5 Common Misconceptions about Treating Sprained Ankles

Sprained ankles can occur while you’re hiking along the trail due to the undulating terrain which poses a danger of losing your step. Treating a sprained ankle usually comes with a list of remedies such as icing the area and elevating the foot. Surprisingly, these common steps have not been backed up by medical professionals and are actually misconceptions about healing a sprained ankle.

So, read on as we debunk the five common misconceptions about treating sprained ankles and provide you with solid advice on how best to treat your injury.

close up of person holding ankle on the trail

Sprained ankles can be a common injury on the trail, but there are several misconceptions of how to treat them. Photo: Pheelings Media via Shutterstock

What Is a Sprained Ankle?

Typically, a sprain happens when one or more ligaments in your foot or ankle become overstretched or torn from overuse or injury. This may result in severe swelling and bruising, which can be quite painful and can limit your mobility depending on the extent of the injury.

The primary function of the ligaments in the knee is to stabilise the joint and prevent an excessive amount of motion. When they are stretched or torn, stability is lost, causing pain and swelling.

Symptoms

Some of the common symptoms of a sprained ankle include:

  • Bruising
  • Swelling
  • Tenderness
  • Pain
  • Stiffness
  • Skin discolouration

Causes

A sprained ankle happens when your foot is turned inward and your ankle over-rotates. Sometimes, swelling or bruising can occur as a result of tripping and twisting the ankle. This often occurs when you do not wear proper hiking shoes that provide adequate support to the ankle.

However, it is important to note that everyone is susceptible to ankle sprains, even if you have well-fitted shoes. Walking on uneven surfaces, which is something hikers are no stranger to, already exposes you to some degree of risk of sustaining a sprained ankle.

The most common cause of sprained ankles is falling from a misstep and landing awkwardly, which is something that most hikers understand well. But not many are aware of the misconceptions towards treating sprained ankles.

So without further ado, here are the misconceptions of which to be aware of as you’re treating and healing your sprained ankle.

man helps woman to heal sprained ankle while hiking

It can be easy to misstep and fall while on the trail, even if wearing proper hiking boots. Photo: Adriaticfoto via Shutterstock

#1: Icing the Ankle

“Icing” is part of the R.I.C.E recovery plan encompassing rest, ice, compression, and elevation. For many years, this has been touted as the surest way of treating sprained ankles.

Following the R.I.C.E framework requires you to rest the injured area, ice it for at least 20 minutes four to eight times a day, apply compression for up to a week and elevate it to reduce swelling and bruising.

While the other aspects of the framework are still effective in dealing with sprained ankles, some medical doctors now question resting and icing the ankle.

According to Gabe Mirkin, the author of the book titled The Sports Medicine Book where the R.I.C.E framework was first introduced, icing right after a sprain helped cool the injury and prevent swelling.

However, he was forced to change his recommendation after reviewing research that showed icing sprained ankle further damages the ligaments by shutting off blood supply to the area. The blood is needed to help the tissue cells heal.

Essentially, icing doesn’t increase the healing but delays it. Mirkin, together with other medical doctors, now recommends skipping the icing part altogether unless the pain is unbearable. Even if you decide to use it, you should keep in mind that it becomes ineffective 24 hours after injury.

Read More: How to Prevent Ankle Pain Before Snowshoeing

#2 Compressing the Ankle Tightly

Compressing your ankle after suffering a sprain can help you recover, but you need to ensure you are doing it correctly.

Wrapping your ankle too tightly restricts blood circulation to the injured area, which will interfere with the healing process. A tight compression can also damage the tissues further.

But, wrapping the injured area loosely may allow too much movement, which prevents the ligaments from getting the support they need to recover.

Instead, the primary purpose of compressing the ankle is to temporarily provide support for moving around. In other words, you don’t really need support when you are asleep unless your sprain is very severe.

That is why doctors don’t recommend wearing the brace when you go to bed. Before you wrap your ankle, wash and dry it thoroughly and take your time to correctly bind the area.

person wrapping sprained ankle while outdoors

When wrapping the ankle, be sure it’s not too tight, but your ankle feels supported. Photo: Only_NewPhoto via Shutterstock

#3 Resting the Ankle and Avoiding Walking

If you are still following the R.I.C.E framework, you will probably argue that rest is essential to your recovery.

