I went to the emergency department for what turned out to be a Grade III ankle sprain. The doctor advised using a cast for a week to 10 days before switching to an ankle brace. I have a newspaper route and can't afford to let the cast slow me down. What are my options?
Ligament injuries of the ankle can be graded as I, II, or III. The higher the number, the more severe is the injury. Grade II and III are often treated with casting for anywhere from 10 days to four weeks.
A recent study from the University of Vermont compared the results of Grades I - III ankle sprains using different treatment methods. Treatment options included an Air-Stirrup brace, Air-Stirrup brace combined with an elastic wrap, or a walking-cast for 10 days. Elastic wrap was used after the cast came off.
Using the Air-Stirrup brace with elastic wrap reduced the recovery time by half. Almost a week's time was shaved off recovery with this method. If your sprain is severe enough to require a cast, ask about using a walking cast. This can help you get around your paper route more easily.
Be aware that switching to an elastic wrap after the cast comes off may also speed up your recovery time. It will still take longer to get back to 'normal' compared to a Grade I or II injury.
In this same study, some patients with grade III sprains treated with an Air-Stirrup (instead of a cast) did quite well. They were able to get back to full activity within three weeks' time. This may be another option for you.
Bruce D. Beynnon, PhD, et al. A Prospective, Randomized Clinical Investigation of the Treatment of First-Time Ankle Sprains. In The American Journal of Sports Medicine. September 2006. Vol. 34. No. 9. Pp. 1401-1412.