Ankle injuries have to be one of the most common types of trauma seen. Injuries occur in people of all ages and range in severity from a simple sprain that heals after a few-days rest to severe fracture-dislocations.
It's sometimes difficult to distinguish an ankle fracture from a simple ankle sprain. Therefore, any ankle injury producing pain, swelling, tenderness, or the inability to bear weight should be evaluated by a physician.Be sure to ask whether there was an audible "pop" when the injury occurred - it can be surprisingly loud, enough that others can hear it. That sound, or the sensation of something popping, can indicate a severe ligament injury.
Immediately after the injury, inflammation brings swelling. Cold reduces swelling. Place the injured foot in a bucket or basin of cold water for about 20 minutes at a time - never longer - three to five times a day or even more frequently - possibly as often as every two hours.
A plastic bag filled with ice and water can substitute for the bucket or basin, but always protect the skin with a towel or washcloth before putting the ice bag over the injured area.
Avoid using ice on those with vascular disease, diabetes, Raynaud's syndrome, etc. Otherwise cold is the first response to an ankle sprain.
Apply an elastic (ACE) bandage to push swelling out of the joint area and back into the circulation. An elastic bandage does not give the ankle, or any other joint, any real support. The elastic bandage should include a soft pliable material (i.e., sock, T-shirt, etc.) folded in a "horseshoe" shape around the ankle bone on the injured side. Then the elastic bandage is applied. This technique applies compression to the soft tissue, not just the ankle bone and tendon. Be sure to check the foot's blood circulation, since often a first aider will apply the elastic bandage too tightly.
Elevate the affected foot to reduce swelling. This helps return accumulated fluid to the circulation.
Do not apply heat too soon. Heat results in swelling and pain if applied too early. A minimum of 24 hours and preferably even 72 hours should pass before any heat is applied to the injured ankle.