While this is true to some extent, medical research suggests that you need to move to aid recovery. That is why some experts have replaced the “R” in R.I.C.E with “M” to form a new acronym, M.I.C.E (Movement, Icing, Compression, and Elevation).

You need to keep in mind that complete inactivity restricts blood flow to the injured area, slowing down the healing process.

On the contrary, some slight movement and physical exercise increase blood and oxygen flow to the injured area while eliminating metabolic waste. The movement aids tissue healing by stimulating the release of chemical growth factors from the surrounding cells.

The release of growth chemicals plays a critical role in combining proteins and other structural scaffolds needed to strengthen, repair, and maintain muscles, tendons, ligaments, and cartilage.

Consider undertaking light balance exercises to reduce the rate of re-injury, which is common after suffering the first sprain. Ask your doctor to recommend appropriate exercises that can help you heal faster.

Read More: Exercises to Improve Your Ankle and Wrist Mobility for Snowshoeing

#4 Elevating the Ankle to Reduce Inflammation

The last “E” in the R.I.C.E framework stands for “Elevation.” In this case, you are required to keep the injured area raised to reduce swelling.

But the real reason for elevation isn’t to prevent swelling but to reduce inflammation. The truth is that most of us don’t like hearing the word inflammation. We have been made to believe that it is bad.

So, is it true that inflammation is always bad? The short answer is “no”. While chronic and low-level inflammation is partially responsible for some diseases, not all inflammation is bad.

In fact, inflammation is a vital part of your immune system. When you suffer a sprain on your ankle, your body’s immune system sets in and starts to pump blood, proteins, and other fluids to the injured area to aid the healing process.

The increased circulation of blood and nutrients to the injured area creates swelling and slight heat to protect and repair the damaged ligaments. This is what most of us refer to as inflammation.

In simple words, inflammation may occur as a result of your body’s natural healing mechanism. Therefore, the swelling you may experience is a clear sign that your body has circulated the necessary blood, proteins, plasma, stem cells, and other fluids to the injured area to begin the healing process.

This type of inflammation is usually acute and temporary. Trying to stop this natural healing process with anti-inflammatory drugs can inhibit your body’s automatic immune response and prolong the healing process.

person holding ankle on white background

The swelling you may experience is a clear sign that your body has begun the healing process. Photo:
ARZTSAMUI via Shutterstock

#5 Avoiding Exercise

Another misnomer is the idea that you should avoid exercise at all costs when you have a sprained ankle. The best way to regain strength after suffering an ankle sprain is through exercise. You can start with short walks then build up gradually to other forms of exercise.

Physical workout restores strength and balance while preventing the injured ligaments from weakening. This can reduce your risk of suffering another sprain.

Once the swelling has subsided and you can walk comfortably, consider exercising the ankle further. The primary objective here is to ensure that the healing process and rehabilitation strengthen the entire lower chain starting with your hip while incorporating balance and coordination.

It also focuses on strengthening the muscle group, which is essential in preventing future ankle sprains. Physical therapy exercises are usually low-intensity and strongly recommended for full recovery and rehabilitation.

Besides preventing recurrent ankle sprains, physical exercise also promotes stability, making your ankle stronger.

Read More: 7 Exercises You Can Do to Support Your Snowshoeing

Summary

Ankle sprains are pretty common and can occur due to strenuous exercise (including hiking), accidents, tripping and twisting your ankle, or even just rolling over in your sleep.

Whenever you suffer a sprained ankle, make sure you do the right thing to kickstart the healing process. As noted, icing and resting the area has been proven to be minimally effective in restoring the ankle.

If your sprain is severe, make sure you see your doctor immediately. They will assess the true extent of the injury and recommend appropriate measures to take.

Have you experienced a sprained ankle while hiking? What steps did you use for healing the sprained ankle? Please share your insights with us in the comments below.

Read Next: Chiropractor Approved Injury Prevention Tips for Snowshoers

About the author

Dr. K.L. Ong

Dr. Ong Kee Leong is a fellowship-trained senior consultant orthopaedic surgeon who subspecializes in shoulder and knee, foot and ankle, hand wrist, and elbow surgeries. He has been registered with the Singapore Medical Council as a specialist in Orthopaedic Surgery since 2011. You can learn more about Dr. Ong at https://drongkeeleong.com/.

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