Sprained Ankle Recovery: PEACE & LOVE Explained | Aceso

chrisdunmall

2 days ago

7 min read

By Chris Dunmall DC | Aceso Chiropractic, Buckingham

I've seen a few sprained ankles in clinic recently.

Different people, different circumstances, but they've reminded me just how easily we can underestimate what seems like a simple injury.

An awkward step off a kerb. A slippery path. A badly timed tackle on the football pitch.

Most of us know the routine. The ankle hurts, it swells, we rest it for a few days and eventually things settle down.

But here's the interesting question.

Just because your ankle has stopped hurting, does that mean it has fully recovered?

Not necessarily.

An ankle sprain can affect more than the ligaments. It may also change how your ankle moves, how well you balance and how accurately your nervous system senses the position of your foot.

That's why good ankle sprain recovery isn't simply about waiting for the pain to disappear. It's about restoring movement, strength, stability and confidence.

And there's a rather wonderful way to remember how.

What Is PEACE & LOVE for an Ankle Sprain?

PEACE & LOVE is a framework for managing soft tissue injuries, proposed by researchers Blaise Dubois and Jean-François Esculier in the British Journal of Sports Medicine.

The principle is straightforward: protect the injury in its early stages, then progressively help the body recover through movement and appropriate loading.

Rather than focusing entirely on rest and symptom relief, it encourages us to think about the whole healing process.

First, Give Your Ankle Some PEACE

P – Protect

For the first few days, reduce activities that aggravate the injury. Protecting the ankle from further damage is important, but that doesn't necessarily mean complete immobility.

E – Elevate

When resting, raise your ankle to help manage swelling.

A – Avoid Anti-inflammatories

This is perhaps the most interesting part of the framework, and one we'll explore in a moment.

C – Compress

An appropriate supportive bandage can help manage swelling and provide some comfort.

E – Educate

Understand what's happened, what recovery involves and why the right amount of movement matters.

Then, Show Your Ankle Some LOVE

L – Load

Gradually introduce movement and weight-bearing as symptoms allow. Our tissues need appropriate loading to regain their capacity.

O – Optimism

Confidence matters. Understanding your injury and having realistic expectations can help you remain engaged in recovery.

V – Vascularisation

Comfortable cardiovascular activity, such as gentle cycling when appropriate, helps maintain fitness and supports the wider recovery process.

E – Exercise

Restore mobility, strength, coordination and balance through progressive rehabilitation.

The important message is that recovery doesn't end when the swelling goes down.

Why Inflammation Isn't Always the Enemy

Here's something I think we often get wrong.

We've become rather good at treating inflammation as something that needs to be switched off.

An injury occurs, swelling appears, and the natural reaction is often to reach for an anti-inflammatory such as ibuprofen.

But inflammation isn't a mistake.

It's part of the body's carefully coordinated response to injury.

Following tissue damage, inflammatory processes help initiate repair, recruit cells involved in healing and prepare the injured area for recovery.

So it's worth asking whether suppressing that response immediately is always the best approach.

The authors of PEACE & LOVE specifically raised concerns about the routine use of non-steroidal anti-inflammatory drugs (NSAIDs) in the early stages of soft tissue healing.

There is a biological argument for allowing the initial inflammatory response to take place, although the evidence that a short course of NSAIDs causes poorer long-term healing in people remains mixed.

Some NHS guidance also suggests delaying anti-inflammatory medication during the first 48 hours following an injury.

Of course, there are circumstances where medication is appropriate. Managing significant pain matters, and individual circumstances should always be considered with a pharmacist or prescribing clinician.

But perhaps we should question the assumption that every injury automatically needs an anti-inflammatory.

Sometimes the goal shouldn't be to suppress the body's response, but to support it.

Why Does an Old Ankle Sprain Still Feel Unstable?

This is where things become particularly interesting from a chiropractic perspective.

Your ankle is much more than a simple hinge.

It's a complex system of joints, ligaments, muscles and sensory receptors, all working together to help you move and adapt to the ground beneath your feet.

When you sprain an ankle, the injury can affect something called proprioception.

What Is Proprioception?

Proprioception is your body's ability to sense the position and movement of its joints without having to look at them.

It's how you know where your foot is when walking downstairs, running across uneven ground or standing on one leg.

