In the US alone, around 2 million ankle sprains happen per year. (1) It’s one of the most common injuries that can happen to anyone but it’s generally easy to treat. Ice, in particular, has been a staple for newly sprained ankles. So, how often should you ice an ankle sprain?
The quick answer is that you should ice your ankles for 10 minutes at a time, several times a day. Leaving it on for longer may cause more harm than good.
I’ll explain why in a little bit, but, first here’s a list of topics you will find here – tap on any of them to go to their sections:
- How often should you ice a sprained ankle?
- Why ice works for ankle sprains
- How to incorporate ice with other at-home treatments (RICE therapy)
- Other forms of treatment
How often do you ice a sprained ankle?
Unfortunately, not many people know how to properly use ice as a form of treatment. They place it on the injury, leave it there for some time, and hope for the best.
But the optimal way to maximize its benefits for ankle sprains is through intermittent icing (2):
- 10 minutes on.
- Repeat every 2 hours for the next 48 to 72 hours.
This method provides longer pain relief and swelling reduction. (3)
But what does ice do to your injured ankle joint, exactly?
Why should you use ice for your ankle sprain?
After a sprained ankle, you’ll immediately feel ankle pain with any foot movement. You might also notice that it is much harder to fit your shoes because of swollen ankles.
To help remedy your ankle sprain symptoms, ice does the following (4, 5, 6):
- Decreases surrounding nerve sensitivity for higher pain tolerance
- Helps lower skin temperature for local analgesia to take place
- Minimizes muscle spasms
- Promotes constriction of blood vessels, which lessens the chance for tissue bleeding
- Reduces blood flow and cell metabolic demand, minimizing further damage
But you can do more than just use ice to get your ankle better faster.
Learn more: Here’s our complete guide on ankle sprains
How do you use RICE therapy for a sprained ankle?
According to a Dutch study, RICE therapy is the preferred method of handling ankle sprains for the first few days of injury. (4) It is an effective and accessible way to promote healing.
RICE is an acronym for:
In this case, resting doesn’t necessarily mean being on the bed the whole day. It means avoiding any strenuous activities that may harm your injury. It’ll help protect the forming scar tissue inside your sprained ankle, which is one of the first few steps in the repair process. (7)
You can still do other low-impact or selective activities, like walking (if it’s safe for you to do so) or working out your upper body.
There are four sensations that you’ll progressively feel whenever you use ice on your body.
This process is normal and means that it is working as intended.
But, the longer you apply ice, the more your skin feels numb. So make sure you have a timer with you.
Just a word of caution: Always use a thin piece of cloth or towel between the ice and your skin. This prevents frostbite and other complications.
Compression helps minimize swelling, provides external support, and prevents further injury in surrounding areas. (8)
An elastic bandage is the wrap of choice for compression. It’s cheap, accessible, and conforms to the shape of your foot if done correctly.
For the ankle, a figure-of-eight pattern is a common bandaging technique used.
How to use a bandage to wrap your ankle sprain
Items you’ll need: One 4-inch bandage with a clip fastener
Foot position: Forming a right angle with your shin bone
- Wrap the bandage twice around your midfoot
- Afterward, pull the bandage diagonally towards your ankle
- Loop it around your ankle and wrap it back to your midfoot in a diagonal pattern, making a figure-of-8
- Repeat each step, overlapping half of the previous wrap
- The whole bandage should cover your whole midfoot and ankle
- Once you’ve used up all the bandage, use the clip fastener to secure the bandage
- The whole wrap should feel snug but should not affect the blood supply to your foot.
Learn more: Other ways to wrap your sprained ankle at home.
Elevating your injured ankle helps drain inflammatory chemicals through your lymph nodes faster. It also lowers local pressure which can help limit bleeding. But how?
It’s very easy:
- Make sure that your ankle is above your heart. This works best while you’re lying down or sitting on a reclining chair.
- Relax and hold this position for 10 minutes at a time and let gravity do its work for you.
So you’ve done RICE for the past few days, but it’s still painful and the swelling hasn’t died down. There are still other options you can consider.
Other treatments for a sprained ankle
There are several ways to treat a sprained ankle, but the most common include:
Both these types of medications can be a good option if you are allergic to ice or have poor skin sensitivity. They are:
Whenever you get an injury, your body produces compounds called prostaglandin to signal inflammation. This, of course, comes with pain.
NSAIDs, or nonsteroidal anti-inflammatory drugs, help lower levels of prostaglandin. And, in turn, leads to pain and inflammation relief. (9)
These medications are more localized in their effect compared to oral medications. They can also be a good option if oral NSAIDs upset your stomach.
