Sleeping with a Sprained Ankle: Bedtime Tips, Daytime Care & More

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Medical experts explain the best ways to sleep with, heal, and care for a sprained ankle

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• Sleeping Comfortably with a Sprained Ankle
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• Using R.I.C.E for First Aid
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• When to See a Doctor
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• Q&A
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• Tips

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Dealing with the pain of a sprained ankle during the day is bad enough, but it sure can be irritating when it keeps you from sleeping comfortably! Thankfully, making a few small adjustments to your bedtime routine and sleeping position can help you get some much needed shut eye (the better you sleep, the faster you heal). In this article, we’ll show you how to fight ankle pain and swelling while you sleep, plus dive into the R.I.C.E (Rest, Ice, Compression, Elevation) first aid method to speed up your healing time. Let’s hop to it (with your good ankle)!

This article is based on an interview with our board certified podiatrist, Catherine Cheung, DPM. Check out the full interview here.

Things You Should Know

• Remove your compression bandage before bed and sleep on your back with your ankle elevated on pillows, blankets, or cushions.
• Use the R.I.C.E. (Rest, Ice, Compression, Elevation) method to treat your sprained ankle for the first 72 hours after injury.
• See a doctor if your ankle pain and swelling don’t improve or get worse after about 3 days of R.I.C.E. care at home.

Steps

Section 1 of 3:

Sleeping Comfortably with a Sprained Ankle

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1. 
   1
   Lay on your back with your sprained ankle elevated. Use spare pillows, blankets, or a cushion to raise your ankle slightly higher than your heart. The elevation will keep fluids from accumulating around your injury and reduce swelling. Keep sleeping with your ankle propped up until it’s no longer consistently swelling up (usually after 2-3 days).

   • If you’re an adamant side sleeper, place pillows between your knees and ankles to raise your ankle a bit, and keep your knees bent at a 90-degree angle so you’re not balled up in the fetal position.
2. 
   2
   Remove or loosen your compression bandage before bed. A compression bandage or sleeve that’s too tight at night can press on your nerves, restrict blood flow, or cause numbness or tingling. To avoid these issues, take your bandage off before bed to let your skin breathe. If the bandage is holding a splint or helps reduce ankle pain, make sure it’s looser than during the day.

   • During the daytime, compression helps stabilize your ankle joint, reduces swelling, and can sometimes help alleviate pain.
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3. 
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   Ice your ankle before bed if it’s still swollen or painful. Apply a cold compress or ice pack to your ankle for 15-20 minutes during your nighttime routine, especially during the first 2-3 nights after the injury. The cold will reduce swelling and pain, making it easier to fall asleep. Just make sure not to sleep with a cold compress on your ankle, since too much cold can damage your skin or nerves.

   • Always place a cloth or layer of clothing between the cold compress and your skin (prolonged, direct contact with your bare skin can cause frostbite or nerve damage).
4. 
   4
   Rest your ankle as much as possible during the day. Activity during the day—even just walking too much—can increase pain and swelling, and by the time you’re ready for bed, your ankle might be sore and puffy. Stay off your feet as much as possible (especially during the first 2-3 days) and sit, recline, or lay with your ankle elevated to keep pain and inflammation under control.

   • If the sprain is mild and not very painful, some light activity is OK. Just make sure to rest up any time you start to feel more pain, tension, or tiredness in your ankle.
5. 
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   Use OTC non-steroidal anti-inflammatory drugs (NSAIDs). Supplement elevation, ice, and rest with over-the-counter meds for pain and swelling if you’re still struggling to get to sleep with your sprained ankle. Take only the recommended dosage, and ask your doctor or healthcare provider about using NSAIDs if you take other medications that may interact negatively. The most common NSAIDs include:

   • Ibuprofen (Motrin, Advil)
   • Aspirin (Bayer, St. Joseph, Excedrin)
   • Naproxen sodium (Aleve)
   • Acetaminophen (Tylenol) is not an NSAID and has no anti-inflammatory properties, but does relieve pain.
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Section 2 of 3:

Using R.I.C.E for First Aid

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1. 
   1
   Rest your ankle as much as possible for the first 24-48 hours after injury. This means as little walking with the sprain, exercising, or general movement as you can manage, especially if the pain and/or swelling is severe. If it’s necessary to move, consider using crutches or a walking boot to keep weight off of your ankle.

