It’s estimated that some 25,000 people sprain their ankle every single day, according to the American Orthopedic Foot & Ankle Society. (1) What are some of the reasons that someone might suffer from an ankle sprain?
Ankle injuries can affect people of all ages. They are commonly caused by things like repetitive overuse and poor posture when exercising. Other causes are muscular compensations, imbalance in oppositional muscles, and impact to a ligament or joint near the foot. For the elderly, who can experience weakness and instability in the ankles, accidents such as falling are another frequent cause.
Common signs of a rolled ankle are pain, swelling, throbbing and even a black/blue appearance surrounding the injury. Sprained ankles can definitely be painful — and also inconvenient, as they usually force you to stay off your feet. The good news is that there are natural sprained ankle treatments to speed the healing of ankle sprains or other related injuries.
Upon rolling or twisting your ankle, it’s important to immediately rest the affected foot. Ideally, elevate the area as much as possible for at least the next 48-72 hours. Natural sprained ankle treatments included below are: icing the ankle, dulling pain with essential oils, and preventing the injury from happening again.
What Is a Sprained Ankle?
A “sprain” is usually a sign that certain parts of the body are overused and stressed. A sprained ankle can also be called a rolled ankle or twisted ankle. Pain often means that a tear has developed in one or more ligaments that support and stabilize the ankle.
Ligaments are strong bands of tissue that hold bones together. They keep joints in place like the ankle, wrist, knee, parts of the lower back, neck, elbow and shoulder. The American Academy of Orthopedic Surgeons states, “An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits and tear.” (2) The ankle ligaments are pulled beyond their normal range of motion.
The lateral ligament is located on the outside of the ankle. It’s the part of the ankle most often injured due to rolling, overusing, twisting or straining. Up to 85 percent of all ankle sprains result from dysfunction of these ligaments. The ankle ligaments are made of small tissue fibers. These fibers can develop injuries ranging from small pulls or twists, to complete tears. (3)
If the ankle ligaments are completely torn, the ankle may become unstable even after the initial injury passes. This sets the scene for weakness, instability and other injuries in the future. Over time, muscular compensations caused by instability can result in damage to the bones and cartilage of the ankle joint. This is especially risky for those who engage in high-impact exercises such as running or playing contact sports. (4)
Common Causes & Risk Factors for Sprained Ankles
The Journal of Manual & Manipulative Therapy states that sprained ankles and fractures are some of the most common injuries to affect the legs. It’s estimated that about one ankle sprain occurs for every 10,000 people each day in Western countries. (5) Studies have found that 16-21 percent of all sports-related injuries are sprained ankles. They tend to occur during activities that can cause impact, fracturing of the ankles, over-twisting or overuse of muscles in the lower body.
Situations in which ankle sprains occur most often include: (6)
- When exercising, such as running or even walking. The risk is highest when moving quickly and on any uneven, hard surface. Unsupportive shoes that don’t feet your feet well create a risk factor for sprained ankles; they set the stage for rolling, instability and twisting.
- Tripping, getting knocked down (such as during contact sports like football, basketball, wrestling or soccer), or falling down. The elderly can sprain an ankle if they lack balance and wind up falling. Athletes commonly roll or overuse an ankle during training or a game. Sometimes an opponent can push a player down in a way that causes twisting, or step on their foot forcefully.
- Using improper form or having poor posture. Excess supination when running or walking, can contribute to ankle sprains.
- Having existing muscular compensations due to poor posture in the legs, sacrum and spine.
- Old injuries, including ankles sprains, stress fractures in the legs or tendon tears. These can leave scar tissue behind that causes instability.
- Overuse, including exercising too much without enough rest or standing for long periods.
- Limited range of motion and stiffness due to aging or conditions like arthritis. Weakness in the ankles or lower body can also occur from too little activity (a sedentary lifestyle).
- Loose ligaments or loss of cartilage in the joints of the feet or ankles (such as those of the subtalar joint).
- In some cases, leg discrepancy (legs are different lengths) due to genetics, which cause instability.
Symptoms of a Sprained Ankle
Some signs that you’ve likely rolled your ankle include:
- Pain when putting weight on the ankle or when moving.
- Signs of a swollen ankle, including puffiness, redness, heat and throbbing near the affected ligaments/joints.
