Stephen J. Schueler, M.D.

Twisted Ankle Home Care

Home care for an ankle injury includes:

  • Perform wound care as directed by your doctor.
  • Clean the skin gently:
    • Use mild soap and water.
    • Do not scrub the skin.
    • Dry the skin.
    • Apply an antibiotic ointment.
  • Apply a cold compress:
    • Wrap ice in a moist hand towel. Do not apply ice directly to the skin.
    • Apply for 20-30 minutes, every 1-2 hours, for the first few days.
  • Elevate your ankle.
    • Above your heart if possible.
  • Apply an elastic wrap.
    • Re-wrap the ankle every 6 hours.
  • Rest the injury.
    • Use a walker.
    • Use crutches.
    • Use a cane.
  • Apply an ankle splint.
    • The splint may help protect the ankle.
  • Ankle exercises
    • Start exercises after 3 days.
    • Gradually increase your activity over 1-2 weeks.
  • Acetaminophen for pain
  • Nonsteroidal anti-inflammatory medications for pain:
  • Take prescribed medications as directed:
    • Don't skip doses of your medication. This makes them less effective.
    • Be aware of the common side effects that may be caused by your medication.

Twisted Ankle Pain in Adults

Medications commonly used to control pain and inflammation in adults with an ankle injury include:


Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
  • Maximum dose is 4,000 mg per day.
  • Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
  • Common brand names include Tylenol, Panadol, and many others.

Aspirin

Ibuprofen

Naproxen

Ketoprofen

NSAID Precautions

Twisted Ankle Pain in Children

Common medications used at home for pain and fever in children with an ankle injury include:


Aspirin and most of the other nonsteroidal anti-inflammatory drugs (NSAIDS) are not used in children except under a doctor's care.

Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Dosing is 10-15 mg per kilogram (5-7 mg per pound) of body weight every 4-6 hours, up to the adult dose.
  • Do not exceed the maximum daily dose.
  • Acetaminophen products come in various strengths. Always follow the package instructions.
  • Avoid this drug in children with liver disease or an allergy to acetaminophen.
  • Common acetaminophen products include Tylenol, Panadol and many others.

Ibuprofen

Naproxen

Twisted Ankle Rehabilitation

Ankle Injury Rehabilitation
Minor ankle sprains, strains and contusions heal in 2 to 6 weeks. For minor injuries, start ankle rehabilitation exercises when the swelling and pain have resolved.

Severe ankle sprains, fractures and dislocations may require months to heal completely. Rehabilitation for these injuries may require formal physical therapy or occupational therapy.

Use the following guidelines for minor ankle injuries:

  • Exercise should be pain-free: do not start until the pain is gone.
  • Exercise motions should be performed smoothly.
  • Progress to difficult exercises quickly, but do so only if you remain pain-free.
  • Consider placing your ankle in an ice bath for 2-3 minutes before exercise. This may improve ankle motion.

Advance through the following exercises gradually. Exercise 2-3 times per day:
  • First, regain full range of motion by using the muscles in your leg to move your ankle in all directions.
  • Bear weight on the injury, first by shifting from foot to foot.
  • Bear weight completely on the heel.
  • Bear weight completely on the toes.
  • Walk, using short strides.
  • Walk, using long strides.
  • Walk in circles and in a figure-8.
  • Jog in a straight line.
  • Jog in circles or in a figure-8.
  • Jog in a sharp Z or smaller figure-8.
  • Sprint 5-10 yards. Start and stop slowly.
  • Sprint 5-10 yards. Start and stop quickly.

Twisted Ankle Skin Wound

Most minor cuts, abrasions and puncture wounds to the ankle can be safely treated at home.

Initial wound care includes:

  • Control bleeding with direct pressure.
    • Use a gauze or clean cloth directly on the wound.
    • Maintain the pressure, constantly, for at least 10 minutes.
    • Do not look at the wound.
  • Clean the wound with mild soap and water. Running water can help remove dirt.
  • You may gently dab the wound with hydrogen peroxide to remove clotted blood or debris. Do not scrub or re-injure the wound.
  • Be sure there is no dirt or other foreign material left in the wound.
  • A butterfly bandage can be used to close very small, clean cuts.
  • Apply an antibiotic ointment and a dry dressing.
  • Cover the wound with gauze or elastic bandage. Wounds to the face may be left uncovered.
  • Keep the wound clean and dry.
  • Protect and rest the injured area.
  • Elevate the injured body part.