More importantly, topical NSAIDS can help reduce your pain in half in over a week’s use. (10)
Some examples include Diclofenac, Ketoprofen, and Capsaicin gel.
This device combines the effect of RICE therapy into one wearable boot.
Compression boots use intermittent pneumatic compression. Meaning, it provides varying levels of compression to help circulate the excess fluid away from your ankle. Aside from this, cold mist coming from the boot is there to help deal with pain.
The only downside of using a compression boot is that you can only use it while you’re laying down.
An ankle brace helps in providing compression and support which are both vital in dealing with acute ankle sprains. (11)
Placing a cold gel pack before you put on an ankle brace helps flush off the excess fluid while also providing ankle relief. And it’s convenient as well since you can still move around while you’re wearing a brace.
Some severe sprains need a more hands-on approach to get it better. The physical therapist’s role is to assess your lower body and look for any deficits. After taking all those information, here are some things that you might do during your rehab session:
This can help: Physical therapy for ankle sprains – full guide.
When should I not use ice?
Avoid ice if you have impaired sensation, open wound, cold allergy, and peripheral vascular disease.
Can ice make a sprained ankle worse?
Remember to keep a timer with you. With more than 30 minutes of continuous use of an ice pack, you can suffer from ice burns and nerve issues.
Should I use ice or heat for my ankle sprain?
Use ice if it’s less than a week from injury and your ankle is still swollen. Choose heat packs if your injury has been more than a week.
Should I elevate my sprained ankles while sleeping?
Yes. It can help decrease swelling and improve blood flow.
Know more: How to sleep with an ankle sprain?
Should you wrap an ankle sprain overnight?
Yes. Just use an elastic bandage and make sure that you don’t wrap it too tight.
Conclusion: How often should you ice a sprained ankle?
You don’t always have to spend a ton of money on a relatively simple injury like some ankle sprains. The combination of rest, ice, compression, and elevation is an inexpensive and effective way of handling mild soft tissue injuries.
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- Herzog, Mackenzie M et al. “Epidemiology of Ankle Sprains and Chronic Ankle Instability.” Journal of athletic training vol. 54,6 (2019): 603-610. doi: 10.4085/1062-6050-447-17
- Bleakley, C M et al. “Cryotherapy for acute ankle sprains a randomised controlled study of two different icing protocols.” British journal of sports medicine vol. 40,8 (2006): 700-5; discussion 705. doi: 10.1136/bjsm.2006.025932
- Hubbard, Tricia J, and Craig R Denegar. “Does Cryotherapy Improve Outcomes With Soft Tissue Injury?.” Journal of athletic training vol. 39,3 (2004): 278-279. https://pubmed.ncbi.nlm.nih.gov/15496998/
- van den Bekerom, Michel P J et al. “What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?.” Journal of athletic training vol. 47,4 (2012): 435-43. doi: 10.4085/1062-6050-47.4.14
- Bleakley, Chris et al. “The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials.” The American journal of sports medicine vol. 32,1 (2004): 251-61. DOI: 10.1177/0363546503260757
- Bugaj, R. “The cooling, analgesic, and rewarming effects of ice massage on localized skin.” Physical therapy vol. 55,1 (1975): 11-9. doi:10.1093/ptj/55.1.11 DOI: 10.1093/ptj/55.1.11
- Norton, Cormac. “How to use PRICE treatment for soft tissue injuries.” Nursing standard (Royal College of Nursing (Great Britain) : 1987) vol. 30,52 (2016): 48-52. doi:10.7748/ns.2016.e10506 DOI: 10.7748/ns.2016.e10506
- Borra, Vere et al. “Compression Wrapping for Acute Closed Extremity Joint Injuries: A Systematic Review.” Journal of athletic training vol. 55,8 (2020): 789-800. doi: 10.4085/1062-6050-0093.20
- van den Bekerom, Michel P J et al. “Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events.” Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA vol. 23,8 (2015): 2390-2399. DOI: 10.1007/s00167-014-2851-6
- Derry, Sheena et al. “Topical analgesics for acute and chronic pain in adults – an overview of Cochrane Reviews.” The Cochrane database of systematic reviews vol. 5,5 CD008609. 12 May. 2017, doi: 10.1002/14651858.CD008609.pub2
- Boyce, S H et al. “Management of ankle sprains: a randomised controlled trial of the treatment of inversion injuries using an elastic support bandage or an Aircast ankle brace.” British journal of sports medicine vol. 39,2 (2005): 91-6. DOI: 10.1136/bjsm.2003.009233