WAG Return following an ankle sprain.

[Gymettemom]

DD sprained her ankle a week ago. She is still having some pain and weakness in the ankle, but has been cleared to return to full use, as tolerated. She has her state meet in 1.5 weeks. How realistic is it to think she will be 100% in time for states?

 

[iwannacoach]

Heat, ice, and compression like crazy for the next 10 days. After that you just settle for what ever comes.

 

[raenndrops]

It would depend on how bad the sprain was. If the doctor has cleared her already, I would think it was only a mild one... but you say she is still having pain.

If you haven't I would get her a good ankle brace. Ice for 20 minutes after practice (I would leave the brace on for it, but that's just how I deal with mine). Elevate it as often as possible and an hour later, remove the brace and apply heat for 20 minutes.

I would also ask the doctor what meds and doasage is recommended for any pain or swelling. (That is so I don't get in trouble for playing doctor, lol).

 

[Gymishome]

Strengthen the ankle, ice, wrap, all as much as you can. Sprains take longer than the time you're giving her to heal, but, although I don't like braces, it may be good to get one or have her coach tape it. Remember, not letting it fully heal you are taking a risk of injuring it worse.

 

[Deleted member D3987]

It would depend on how bad the sprain was. If the doctor has cleared her already, I would think it was only a mild one... but you say she is still having pain.

If you haven't I would get her a good ankle brace. Ice for 20 minutes after practice (I would leave the brace on for it, but that's just how I deal with mine). Elevate it as often as possible and an hour later, remove the brace and apply heat for 20 minutes.

I would also ask the doctor what meds and doasage is recommended for any pain or swelling. (That is so I don't get in trouble for playing doctor, lol).

the new metric is 15 minutes of ice only. the best method is 15 minutes of foot in a bucket of ice water. ice whirlpool even better.

then immediately following ice bath, submerge foot in a bucket of hot water until the foot thaws.

the below is a response and explanation from Larry himself in response to an article that is too long to post here.

Use of ice explained.
Here is a quick "Selfie" type video I made on my cell phone explaining the use of ice. Sorry about the crudeness of the video and it was done just with one take off the top of my head. I hope it gives a good overview.
Ice is nice but it needs to be done properly and as part of a therapy regimen. Just like so many other things, it can be overused. It is one of the most commonly applied therapies but it is also one of the most poorly understood therapies too.
I agree that inflammation is needed. However, the body can also "over do it" too. Too much of a good thing makes it bad. So controlled inflammation is the key. Too much bleeding is not good, too much inflammation is not good, too much ice is not good, too much.... Get the point.

Here is some more information
The above article is very superficial and does not explain inflammation vs Hemorrhage/bleeding. Does not do a good job of explaining acute vs chronic inflammation or the difference between tendinitis and tendonosis. Overall, it is so superficial that it is misleading. Lack of blood to an area is bad. we all know that. the scaphoid bone in the wrist has bad blood supply and has a hard time healing, OCD of the elbow, knee, ankle is due to poor blood supply to the bone and the bone can become necrotic. No need for ice on these type of injuries.
When you have acute trauma and blood vessels are broken and hemorrhaging, that is not inflammation. You want to try and stop the acute bleeding. Compression does help more than ice since compression of blood vessels helps constrict them and stops the bleeding. However, ice helps to control the acute bleeding too.
Ice over a superficial nerve can adversely affect that nerve. It is a basic principle when medical people are trained with the proper use of ice, avoid applying ice over a superficial nerve. Also do not use ice over an area that has nerve damage. The article confuses use of ice improperly with use of ice overall. Of course, if you use ice improperly, there can be a poor outcome. If you use heat improperly, if you use compression improperly, if you stare at some one too long.... You always can have a poor outcome if you do something improperly.
The article should have done a better job of explaining the different forms of ice from cold baths, to ice massage, to chemical packs, to ice bags, to contrast baths.. They could have stated the pros and cons and how to minimize the risks and maximize the potential benefits.
There are comments following the article on the blog about Chinese medicine and that they do not use ice. Yes, they do not use ice after acupuncture and some of their other treatments. But, I was at the World Championships for Gymnastics a few years back and I was talking and joking with to the doctor from China and I said to him, "Thank you for acupuncture. I do it on our gymnasts and it helps them with their injuries so we can beat China!" he said, "thank you for ice! we now have ice machines in our National Training Center and it helps our athletes with their injuries so we can beat the USA!" I enjoy sharing and talking with doctors from all over the world in my travels with gymnastics. We learn form each other and it is fun! So, back to the item at hand. So, even in China, they are using ice on their athletes because they ahve seen the benefits.
Use ice properly. Use it to assist with therapeutic exercises, Use it to assist with control of acute trauma. Use it to help with moderating inflammation. Yes, Inflammation is a part of the healing process and controlled inflammation is a good thing. But like anything else, too much inflammation, inflammation out of control, are not good.
There is so much more but keep it simple:
1. Ice for 10-15 minutes
2. cold baths should be 50 to 55 degrees for 10 -15 minutes
3. compression is important to help control acute injury bleeding
4. Ice can be used to assist in a therapeutic exercise program
5. controlled exercises to help with restoration of function is important
6. do not place ice over any superficial nerves.
7. Do not place ice over any nerve damaged area
8. Be careful with the chemical ice bags, If they leak they can cause chemical induced damage to the skin
9. Be careful with reusable ice things since you can not control the temperature of them to well and you do not want something that is too cold on the skin. With ice you know it is 32 degrees. Some gel packs can get much colder and increase the risk of hypothermic damage.
10. Use it, do not abuse it,respect it, do not neglect it.
Best of luck and keep them healthy!
Larry

 

[Empowered]

Can I just advise you to NOT rush her back. Not sure of the level, but my daughter competed 9 this year. She had an ankle injury mid-season and pushed getting back because she was determined to show her coaches she was tough. Doctor told her to take 3 weeks off, she took 1.

Due to the ankle weakness though, she ended up hurting her foot coming up short on a vault and a toe because of her instability on beam. By the end of season every routine was watered down but bars because of the injuries. Though her ankle is healed now, the foot and the toe are still not 100%.

She should have just taken the 3 weeks off and been done with it, but hindsight is 20/20.

 

[raenndrops]

Thanks @dunno. I have an "old fashioned" ortho and was repeating what he told me after my 8th ankle sprain. With MY ankle brace, it takes a bit for the ice to do any cooling, so the 20 min seems right for me... I guess it takes 5-10 for me to even feel it, lol.

I had heard that they are moving away from Ice as part of standard protocol and it makes sense. I have read a lot of articles about it and am moving away from it S-L-O-W-L-Y... and have ALWAYS been a big fan of compression

Have a great day.