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When to Immobilize a Sprained Ankle

The effects of immobilization on a sprained ankle have long been debated. While immobilization helps the healing process in some cases, in other instances it can impede the body's natural ability to heal, by restricting motion--often for extended periods of time. Individuals who have learned to immobilize sprained ankles immediately following injury run the risk of keeping the sprain braced for too long, which can result in a decreased range of motor function and, in severe cases, atrophy. Injuries that are expected to heal rapidly shouldn't be immobilized. Otherwise, immobilization is a key factor in healing sprains.

  1. Grade 1 Sprains

    • In general, it is not recommended that a sprained ankle be immobilized if the sprain is not serious; that is, if collagen fibers are only torn microscopically. Sprains or strains of the ankle that produce only a minimum of swelling, redness, and discomfort are considered first-level (or grade 1) sprains. Such sprains may be slightly tender to the touch, or they may feel no different than a perfectly healthy ankle. A minor amount of swelling can be evident in such sprains, although the range of motion is not significantly decreased. Range-of-motion and isometric exercises, as far as the individual can bear such exercise, may be attempted in therapy; however, splinting and immobilizing should be avoided.

    Grade 2 Sprains

    • A grade 2 sprain results in a decreased range of motion and significantly more swelling and tenderness than a grade 1 sprain, due to complete tears of some of the collagen fibers that support the ankle. Instability and moderate impairment are usually evident in such sprains. Immobilization should be attempted in the case of such injuries--an ACE bandage is usually sufficient. Tubular compression bandages should not be applied. In instances of grade 2 injuries, air splints provide the best and quickest healing. Unlike grade 1 sprains, such an injury requires some form of immobilization to ensure proper healing and collagen regrowth.

    Grade 3 Sprains

    • Instability and swelling are readily evident in the case of grade 3 sprains. Such a sprain obviously decreases the range of motion in the ankle, even after compresses are applied, and a complete tear (or total rupture) of a ligament causes pain and instability. Impairment in the case of grade 3 sprains is considered severe. Such sprains may require a cast, although it is not recommended to insert any objects into the cast to keep the ankle straight. A SAM splint--a thin layer of aluminum alloy--is often required to prevent motion in the ankle following such an injury, and prevent recurrence or further injury to the soft tissues that support the ankle.

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