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5 Best Ways to Tackle an Ankle Sprain - to R.I.C.E or not ?

Updated: Apr 18, 2022

Recent advice by major sporting bodies has changed how we treat ankle sprains so read on for advice about treating a ' turned ankle '

I think most people automatically reach for the ice pack and Ibuprofen if they have twisted their ankle or tweaked a muscle. We've all seen our favourite players having the ' Magic Sponge ' treatment for a fresh injury and have followed suit. Indeed the longstanding anocronym of R.I.C.E was for years the gold standard for frontline treatment of sporting injuries :

R= Rest

I = Ice

C = Compression

E = Elevation

Yet recent research by major sporting medics and published in the British Journal of Medicine has disputed this long held protocol and has proposed a change in how we treat sprains and strains in order to minimise further damage and far more importantly to promote healing and get you back to activity quicker and with less ongoing problems. Clearly these comments and suggestions are for minor to moderate soft tissue injuries - as with all injuries if you are unsure tehn always get an opinion in person froma q ualified medic or physio.

Rather than R.I.C.E ing their suggestion is we shoud all be P.E.A.C.E ing instead !

P = Protect

Preventing any further damage is always paramount so relative rest for a couple of days is fine as is protecting vulnerable new tissue as it is laid down. This might be in the form of a brace or using crutches or a stick to help take some of the load off the ankle in the early days. Walking well rather than hobbling is important and it would be wise to use a stick or crutch to allow a normal walking pattern. This stops any bad habits forming and ensures some gentle load goes through the tissues to help promote healing and formation of a good scar over any damaged tissues.

E = Elevate

Elevating the affected part higher than the heart can help to limit swelling building up allows gravity to drain any excess fluid that has accummulated in the injured area - kind of like getting the sauce out of the bottom of a ketchup bottle ! Too much swelling irritates the surrounding tissues, limits movement and can cause pain by distending teh tissues.

" Inhibiting inflammation using medications may negatively affect long-term tissue healing "

A = Avoid anti-inflammatories & ice

Yes, I know it flies in the face of all advice given in the past but latest research is that both of these things actually DELAY healing rather than helping. Remember, inflammation is an important phase of the body's natural healing process so the less we can disturb Mother Nature the better. Let her do her bit. Ice can be great when used as a painkiller but will also limit blood supply to the area which is necessary to ensure healthy new tissue is formed. Stick to painkillers like Paracetamol to help with the pain.

C = Compress

An elastic, cohesive bandage or tubigrip will help to limit swelling in the damaged area which in turn means less irritation of the surrounding tissues and less pain which can only ever be a good thing surely ! Always make sure there is some ' give ' or elasticity in the bandage and that it's not too tight though !

E = Education

That's what you are doing now ! All too often we collect patients who have been seen in A&E following their injury, have been told what to do in the next couple of days but not given any advice for the next weeks or months. When we see them they have often missed the window of opportunity to ensure maximum healing potential and avoiding any long term consequences of their injury. This is particularly true in the case of twisted ankles where a common pattern we see is a patient who has repeatedly ' gone over ' on their ankle for a number of years and has eventually ended up with long term damage to the joint and surrounding soft tissues. Frustrating when it could have been avoided with a good rehab programme early on.

And after P.E.A.C.E comes L.O.V.E of course !

L = Load

O = Optimism

V = Vascularisation

E = Exercise

This next phase is when the new tissues need to be challenged and this is when many run into problems and problems are always best avoided rather than dealt with further down the line so if you are someone who ' goes over ' on your ankles a lot, has balance issues or persistent pain and weakness in your ankles then why not contact us to see how we can help.

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