   • Once the initial severe pain and swelling go down, gradually increase the amount of time you spend putting weight on your ankle. Take it slow, and return to rest if you feel increased pain, tension, or tiredness.
2. 
   2
   Ice the ankle for 15-20 minutes every 2-3 hours for about 2 days. Wrap a cold compress or ice pack in a thin, dry cloth and hold it to your sprain to soothe pain and keep swelling under control. After the initial swelling goes down after 2-3 days, ice as needed to manage pain.

   • After the swelling and acute pain are gone, use heat to soothe general soreness and help get your range of motion back.
   • Do not apply heat when the ankle is still swollen, since this can increase the blood flow to the injury and make swelling worse. This also includes hot showers or heat rubs.
3. 
   3
   Wear a compression bandage or sleeve for up to a week after injury. To secure your ankle, wrap the bandage around the ball of your foot 2 times, then wrap diagonally up your foot and around your ankle while holding the bandage taut. Wrap your lower leg a few times (about 2 in (5.1 cm) above the ankle) and use a fastener to hold the bandage in place.

   • Wrap your ankle firmly, but not so tight that it causes more pain, constricts the ankle, or restricts your circulation.
   • If an elastic bandage is too cumbersome, try an over-the-counter ankle brace with laces or Velcro to compress and stabilize the joint.
   • Only wear your bandage during the day when you can monitor the tightness and comfort. Take it off or loosen it significantly when you go to bed.
4. 
   4
   Elevate the ankle whenever you’re resting for the first 2-3 days. If you’re sitting, try to raise your ankle to the height of your hip. Try sitting in a recliner with the footrest up, pulling up an ottoman or chair to rest your ankle on, or sitting sideways on the couch with your leg and ankle resting on the cushions. If you’re laying down or sleeping, elevate the ankle above the level of your heart with pillows or cushions.

   • Elevation helps drain fluid away from your ankle and reduce swelling. As the swelling improves over time, start to lay or sit normally more often.
5. 
   5
   Return to high-impact activity or exercise slowly. After the initial pain and swelling go away after 2-3 days, gradually reintroduce low-impact movements like walking short distances, biking, swimming, or using an elliptical. Steer clear of movements that are hard on your ankles like running, jumping jacks, or sports like soccer that could recreate or worsen the injury.

   • Start incorporating strenuous activities like running after about 8 weeks. This gives the ankle time to recover before putting regular pressure on it again.
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Section 3 of 3:

When to See a Doctor

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1. 
   Call your doctor if pain and swelling don’t improve after 2-3 days. Most sprained ankles can be healed at home with R.I.C.E., but some injuries may be more severe than they seem at first. If your ankle doesn’t improve at all or starts to hurt even more after about 2 days, visit your healthcare provider or an emergency room for evaluation. Signs of a serious sprain or other injury could include:

   • Pain that’s getting worse over time and doesn’t get better after taking pain medicine
   • Toes that turn pale or blue, go numb, or tingle
   • Severe pain that gets worse when you move your ankle
   • The skin over the injury turning red and warm
   • Fever or chills

Community Q&A

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• Question

  Which medicine is best for ankle pain?

  

  Community Answer

  You could take ibuprofen for ankle pain to help with pain and swelling. If pain persists, see a doctor.

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Tips

• Avoid H.A.R.M. during the first 72 hours after your injury to speed up recovery:

  • Heat (hot baths, saunas, heat packs)
  • Alcohol (it increases swelling and stalls healing)
  • Running (or other high-impact activities)
  • Massages (they increase blood flow and swelling)
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