Tips for Managing Acute Ankle Pain

May 17th, 2021

You’re out on the trail, traversing through the woods, blissfully happy to be soaking up the sunshine, when suddenly… the dreaded rolled ankle. You must have landed wrong, and you’re pretty sure you both heard and felt a loud pop. There’s now a decent amount of pain kicking in. What should you do?

Luckily, there is a series of tests, known as the OTTAWA Foot and Ankle Rules, that help determine if you need to go get an x-ray to rule out a fracture after an acute ankle injury like this.

According to these rules, you should get an x-ray if you present with any of the following:

  • Inability to bear weight for 4 steps immediately after injury
  • Bony tenderness at any point depicted in the image below (A, B, C, or D)

It’s important to apply these rules correctly, so if you are unsure of what you are feeling, we are happy to help! You can call our office to set up a quick screen, either virtually or in-person, and we will guide you towards the best management. An ankle/foot fracture is managed very differently from an ankle sprain, so we want to make sure we get this diagnosis right!

Ankle and foot fractures are managed with a period of immobilization or non-weight bearing so that the bone has time to heal. This means potential crutches, walking boot, cast, etc. Ankle sprains and strains are best managed with protected mobilization, specific exercises and soft tissue work. This means we still protect the injured tissue, but we also want to get things moving as soon as possible while reducing pain and inflammation. Physical therapy is a great tool while recovering from an ankle sprain, even if it seems minor or like a one-time thing that will self-resolve. For more information on best management of ankle sprains, see our additional blog posts.