Ankle Injuries: Basic Home Care

Ankle Injury Patient Instructions: Grade 1 Sprain

McKenzie Pediatrics

Phase 1 (First 48-72 hours):

• PRICE (Protection, Rest, Ice, Compression, Elevation)

• Protection: Protect the ankle with either an air-stirrup brace or a lace-up brace, and use crutches when walking
• Rest: Do not bear weight on the ankle for the first few days, until the swelling and pain have decreased
• Ice: Elevate the ankle to above the level of the heart. Apply bags of crushed ice or of frozen peas or corn to the ankle for 20-30 minutes at a time every 2-4 hours while awake. Place a threadbare washcloth between the cold bag and the skin.
• Compression: By means of open-basket-weave ankle taping or a simple elastic wrap increases comfort and limits edema. Keep tape or elastic wrap on ankle at all hours except when icing and when bathing.
• Elevate: Keep the ankle elevated above the level of the heart for as much time as possible during the day in order to decrease swelling. Even at night, if the child is able, have them sleep on their back with their ankle and foot resting on a thick pillow.
• It is ok during the first 2-3 days to move the ankle, but only by moving the foot down and up and only within the pain-free range of motion. Moving the ankle side-to-side is likely to be more painful, and should be avoided during this period.

Phase 2 (Begins When Acute Pain & Swelling Has Subsided):

• If pain and swelling have not significantly diminished by 72 hours after the injury, call your doctor. Otherwise:

• Begin Contrast Baths

• Immerse the affected ankle alternately in cold (for 1 minute) and warm (for 3 minutes) water over 20-30 minutes 2-3 times per day.

• Begin Range-of-Motion Exercises (ROMEs)

• Begin stretching exercises by having the child seated, and have them hold a towel around the sole of the foot with the ends of the towel in either hand. Have the child push their foot as far as possible against the tight towel, then pull the towel back as far as possible. Repeat 10-20 times, 2-3 times per day.
• Then, remove the towel, and have the child pretend to use her foot to “write the alphabet” A to Z. Do this 2-3 times, also 2-3 times per day.
• Once able to bear some weight, have the child stand with feet flat on the ground. Have them rock the heel by pulling the toes up as much as possible, then bring the foot down slowly along the outside until the toes are touching the ground and the heel is lifted. Repeat 10-20 times, 2-3 times per day.
• Also once able to bear some weight, have the child sit in a rolling chair and move the chair forward then backward with foot & ankle touching the ground. Repeat 10-20 times, 2-3 times a day.