The official line from the Red Cross, coaches, physiotherapists, and most doctors, is that there is a scientific method to dealing with a sprain – Ice, Compress, and Elevate (the so-called ICE method). But a recent position paper from the National Athletic Trainers Association (pdf) says that's probably not the best approach to a sprain. After reviewing available science on the diagnosis, treatment, and rehab of sprained ankles, the most common joint injury in sports, the Trainers Association found that ICE was an oversimplified method and not effective at speeding up the healing process. The group made 30 recommendations that should guide us to treating our sprains in a different manner.
The first thing to do once you sprain your ankle, according to the new guidelines, is to rest it immediately. The common wisdom that you should push through a sprain came from the locker room, not the doctor's office. "Don't just walk it off," says Tom Kaminski, the lead on the study. "If you get back into activity too soon, there's a risk of ongoing problems throughout life, like ankle arthritis and persistent instability."
Next, let it swell. If you can't put any weight on the injured leg and the joint gets extremely swollen, see a doctor. Otherwise, skip the ice or anti-inflammatory meds. "The inflammation process assists in healing," says Kaminski. "We don't want to interrupt that." Likewise for bypass compression, which had no real impact on recovery, according to the study. If you are in extreme pain, you can apply ice, which is actually fairly ineffective for reducing swelling but can relieve pain.
For two days after the sprain, rest and then work to build the strength back. Walking helps to maintain blood flow and flexibility to the injured ankle, both of which are proven to speed recovery. Once swelling subsides, in two to seven days, do balance exercises to retrain the stabilizer muscles that support the ankle. Begin by standing on one foot on a firm surface, says Kaminski, and progress to softer surfaces. And once you're ready to get back in the game, buy a brace. Kaminski recommends wearing one or at least taping the ankle. "The biggest risk factor for an ankle sprain is a previous ankle sprain," he says. "There's a lot of evidence to back up taping and bracing as effective preventatives."