In the acute phase of a lateral ankle sprain, which strategy is recommended for initial management?

• A. RICE in the acute phase with protection and gradual weight bearing
• B. Immediate return to running and sprinting
• C. Immobilization for six weeks with no movement
• D. Immediate surgical consultation

Answer: (A)

In the acute phase, the aim is to control swelling and pain while protecting the injured ligaments and allowing safe, gradual loading to promote healing. Using the RICE approach with protection and gradual weight bearing achieves this balance.

Rest and protection means supporting the ankle with a brace or wrap and avoiding activities that stress the torn ligaments, preventing further injury. Ice helps reduce swelling and numb pain, typically applied in short bouts several times a day for the first couple of days. Compression minimizes edema, and elevating the leg above heart level aids swelling control. Gradual weight bearing, as tolerated and with protection, encourages normal walking patterns and stimulates healing without overloading the injured tissue. Over the next days to weeks, gradually increasing movement and loading supports tissue remodeling and prevents stiffness.

Avoid returning to running or sprinting immediately because the ligaments need time to heal before bearing high loads. Immobilizing for six weeks with no movement can cause stiffness, muscle atrophy, and delayed functional recovery. Immediate surgical consultation is unnecessary for a typical acute lateral ankle sprain unless there are red flags such as fractures, severe instability, or signs suggesting a more complex injury.