The R.I.C.E. protocol should be followed every couple of hours for the first 3 days on the way to the hospital, or before consulting a doctor.
Rest is attained by not moving the ankle joint or not putting any weight on it.
Ice therapy or cryotherapy can be applied to the ankle for 20 minutes at a time, to decrease swelling and pain.
Compression is done by wrapping the ankle with an elastic bandage.
The affected ankle is placed at about the same level as the heart. An easy way to do this is by sitting in a chair and placing the injured ankle on another chair or stool.
Thermotherapy is used to relax the muscles that in turn help to perform the exercise program.
Ultrasound is found to be effective in breaking adhesions and improving flexibility.
Transcutaneous Electrical Stimulations (TENS):
Transcutaneous electrical nerve stimulation helps to provide pain relief that may occur after performing stretching exercises.
Laser therapy is used for the pain management of patients suffering from ankle dislocation.
Kinesio-taping helps to reduce the movement of the ankle joint, it holds the ankle in the proper position while the muscles around it work properly to hold the ankle in position.
Manual therapy consists of different techniques like manipulation, soft tissue mobilization, joint mobilization, etc, that help to decrease pain and improve functional mobility of the ankle joint.
Range of motion exercises:
Range of motion exercises help to improve the contraction of the ankle muscles such as dorsiflexion and plantar flexion done by moving the foot directly up and down using the ankle joint, ankle circles are done by moving the toes in a circle using the ankle joint. These exercises are very important to improve the flexibility of the muscles and the functionality of the ankle.
Once the person can perform the range of motion exercises with minimal pain and the range of motion is improved, then the patient is recommended to begin strengthening exercises like pushing the ankle up against a fixed object, counting to 10, relaxing, and repeating 5 times. Using a resistance around the bottom of the toes, hold the ends of the band with the hands and gently push the ankle down as far as possible, then bring it slowly back to the starting position and repeat 10-15 times, another example is stand using the foot of the injured ankle, hold this position for 30 seconds and repeat 3 times.
Stretching exercises improve the flexibility of ankle muscles. These exercises are important to ensure that each muscle group is offering the full range of mobility.
Proprioception and balance exercises:
Proprioceptive and balance exercises are also recommended to improve the stability and balance of the affected ankle joint.
Gait training is started gradually with crutches and a brace to hold the joint in place.