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First Aid: Ankle Sprains

Ankle sprains are among the most common injuries in the outdoors. Hikers, joggers, and porters cover rough terrain and may fall and twist their limbs. Every outdoor enthusiast should know the basic approach to treating an ankle sprain.What are sprains?

Sprains are injuries to ligaments (which attach one bone to another) and tendons (which attach muscle to bone) that are incurred by twisting, direct blunt trauma, or overexertion. Symptoms include pain, swelling and/or deformity, decreased range of motion secondary to pain, and bruising.How do I treat an ankle sprain?

  1. Elevate the injured part above the level of the heart.
  2. Treat the ankle with cold applications (ice packs, snow, or immersion in a cold stream, always taking care to avoid cold induced injury) on-and-off for 30 minute intervals for the first 24 to 48 hours. This is to limit swelling.
  3. Avoid weight bearing as best possible. Prevent reinjury (ankles are notorious) by proper wrapping or the application of a splint. Because the injured joint is immediately weakened, do not rely upon it for great exertion.
  4. If the injury is minor (no chance of a fracture) and/or if the victim needs to put weight on the ankle in order to be rescued, wrap the ankle snugly with an elastic wrap in a figure-of-eight method or tape in a crisscross weave.
    • During the wrapping or taping, have the victim point the toes and ankle upward by passing a slender rope or strap around the ball of the foot and pulling toward the body. This allows the ankle to be strapped with the foot perpendicular to the leg and the ankle ligaments in the shortened position in which they best should heal.
    • Fashion a splint from a SAMO Splint to provide additional support. If the sprain is severe, splint the ankle as for a fracture. An Aircast Air-Stirrupa ankle brace is excellent for in-shoe support.
What to do if the ankle may be broken.

A broken ankle can be stirrup-splinted or wrapped to prevent movement.

  1. Use a SAMO Splint, parka, or piece of rolled foam taped or wrapped into place.
  2. Remove or loosen the boot or shoe to avoid entrapment due to swelling, which could impair circulation.
    • If the victim must walk out under his own power, replace footwear as soon as possible before swelling makes this impossible.


Brought to you by Paul S. Auerbach, MD, author of Medicine for the Outdoors.
- Paul S. Auerbach


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