- Bruising near the bone or other types of discoloration of the skin. Severe ankle sprains are often accompanied by bleeding that in turn causes bruising, This causes a black and blue appearance.
- Some report hearing a snapping or popping sound when the injury takes place. This usually happens in the case of a severe sprain in which the ligament completely tears.
- Loss of functionality and reduced range of motion in the lower body. Sometimes pain and dysfunctional musculoskeletal problems can extend up to the ankles, calves, outer thighs or knees. This makes it hard to go about normal activities.
- If you repeatedly roll the ankle, you might notice pain on the bottom of the feet (in the ball of the foot). Or you may develop clawed toes/hammertoes due to your form/stance.
Conventional Sprained Ankle Treatments
Doctors sometimes perform an X-ray on an injured ankle to ensure no bones are broken. Oftentimes it’s possible to diagnose a sprained ankle based on symptoms and appearance. Your doctor will look for signs of ankle swelling. She will talk to you about your symptoms and how the injury happened. She may also move around or press the ankle to determine how limited your range of motion has become. Once diagnosed, your orthopedist or doctor’s recommended treatments for the sprained ankle can include:
- Taking an over-the-counter pain killer. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help initially control pain and swelling.
- Resting and icing the foot. Use compression dressings, bandages or ace-wraps to keep your ankle still. Elevate your ankle by placing it above the level of your chest, ideally for about the first 48 hours.
- Improving your form when exercising (more on this below) and wearing more supportive shoes with inserts.
- Changing your sneakers/shoes when exercising is usually the first step, which might include wearing orthotic inserts for support. Orthotic inserts used in sneakers or shoes consist of arch support and sometimes a lifted heel. They control the rolling-forward motion of the foot. They can take pressure off the small toes and help stabilize the ankle.
- Depending on how severe your supination problem is, your doctor might also recommend physical therapy. Physical therapy can “reteach” your muscles and joints how to distribute your weight in a healthier way, from your feet upward.
7 Natural Sprained Ankle Treatments
1. Rest & Icing
Rest is vitally important for the healing process of any injury. It’s also one of the basic sprained ankle treatments. After you initially heal, you should start moving the ankle again to reduce stiffness. In the first 1-2 days after the injury, try to ice the ankle to keep swelling down. Use an ice pack or even a frozen bag of veggies. Press it against a cloth and the ankle for about 15-30 minutes at a time. Ideally, do this several times per day. Keep strong heat away from the affected foot and be careful not to apply ice directly to your skin.
Plan to rest the area for at least about 72 hours/3 days post-injury. Experts recommend a “three-phase” treatment program for optimal healing. It can take just 2 weeks to complete for minor sprains. It may take or up to 6 to 12 weeks for more severe injuries. Specific rest time will depend on your symptoms and ability to heal. Once you’re back on your feet, two of the best exercises are swimming in a pool and performing band exercises. You can also try cycling or using an elliptical when you’re ready; it’s probably best to ask your doctor before doing so.
2. Fix Your Form
Those who have poor posture and form when walking or exercising are at the highest risk for ankle sprains. This is especially true in the case of over-supinating the foot. Supination describes the rolling outward motion of the foot, therefore over-supinators don’t roll their root inward enough when moving forward. Excess supination is also called “underpronation” — since supination is the opposite of pronation of the foot (rolling inward). (7)
Both oversupination and overpronation also put too much stress on the bottom or outside edges of the foot. This often leads to leg pains or common running injuries. Those with high arches (the opposite of “flat feet” or collapsed arches) and tight Achilles tendons tend to be under-pronators/supinators. (8) In addition to spraining your ankle, this common type of poor form can cause other injuries. These include: “hammertoes” (clawed toes), Achilles tendinitis, plantar fasciitis, shin splints and iliotibial band syndrome, affecting the knees. It also causes poorer performance due to general instability and weakness.
Another problem is due to abnormal dorsiflexion of the foot. While supination describes the outward rolling motion of the foot, dorsiflexion describes the bending backward of the foot. Dorsiflexion decreases the angle between the foot and the ankle; in other words, it means the toes are lifting up and away from the ground, toward the ankle/body. (9) Proper dorsiflexion safely brings the knees over the ankles, such as when bending over, squatting or jumping forward. However, too much dorsiflexion is also problematic and leads to instability. Too much motion due to weakness in the muscles and joints of the feet can contribute to ankle rolling.