Ongoing care for minor skin wounds includes:
  • Abrasions may be cleaned 2-3 times a day with a mild soap such as dilute baby shampoo.
  • Abrasions to the feet need special care. These tend to become infected very easily. Clean foot abrasions three to four times a day and wear an open shoe.
  • Gently clean scabs of the face with a warm, wet, soft cloth and hydrogen peroxide - try not to cause bleeding. Do not disturb dry scabs in other parts of the body.
  • Dry the wound gently, and completely, with a clean towel or gauze.
  • Apply an antibiotic and a dressing as needed.

Tetanus Considerations
A tetanus shot is necessary right away if you have not had three tetanus shots in the past.

If you have received three tetanus shots in the past, you need a tetanus shot within three days for:
  • A dirty wound and you have not had a tetanus shot in the past five years
  • A clean, minor wound and you have not had a tetanus shot in the past ten years

Twisted Ankle Toe Ring Removal

Remove toe rings immediately after an ankle injury, because it is difficult to remove the ring if the toe becomes swollen. Sometimes, the toe becomes so swollen that the ring must be removed with a ring cutter. The following will help you remove a toe ring from a swollen toe.

Ring Removal

  • Elevate the toe above the heart and apply a cold compress for 15-20 minutes.
  • Lubricate the ring:
    • Apply soapy water to the ring.
  • Ask another person to pull the skin tightly away from the ring, and then try to twist the ring off gently.
    • Stop if this causes pain or skin damage.
  • If this does not work, loop a piece of thin string or ribbon under the ring on both sides of the toe. Ask another person to grab the ends of both strings. Have the person pull equally on the ends of each string, while you gently twist.

Reducing Toe Swelling
In order to reduce toe swelling, you may wrap a wide rubber band around the toe. Start at the tip of the toe and wrap towards the ring. Overlap the edges of the rubber band as you wrap the toe. After 5 minutes, remove the rubber band and try to remove the ring.

Do not wrap the toe with a rubber band if:

Seek medical care immediately for:

Twisted Ankle Using a Cane

A cane may help you walk if you have an ankle injury or pain in one leg.

Proper Cane Length
Adjust the cane so that the handle reaches the crease in your wrist while you stand upright.

Using a Cane
Hold the cane in the hand on the opposite side of the leg that needs support. With the cane, you can support some of your weight with your opposite arm. For example, if your left leg needs support, you should use the cane with your right arm. When you step with your left leg, the cane and your left leg should be on the ground at the same time, and you should support some of your weight with the right arm.

Follow these steps:

  • Position your cane one small stride ahead and step forward onto the bad leg. Place weight on your bad leg and the arm that is supported by the cane. Your elbow should be slightly bent as you support your weight.
  • Step forward with the good leg.

Climbing Stairs with a Cane
Climb one stair at a time and rest on one step before moving to the next step.

Follow these steps:
  • Grasp the handrail with the hand that is on the same side as the bad leg.
  • Place your weight on the bad leg and on the arm that is supported by the cane.
  • Step up to the next step with your good leg.
  • Transfer your weight to the good leg.
  • Move the cane and the bad leg to the step where you placed the good leg.
  • Support and stabilize yourself with your legs, the cane, and the handrail before moving to the next step.

Going down Stairs with a Cane
Go down one stair at a time and rest on one step before moving to the next step.

Follow these steps:
  • Grasp the handrail with the hand that is on the same side as the bad leg.
  • Place your weight on the good leg.
  • Place your bad leg and the cane on the step below.
  • Transfer your weight to the bad leg and the arm supported by the cane.
  • Move the stable leg to the step where you placed the cane and the bad leg.
  • Support and stabilize yourself with your legs, the cane, and the handrail before moving to the next step.

Twisted Ankle Using a Walker

Elderly patients with ankle injury may require more support than a cane or crutches can offer.

A walker is much more stable than crutches or a cane. Adjust the walker so that the handles reach the crease in your wrist while you stand upright.

Using a Walker

  • Place your walker one stride ahead of you. Make sure that all 4 legs of your walker are on the ground.
  • Grasp the handles on the walker with both hands. Lean forward and support your weight on your arms.
  • Step forward with your good leg. Place your foot in the center of the square that is made by the walker feet.
  • Step forward with the other leg.

Walker Rules
  • Take small steps when you turn.
  • In order to sit in a chair, back up until your legs touch the chair. Reach behind you in order to feel the seat and then sit down.
  • In order to get up from a chair, push yourself up with your arms and then grasp the handles on the walker.
  • Make sure that the rubber tips on the legs of the walker are tightly fastened. Replace the rubber tips if they become worn.
  • Do not use your walker to climb stairs.
  • Do not use your walker on an escalator.

