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Is there any time you should use heat for an ankle sprain? How long should I keep using ice?

Acute injuries with pain, swelling, and bruising are still treated conservatively with R.I.C.E. (Rest, Ice, Compression, Elevation). Acute refers to the first few days up to the first week. You can assess this by looking at the amount of tissue swelling (if any) is present after the first few days. Once the initial swelling is gone, you may consider using mild heat for short periods of time. This is augmented with foot/ankle movement exercises. Usually just moving the foot and ankle up and down (called ankle pumps) is very helpful. The goal of the heat is to draw blood supply to the area for healing. Too much heat and you can end up causing increased (rather than decreased) swelling and prolonged inflammation. The movement exercises help distribute the fluids and prevent any pooling and subsequent increased or return of swelling. In many cases, damage to the soft tissues of the ankle is much more severe than the patient realizes. Recent evidence has shown that a short-leg cast may actually result in faster healing for moderate to severe ankle sprains than using a splint or elastic wrap to support the lower leg and ankle. If you have more than a mild sprain and/or you have sprained the same ankle more than once, it might be a good idea to see an orthopedic surgeon who can evaluate what's going on and the best treatment approach for optimal results.

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