Here are tips to help you stretch and strengthen the lower legs after your initial injury heals. They are sprained ankle treatments that will help correct your form and prevent future sprains:
- If walking or running fast, come to a soft landing. Land closer to the middle of your foot, instead of the back of the heel. Try to land with a mostly flat foot, attempting to avoid too much curving of the toes inward or outward.
- Slightly increase your cadence and potentially shorten your stride to keep proper form in the feet and legs.
- Run with upright posture through your back and stay relaxed.
- Gently stretch/mobilize the muscles in the legs prior to exercise and afterward. This helps break up adhesions and allows you to sustain proper form. You can use a foam roller on the floor. Position your body on top so the roller is under your calves, then move back and forth gently. Also, try massaging the fascia (soft tissue) in the bottoms of the feet with a tennis ball under the foot.
- Increase strength in your legs by doing exercises. Examples are crab walks (holding an upside down “V” with your body), calf lifts, squats, forward bends, and lunges.
- Stretch your lower legs as you lay on your back. Then lift the legs in the air and flex the ankles back and forth. Or, perform heel raises by placing your toes up against a wall, tilting the toes back towards the body. Use a resistance band (also known as exercise band) wrapped around the ankle to gently pump and improve ankle flexibility. (10)
3. Correct Your Posture & Stance
Weak ankles prone to rolling can also put you at risk for other types of strains tied to poor posture. The muscles in the legs and feet get trained to push the foot away from the ground by using mostly the outer toes/pinky toes. These are weak areas of the feet, not capable of withstanding much pressure or weight. This can contribute to the formation of scar tissue in the lower legs. Once the legs are weakened, postural problems can extend up to the hips, pelvis and lower back.
Using sprained ankle treatments to correct your posture and stance is key. I recommend working with a physical therapist or postural trainer. They can assess how you can better control compensations and reduce risk for injury. You may want to find an Egoscue Posture Therapist and/or see a Spinal Correction Chiropractic doctor (ideally from a clinic such as the Clear Institute) if you suffer from back problems. Weakness and back compensations can work their way down to the feet because the body is fully connected. This is why a full-body approach to correcting posture is best.
4. Lower Inflammation & Support Joint Health With a Collagen-Rich Diet
Diet might seem unrelated to leg injuries, but your body needs nutrients to keep your muscles, joints and ligaments strong. There are several foods that make great natural sprained ankle treatments. Here are the top anti-inflammatory foods that can reduce swelling in a sprained ankle and support healing of damaged tissues:
- Sources of collagen. Collagen is the most abundant protein in the human body. It’s needed to keep all types of connective tissue strong. Bone broth contains collagen and can help speed recovery. It can also complete healing of sprains, strains and ligament injuries. In addition to providing collagen, bone broth contains amino acids and many minerals.
- Clean lean protein. The body cannot rebuild stressed tissue without enough protein. Eat at least 3-5 ounces per meal from a high quality, organic lean protein. A couple of options are wild-caught fish or grass-fed beef.
- Green leafy vegetables. Kale, broccoli, spinach and other greens are high in antioxidants, vitamin K and many minerals, which are essential for healing.
- Foods with vitamin C. Vitamins like C help rebuild collagen, an essential component of skin and tissues. Increase your intake of vitamin C rich foods, including fresh fruits and vegetables. Good choices include citrus fruit, bell peppers, strawberries and broccoli. Foods rich in electrolytes like magnesium and potassium can help speed healing and reduce muscle pains. Examples include coconut water and bananas.
- Foods high in zinc. Zinc facilitates chemical reactions that rebuild tissues and support the immune system. To increase your intake of zinc, add things like beef, pumpkin seeds and spinach to your diet.
- Antioxidant-rich foods. As you get older, if you’ve been very active, or if you’re under stress, free radicals will form. They can cause damage throughout the body. Free radicals are linked to many different signs of aging, stress and weakness. To prevent this damage include more foods with antioxidants, which counteract free radicals. These include berries, greens, sea vegetables, cocoa, green teas, fresh herbs and other superfoods.
I also recommend avoiding foods that can worsen or contribute to inflammation, signs of aging and slowed healing including:
- Alcohol. Alcohol promotes bone loss and inflammation.
