can, with or without crutches.
  • It is also safe to begin the starter exercises in this leaflet immediately, with their foot out of the boot.
2 to 4 weeks
  • Try to reduce the amount of time they wear the boot now.
  • Keep doing the starter exercises and add the progression exercises.
  • Try to add some gentle cardiovascular activity like cycling or swimming.
  • Keep other parts of their body moving. If they are old enough to use a gym, they can try doing some core stability exercises or upper body exercises.
4+ weeks
  • Gradually go through all of the exercises in this leaflet over the next few weeks.
  • If they have followed these exercises and gradually built up their activity levels, it is safe to start re-introducing other activities. For example they can try gentle running and jumping. They can also gradually return to sports training and PE.
  • Always be guided by how your child says their ankle feels. A little pain and/or swelling that goes away in 24 hours is usually nothing to worry about.
  • If they experience high levels of pain and/or swelling that do not settle quickly, get in touch with us and ask for an appointment. 

Your child must not try to 'push through' pain. This may delay their healing.

After 4 weeks

If your child still experiences any of the following after 4 weeks, get in touch with us (see Contacts) and ask for an appointment.

  • difficulty fully moving their ankle in all directions
  • significant swelling. Signs include shiny, puffy skin with loss of ankle shape and joint definition. (Small amounts of swelling are normal.) 
  • unable to put all their weight through their leg without crutches
  • feeling their ankle is going to give way when walking.

Starter exercises

Do each exercise 10 times (= 1 set). Repeat the set 3 times. 

Move the ankle up and down

Ankle up and down.png
Heel raises

Heel raises.jpg
Single leg balance

Single leg balance.jpg
Elevated (raised) leg

Elevate (raise) leg.jpg

Progressive exercises

Do each exercise 10 times (= 1 set). Repeat the set 3 times. 

Single leg heel raise

Rise up and down on one leg, holding on lightly to a chair

Single heel leg raise.jpg

Sideways hop

Hop side to side

Sideways hop.jpg

Single leg sit to stand

Stand up from a chair on one leg, and sit down gently

Single leg sit to stand.jpg

 

Step ups

Step up on the bad leg and raise the other knee

Step ups.png

 

Further treatment

If your child has not returned to everyday activities after 6 weeks, get in touch to ask for a physiotherapy appointment (see appointment booking below).

Remember that a full return to sports may take up to 3 months, depending on how serious their ankle sprain is.

Contact information

Richmond Children's Community Physiotherapy 

Telephone:

Appointment booking: 020 8891 8195