Sprain, Etc. -- When To Switch From Ice To Heat?

So I took a tumble and wrenched the Hell out of my ankle a week ago. Diagnosed as severe sprain with hairline fracture. Grotesque swelling at first, but Rx was splint, ice, Motrin. There’s still some swelling/stiffness. I kind of feel like the ice, while maybe helping the swelling (some I suspect will just need to subside on its own), exacerbates the stiffness, and I’ve been told to try to gently keep the foot limber through low-impact movement. So – is it too early to move to a hot soak instead of (in addition to?) ice? I know in advance – YANAMD or not mine, just looking for some thoughts.

ETA: Oops, wrong forum – if a mod can move to GQ . . . .

I think this is more of an IMHO thing. Moved.

You use ice for a sprain, it helps the most. In additon aspirin, ibuprofen or aleve is also useful. Tylenol if you can’t take those.

Heat FEELS better but isn’t as useful as cold to promote healing. What I suggest is alternate, use cold compresses (Ice bags or frozen bags of peas) and then alternate with a hot water bottle. Then go back to the cold. Use as much ice as possible, then for feeling better try the heat.

In between times wrap the sprain as your doctor directs. You want it as tight as possible without being constricted.

My impression was ice for the first 48 hours, heat after that, but IANAD, YMMV, etc., etc.

Are you still swollen? My understanding (IANAD, btw) is that you needed to ice it only for the first couple of days or until swelling subsided. I could be wrong. When I sprained my ankle last year (and reinjured it a couple of months later), I used RICE (rest, ice, compression and elevation). I also splinted with an air cast for about a week or so while I was at work since I work on my feet all day. It’s really important to recondition the muscles and tendons in your sprained foot though, otherwise it’s very easy to reinjure it. There are easy exercises and stretches that you can do to strengthen your injured foot. I don’t think you really want low-impact as much as no impact stretching that gently flexes the muscles.

Slightly OT, random tips:
As the veteran of three moderate-to-severe ankle sprains (including one that required surgery), I highly recommend Vet Wrap for wrapping. I used most, if not all, of a 4" roll each time, which may have been a bit excessive but even kept things pretty much in place prior to surgery (I ruptured my peroneal retinaculum). Vet Wrap does a better job of stabilizing your ankle than the soft Ace bandages you get at CVS, and the compression helps reduce swelling/edema, reducing pain and tissue damage. The downside is that you have to cut it off with bandage scissors at the end of the day, and thus it ends up costing more.

Put another chair next to your desk chair, and prop your feet up while surfing SDMB. Ice it (and take NSAID’s as directed) every time you stress it, and after you’ve been up and around (gravity also increases edema, which increases pain).

A recent article in New Scientist on exercise pointed out that the best long-term recovery for a sprained ankle appears to be the use of a wobble board or similar.


I have another question about sprained ankles:
I sprained mine at the beginning of November - bad, I had a huge swollen lump on the side of my ankle. Did the ice and compression, but don’t anymore. Swelling is gone (has been for some time), but there is still some pain, especially when I am walking for 1/2 hour plus. (like grocery shopping, running errands, etc). How long should it take to heal to the point where there is no pain? (I guess I forgot to add that I hurt it again in December)

Good call. I just had a customer who happens to be in physical therapy tell me about this yesterday. Although, I have balance exercises I can do on my Wii, I think I may go out and get a wobble board. As she explained and I have read further, it helps to retrain the receptors, which may also be damaged in connection to the injury, to send messages to the brain with regard to positioning.

That’s cool to know and makes sense, as “stability” excercises are widely touted for recruiting multiple, mutually-supportive bundles of muscle that are sometimes neglected.

However, flip side – it’s going to be a while before I feel comfortable standing with the bum foot on something that might tip me off and screw everything up again.

I found out only recently ( :mad: ) that wobble board exercises can retrain receptors long after the fact. I viciously sprained my one ankle years ago, and while my doctor explained how my “ankle no longer knows where it is in space” making me prone to re-injury, at no point did the dumbass think to mention the exercises that would address that very problem! :mad: I’m doing the exercises now though. Only I’m using a Bosu (or whatveritchamacallit).

My high school coach/Poli-sci/first aid teacher used a catchy phrase which I’ve never forgotten.

Ice is nice for 24 hours, after that, heat is neat.

I have no idea if that’s the case any more though.