As soon as someone sprains a joint, an ankle or elsewhere, everyone usually runs to apply ice, compression, rest and elevation for the next two or three days. But now, recent information questions the use of both the “ice” and “rest” components of this approach.
Following is the best current advice: First, before attempting any treatment, decide whether you need to see a doctor. With sprains involving the lower extremities, if you can’t walk more than three steps, you should seek medical help as soon as possible to avoid further injury. The same holds true if you are in a lot of pain, the joint looks abnormal (such as bent or displaced}, or if you have considerable swelling. If there is only minor swelling and pain—which allow for a full range of motion—the following measures are now recommended:
1) Avoid ice: For many years, logic dictated that icing right after a sprain or strain reduced swelling and pain. But actual research has refuted this claim. For example, a study published in 2014 by the European Society of Sports Traumatology disclosed that icing injured tissue shuts off the blood supply that brings in healing cells, thus delaying repair. The current recommendation skips ice completely unless the pain is unbearable, and in that case, apply ice packs only two or three times total, for 15 to 20 minutes at a time, which at least an hour in between.
A better option for reducing pain and improving short-term function is to use over-the-counter medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve). But do so only for the first 24-48 hours, because they, too, slow down recovery by suppressing inflammation. For longer periods, if pain continues, consider acetaminophen (Tylenol and generic), which has no anti inflammatory effects.
2) Forget the complete rest. Conventional wisdom previously called for complete cessation of activity until an injury healed. New research, however, suggests that gentle exercise within the first 48-72 hours, such as “drawing the alphabet” with a sprained ankle two to three times daily, is more beneficial. A review of ankle sprains—the most common sprained area—in 2013 by the National Athletic Trainers’ Assoc gave top marks to this type of movement, concluding that “by contracting and relaxing a joint, you improve blood flow, which improves healing.” Supplementing this, balancing exercises are useful for reducing the likelihood of reinjury.
3) Some recommendations remain unchanged: The measures of compression and elevation still hold. So wrapping a mild strain or sprain with an elastic bandage will help reduce swelling. Once swelling subsides; however, unwrap, for evidence shows that injured joints may develop long-term problems, such as premature degenerative changes. Elevation of the involved limb throughout the day and overnight, if possible, by propping a sprained ankle in a pillow, will also help to minimize swelling.
In conclusion, we must always keep and open mind and question so called “conventional wisdom”, for that is how science can make our lives progressively better, longer, and less painful!