Sprained ankle: Hot or cold compress?

November 24, 2008 | 09:19 pm By: EDGAR MICHAEL TIU EUFEMIO, M.D.
sprain.jpg

Dear Doc, I sprained my ankle during a game. What should I apply? Hot or cold compress?
Suuri Zang, College student, 18 yrs old

All throughout my training, I too have heard different protocols for the management of ankle sprains. Obviously, the rolling of the foot over a Coke bottle no longer applies. I generally follow the CRIMES protocol:

C    compression (with an elastic bandage or a tight sock)
R    rest
I    ice ( as long as there is swelling – this may be as long as 4 to 7 days)
M    medication (mostly anti-inflammatories and/or painkillers)
E    elevation
S    support (in the form of a splint or a tape job) *this is optional

I tell my patients they can start on the warm compress regimen only after swelling has subsided.  Personally, I do not even think this is necessary since I start them on a physical therapy program when I feel they can tolerate it already.
 

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