By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

“FOOT WRITING” CAN HELP SPEED MILD ANKLE SPRAIN RECOVERY

Question: I sprained my ankle recently. When I went to the ER, they took an X-ray, which they said was negative for a fracture. They put me in an air splint and told me to go home and “RICE” it. It was a mild sprain. I was off my crutches in a few days, but my ankle was stiff for a while, and it is fine now. I wasn’t really sure what RICE was. I really would like to know if what I did was OK. Could you tell me more about RICE?

Answer: When treating a mild sprain, it is not unusual to hear people talk about RICE. It stands for Rest, Ice, Compression and Elevation. This is the initial treatment for a mild sprain.

Ligaments connect bones to bones and keep them in place. When you “twist” your ankle, it’s usually due to the ankle rolling outward and the sole of the foot turning inward. This unnatural movement can stretch or tear the ligaments that attach to some of the bones around the ankle joint. The result is what’s called a “lateral ankle sprain,” the most common type.

The signs of a sprain are pain after an injury, swelling, bruising, and pain with walking or weight bearing. Sprains can range from mild, like yours, to very severe, sometimes requiring treatment with surgery or a cast.

When treating a mild ankle sprain, many practitioners recommend RICE as you know. There are also some variations on this. RICE-M is one. This adds “Movement” to the treatment of the sprain. Movement is usually started within the first 72 hours. It starts with gentle range of motion exercises and little stretching of the ankle.

I have a particular exercise that I recommend to my patients with mild ankle sprain. It may sound a little strange at first, but it works. I ask them to write their full name, in cursive, with their injured foot several times a day. The more they do it, the easier it gets. Also, it is important to begin weight bearing. This is gradual at first, but most people are off crutches in just a few days.

In the early part of your recovery period, you may need pain medication. Non-steroidal anti-inflammatory medications such as ibuprofen are often used to help with both the pain and inflammation of the ankle injury.

Building up the strength in the ankle to prevent re-injury is also important -- especially in the first few weeks after the injury. Some easy home exercises are picking up marbles with your toes, toe walking and heel walking.

Most non-sports ankle injuries occur when walking on uneven ground. Working on your balance can also help to prevent twisting your ankle when an unexpected hole in the ground is encountered. There are several different exercises that can help you improve your balance. Your physician may send you to physical therapy to get instructions on these and other helpful exercises.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.