General Safety Tips
  • Remove small area rugs, electrical cords, spilled liquids or other items that may cause you to slip.
  • In the bathroom, install non-slip bath mats, toilet grab bars, a raised toilet seat, shower grab bars and a shower tub seat.
  • Keep household items in close reach.
  • Use a backpack, fanny pack, apron or shoulder bag to carry items.

Twisted Ankle Using Crutches

Some patients with an ankle injury will require crutches.

You must be able to support your entire weight on one leg, in order to use crutches. Crutches allow you to walk without placing any weight on an injured or painful leg.

Proper Adjustment for Crutches

  • The top of your crutch should be 1-1.5 inches below your armpit as you stand upright with the crutch resting on the floor.
  • The hand grips should be even with your hip joint.
  • Your elbows should bend as you use the hand grips.

Non Weight Bearing Technique
  • Stand on the good leg while using the crutches for balance.
  • Hold the bad leg off the floor.
  • Begin your step as if you are going to step on the bad leg, but do not place any weight on this leg. Instead, place both crutches in front of you and place your weight on your arms.
  • Your arms are supported by the crutches as you grip the crutch handles.
  • The crutches should be placed on the floor at an angle away from the side of your body, in a shape like the upright arms of the capital letter, "A."
  • Your elbows should bend as you support your weight.
  • Gently push off with your good leg after the crutches are firmly planted on the floor. Swing your body forward between the crutches.
  • Rest the top of the crutches tightly against each side of your chest and continue to support your weight with your arms.
  • Do not rest your armpits on the tops of the crutches. This can cause nerve damage.
  • Place your good leg on the floor and allow it to completely support your weight. Swing your crutches slightly away from your body and forward. Place the crutches on the floor to prepare for the next step.
  • Focus on where you are walking -- do not look at your feet.

Partial Weight Bearing Technique
  • Stand on the good leg while using the crutches for balance.
  • Begin to step on the bad leg, but do not place your entire weight on this leg. Instead, place most of your weight on your arms.
  • Your arms are supported by the crutches as you grip the crutch handles.
  • The crutches should be placed on the floor at an angle away from the side of your body, in a shape like the upright arms of the capital letter, "A."
  • Your elbows should bend as you support your weight.
  • Gently push off with your good leg after the crutches are firmly planted on the floor. Swing your bad leg forward between the crutches.
  • Rest the top of the crutches tightly against each side of your chest. Continue to support your weight with your arms and the bad leg.
  • Do not rest your armpits on the tops of the crutches.
  • Place your good leg on the floor and allow it to completely support your weight. Swing your crutches slightly away from your body and forward. Place the crutches on the floor to prepare for the next step.
  • Focus on where you are walking -- do not look at your feet.

Climbing Stairs with Crutches
When climbing stairs, you should climb one stair at a time, completely resting for a moment on one step before moving to the next step.

Follow these steps:
  • Start by supporting your weight with your good leg and both crutches.
  • Place your weight on both of the crutches and move your good leg up to the next step.
  • Transfer your weight to the good leg.
  • Lift the bad leg and the crutches onto the same step where you placed the good leg.
  • Support and stabilize yourself with both crutches and the good leg before moving to the next step.

Going down Stairs on Crutches
When going down stairs, you should go down one stair at a time. Stop and rest for a moment on one step before moving to the next step.

Follow these steps:
  • Start by supporting your weight with your good leg and both crutches.
  • Place your weight on the good leg and place both of the crutches onto the next lower step.
  • Transfer your weight to both crutches.
  • Place the good leg onto the same step where you placed the crutches.
  • Support and stabilize yourself with both crutches and the good leg before moving to the next step.

Twisted Ankle Warning Signs

Notify your doctor for an ankle injury and any of the following:

Continue to Twisted Ankle Underlying Cause

Last Updated: Nov 29, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Twisted Ankle References
  1. DiGiovanni BF, Partal G, Baumhauer JF. Acute ankle injury and chronic lateral instability in the athlete. Clin Sports Med. 2004 Jan;23(1):1-19, v. [15062581]
  2. Kunkel M, Miller SD. Return to work after foot and ankle injury. Foot Ankle Clin. 2002 Jun;7(2):421-8, viii. [12462119]
  3. McKay GD, Goldie PA, Payne WR, Oakes BW. Ankle injuries in basketball: injury rate and risk factors. Br J Sports Med. 2001 Apr;35(2):103-8.[11273971]
  4. Pugia ML, Middel CJ, Seward SW, Pollock JL, Hall RC, Lowe L, Mahony L, Henderson NE. Comparison of acute swelling and function in subjects with lateral ankle injury. J Orthop Sports Phys Ther. 2001 Jul;31(7):384-8.[11451309]
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