This is the least stable position of the ankle, in which it is most susceptible to twisting forces rolling the foot inward or outward. A snap or tear may be heard or felt when the injury occurs. Immediate swelling after a sprain means bleeding around the ligament, and implies a more significant tear. True sprains of the ankle always produce some degree of instability of the ankle joint. Complete diagnosis of the severity of a sprain may require re-examination several days after the initial injury, when the pain and swelling have subsided enough to allow the doctor to examine the joint properly.
First priority is control of swelling.
Swelling and bleeding further stretch the ligaments of the joint and can lead to further late complications. An elastic bandage, ice water, and elevation are often helpful in controlling swelling. Strains and mildly to moderately severe sprains are managed by repeated ice packs, followed after 48 hours by hot soaks. The ankle is splinted or taped for one to two weeks to maintain stability during healing. Partial weight bearing is accomplished by using a crutch until pain subsides.