Which treatment is recommended acutely after an ankle sprain?

• A. RICE acutely
• B. Immediate immobilization for 6 weeks
• C. Surgery is required for all grade I sprains
• D. No NSAIDs allowed

Answer: (A)

Immediately after an ankle sprain, controlling swelling and pain is the first priority to protect tissues and allow early movement. The RICE approach—Rest, Ice, Compression, Elevation—provides a practical, well-supported plan for the acute period. Rest keeps the injured area from further strain, icing reduces bleeding and inflammation by causing vasoconstriction, compression helps limit swelling, and elevating the ankle lowers fluid buildup by reducing gravitational forces. Together, these steps help minimize pain, swelling, and tissue damage, setting the stage for soon-after gentle ROM exercises and gradual loading.

Immobilizing the ankle for six weeks is unnecessarily long for most sprains and can lead to stiffness and weakness, delaying return to function. Surgery is not required for all grade I sprains, which are typically treated non-operatively. NSAIDs are commonly used short term to manage pain and inflammation, so a blanket prohibition isn’t accurate.