How to reduce swelling in a sprained ankle
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A sprained ankle swells because small blood vessels tear and fluid collects in the tissue. Most of that happens in the first day or two, and most of the discomfort comes from the pressure it creates rather than the original injury.
The first 48 hours
- Rest it enough that you are not making it worse, but not so completely that it stiffens.
- Ice for 15 to 20 minutes at a time, with a layer between the ice and the skin.
- Compression to limit how much fluid collects.
- Elevation above heart level where you can manage it, which is what actually moves fluid out.
Elevation does more than people expect and costs nothing. Compression is the part most people get wrong.
Getting compression right
Compression should feel supportive, never tight. If your toes tingle, go numb, feel cold or change colour, take it off. That is not compression working, it is circulation being restricted.
A wrapped elastic bandage is hard to apply evenly to your own ankle, and the tension varies every time you redo it. A tubular bandage is cut to length and slides on like a sleeve, so the pressure is set by the size you chose rather than by how hard you pulled. For most ankles that is Size C, D or E depending on the measurement.
Measure the ankle while it is swollen, not from memory. Swelling changes the number considerably.
What not to do
- Do not wrap it tighter because it hurts. Tighter is not better.
- Do not leave compression on overnight unless you have been told to. Several NHS hospital guides advise removing tubular compression at night after an acute sprain.
- Do not ignore it if you cannot put weight through the ankle at all.
When to get it looked at: swelling that appears suddenly, affects one limb only, comes with calf pain, warmth or redness, or follows a long period of immobility should be assessed promptly rather than treated with compression at home. Those can be signs of a clot.