- Too much sodium/salt. Too much salt prevents healing and removes critical nutrients from your body.
- Sugar and refined grains. Avoid these foods since they decrease immune function and provide very few nutrients for wound healing.
- Hydrogenated oils and fried foods. These foods increase inflammation and slow healing.
- Too much caffeine. Compounds in caffeinated beverages bind to calcium. This prevents absorption and limits healing.
5. Try Supplements That Help Repair Tissue
In order to heal damaged tissues, you need nutrients that help reduce inflammation, support tissue repair and increase growth factors. To help you naturally heal faster, I recommend considering taking these supplements as one of the 7 natural sprained ankle treatments:
- Bromelain (500 mg 3x daily). Bromelain is an enzyme found in pineapple, helps with healing and has an anti-inflammatory effect.
- Collagen (take as directed depending on specific product dosage). Tendons and ligaments are made of collagen, so this can help with healing.
- Omega-3 fats (4g daily). EPA and DHA found in fish oil are necessary for wound healing and reduce inflammation caused by an acute injury.
- Green superfood powder (follow package instructions). Look for a powder that contains nutrient-rich sea vegetables and essential minerals that support rebuilding of ligaments and tissues.
- MSM (1000 mg 3x daily). MSM has an anti-inflammatory effect and is a source of sulfur, necessary for tendon health.
6. Speed Healing With Prolotherapy & Soft Tissue Therapy
Even if you’re in a lot of pain, remember that almost all ankle sprains can be treated without surgery. Even severe sprains usually heal well with proper care and prevention of future injuries. Consider the natural sprained ankle treatments below.
Relieving tight muscles and trigger points can make a big difference in reducing joint stress and rebuilding stability. You may want to visit a clinic or specialist who does Active Release Technique (ART), Graston Technique® (GT), dry needling or Neurokinetic Therapy. These methods help “turn on” muscles that have been “turned off” due to injury. They help eliminate muscular pain in order to prevent future sprains.
I also recommend considering an orthopedist who performs prolotherapy treatments, or PRP. Some studies have found that prolotherapy treatments help reduce ankle and foot pain-associated arthritis, tendon ruptures, plantar fasciitis, misalignments, fractures and ligament injuries. (11) Prolotherapy is an injection procedure. It helps heal tiny tears or injuries to connective tissue throughout the musculoskeletal system (ligaments, tendons, muscle fibers, fascia and joint capsules). Connective tissue often is injured when it is torn away from a nearby bone. Prolotherapy is used most often on injuries or conditions that cause chronic pain, and don’t respond well to other natural therapies or medications (nonsurgical treatments).
7. Essential Oils for Reducing Swelling & Pain
Try essential oils. There are several essential oils that are excellent natural sprained ankle treatments.To reduce inflammation and increase circulation to the painful ankle you can apply cypress essential oil. To reduce bruising and decrease inflammation also try applying frankincense oil and peppermint oil. Mix 2 drops of each oil together with 1/2 tsp of coconut oil. Apply to the sprained area 3-5x daily. Then put a warm compress over the area for 2 minutes. You may also use this homemade muscle rub on the area after the first 24 hours when pain is likely to be at its worst.
Precautions When Treating an Ankle Sprain
Head to your doctor right away if your ankle is very swollen and painful to walk on. If you have trouble putting weight on your ankle and walking, you likely have a sprain or tear. Don’t ignore the problem. Medical attention is necessary in many cases. It’s also important not to put weight on the affected foot. This prevents symptoms from worsening and becoming more complicated.
It’s important to treat sprains. Neglecting to correct the stressed ligament will wind up weakening your ankle, sometimes long-term. This will make it more likely that you’ll suffer from future injuries and possibly even other muscular compensations. Repeated ankle sprains can even sometimes lead to chronic ankle pain, arthritis, problems with balance and stability, or falls.
- Acute ankle injuries are among the most common injuries that children, adults and the elderly experience. Things like ligament overuse, impact, instability, poor form, falling or weakness in the legs cause sprained ankles.
- Symptoms and signs of a sprained ankle include: pain when putting weight on the ankle or when moving, a bruised or swollen ankle, puffiness, redness, heat and throbbing.
- Natural sprained ankle treatments include: resting and icing the ankle, correcting your form when exercising, improving your posture, prolotherapy and soft tissue treatments.