“How to treat a child's sprained ankle?”
My 11 year old daughter sprained her ankle while playing soccer. My doctor said it wasn't broken and told her to ice it. But it still hurts her a week later.
5 Answers
Great question, and a very common one.
About 10,000 ankle sprains happen in the US every day and are often under treated by primary care docs and other health care providers.
Simple treatments such as rest, elevation, ice and compression are good in the first 12-24 hours, but a few more modalities are needed after this.
Keep in mind a sprain of any joint in the human body by definition is an injury to the stabilizing ligaments of that joint. They are either stretched (Grade 1), partial torn (Grade 2) or completely torn or ruptured (Grade 3). Thus, depending on the severity an ankle sprain can sometimes indeed be as bad as a bone fracture.
With bad sprains (severe swelling, bruising, pain, limp while walking or inability to walk) an orthopedic walking boot (easily purchased online) is recommended for the first 10-14 days. This provides rigid immobilization and support to the ankle, facilitating decreased swelling and pain, and allowing the patient to walk. If the sprain is not as bad, or after the boot, a medical grade brace that can be worn with a shoe is recommended, such as an ASO brace (again available online). This provides support and compression but is less cumbersome than the boot. This is typically worn for about 6-8 weeks.
In addition, during the first 2-3 weeks of a sprain the body is generating an inflammatory reaction around the ankle joint in response to the injury. To address this one should consider the use of an over the counter anti-inflammatory such as ibuprofen, motrin or aleve. Take an appropriate dose 2-3 times per day. Obviously consult with your primary care doc if there are any concerns about taking this if you have other medical conditions.
Lastly, the #1 reason to have long lasting issues after an ankle sprain is the lack of appropriate rehabilitation. Meaning, physical therapy is important. So, at a minimum one should work with a physical therapist for at least 2-3 visits to be taught an extensive home exercise program and be educated on the equipment needed to do this (theraband & BAPS board, both available online).
If after 10-12 weeks significant pain or instability (ankle rolling frequently even with brace) persist then seek evaluation with a foot and ankle trained orthopedic surgeon.
About 10,000 ankle sprains happen in the US every day and are often under treated by primary care docs and other health care providers.
Simple treatments such as rest, elevation, ice and compression are good in the first 12-24 hours, but a few more modalities are needed after this.
Keep in mind a sprain of any joint in the human body by definition is an injury to the stabilizing ligaments of that joint. They are either stretched (Grade 1), partial torn (Grade 2) or completely torn or ruptured (Grade 3). Thus, depending on the severity an ankle sprain can sometimes indeed be as bad as a bone fracture.
With bad sprains (severe swelling, bruising, pain, limp while walking or inability to walk) an orthopedic walking boot (easily purchased online) is recommended for the first 10-14 days. This provides rigid immobilization and support to the ankle, facilitating decreased swelling and pain, and allowing the patient to walk. If the sprain is not as bad, or after the boot, a medical grade brace that can be worn with a shoe is recommended, such as an ASO brace (again available online). This provides support and compression but is less cumbersome than the boot. This is typically worn for about 6-8 weeks.
In addition, during the first 2-3 weeks of a sprain the body is generating an inflammatory reaction around the ankle joint in response to the injury. To address this one should consider the use of an over the counter anti-inflammatory such as ibuprofen, motrin or aleve. Take an appropriate dose 2-3 times per day. Obviously consult with your primary care doc if there are any concerns about taking this if you have other medical conditions.
Lastly, the #1 reason to have long lasting issues after an ankle sprain is the lack of appropriate rehabilitation. Meaning, physical therapy is important. So, at a minimum one should work with a physical therapist for at least 2-3 visits to be taught an extensive home exercise program and be educated on the equipment needed to do this (theraband & BAPS board, both available online).
If after 10-12 weeks significant pain or instability (ankle rolling frequently even with brace) persist then seek evaluation with a foot and ankle trained orthopedic surgeon.
It is normal for a sprained ankle to continue to have symptoms beyond 1 week. The treatment generally goes like this: rest, ice, compression (Ace wrap or wraparound soft ) brace; crutches if it hurts to bear weight or the athlete is limping; Ibuprofen for pain and swelling. Once these symptoms have resolved (may take 2 weeks or even longer), allow the athlete to return to walking. Once she can walk without pain she can run. Then, she needs to do exercises to strengthen the muscles on the outside of the lower leg (peroneus longus and peroneus brevis) to provide dynamic stability to the ankle and reduce the risk of recurrent sprains (you can look up exercises online).
She can return to play when she has no swelling, no pain, no feelings of instability, can run full speed, and can make soccer moves at full speed.
She can return to play when she has no swelling, no pain, no feelings of instability, can run full speed, and can make soccer moves at full speed.
Routine sprained ankles usually take 2 weeks to heal and stop hurting. If it does not improve by then, further work up should be considered.
Ron Noy, MD
Ron Noy, MD
Growth plate injury. Not an ankle sprain. See on orthopedic surgeon.
Go to a sporting goods store and buy a lace up ankle brace. Continue the ice and give liquid advil 3 time a day, the dose based on her weight. An ankle sprain usually takes 3-4 weeks to resolve.
Hope it helps!!
Dr. Bose
Hope it helps!!
Dr. Bose