Much of this happens automatically through communication between your nervous system and the rest of your body.

After an ankle sprain, that communication and the way you control movement can be affected.

You might notice:

One ankle feels less stable than the other.
You struggle to balance on the previously injured leg.
Your ankle feels stiff when squatting or walking downstairs.
You keep rolling the same ankle.
Something simply doesn't feel quite right, even though the pain has gone.

This is one reason rehabilitation needs to address movement and coordination, not just the injured ligaments.

Can Chiropractic Care Help After an Ankle Sprain?

At Aceso Chiropractic in Buckingham, we're interested in how the whole body works together.

An ankle injury is a good example of why.

When someone comes into clinic following an ankle sprain, once more serious injury has been excluded, we may look at several things:

How freely the ankle and foot joints move
Differences in movement between the two sides
Balance and proprioception
Walking patterns and weight distribution
How the knee, hip and rest of the body respond during movement

Sometimes an ankle can retain restricted movement long after the initial injury.

Where appropriate, gentle joint mobilisation or chiropractic manual therapy may help improve mobility and comfort. Research supports manual therapy as a useful addition to exercise for some people recovering from ankle sprains, particularly for short-term improvements in movement.

But hands-on care is only one part of the picture.

Restoring strength, coordination and confidence through appropriate exercise remains essential.

The aim isn't simply to get the ankle moving again.

It's to help you regain confidence in how your body moves, responds and adapts.

A Simple 20-Second Balance Test

Here's a little experiment you can try at home.

If both ankles are currently pain-free and you can stand safely:

Stand beside a kitchen worktop or sturdy chair.
Lift one foot off the floor.
See whether you can balance comfortably for 20 seconds.
Repeat on the other side.

Does one side feel noticeably less steady?

Perhaps one foot moves around more, or you find yourself reaching for support.

It's not a diagnostic test, and balance is influenced by many things, but it can be an interesting way to notice differences between the two sides.

If you've previously sprained one ankle, those differences may be worth exploring.

Don't attempt this on a recently injured, painful or unstable ankle without appropriate advice.

How Long Does a Sprained Ankle Take to Recover?

There isn't a single answer.

Mild ankle sprains often begin to feel considerably better within a couple of weeks, while more significant ligament injuries can take several weeks or months to recover.

And feeling comfortable walking around the house isn't necessarily the same as being ready to run, jump or return to sport.

Recovery depends on the severity of the injury, the demands you place on your ankle and how well movement, strength and balance have been restored.

When Should You Seek Medical Assessment?

A fresh ankle injury should be assessed promptly if you cannot bear weight or walk a few steps, have severe pain or substantial swelling, or have particular tenderness over the bones of the ankle or foot.

Deformity, numbness, a cold or discoloured foot, or a suspected fracture needs urgent medical attention.

If your ankle isn't improving as expected, it's worth having it examined rather than assuming it will eventually sort itself out.

Frequently Asked Questions

Should I Take Ibuprofen for a Sprained Ankle?

Not automatically. Although ibuprofen can reduce pain and swelling, inflammation also plays an important role in early tissue repair. The PEACE & LOVE framework encourages avoiding routine anti-inflammatory use in the early stages. The clinical evidence is mixed, so seek individual advice about medication rather than stopping anything prescribed.

Should I Rest or Walk on a Sprained Ankle?

Both protection and movement have their place. Initially, avoid movements that aggravate the injury. As symptoms allow, gradually reintroduce comfortable movement and weight-bearing. More severe injuries may need additional support or a period of immobilisation.

Why Does My Ankle Still Feel Weak Months After a Sprain?

Persistent weakness or instability may reflect changes in strength, joint mobility, balance or proprioception. These can sometimes remain even after pain has improved. A clinical assessment can help identify what needs attention.

Can a Chiropractor Help With an Old Ankle Injury?

Depending on the findings, chiropractic assessment and appropriate manual therapy may help address restricted joint mobility and movement difficulties. This is best considered alongside rehabilitation exercises, rather than as a replacement for them.

A Final Thought

One of the things I find fascinating about the human body is its remarkable ability to adapt.

But adaptation doesn't always mean we've returned to where we started.

Sometimes we become very good at compensating for something that hasn't fully recovered.

An old ankle injury is a perfect example.

So perhaps the next time you roll an ankle, remember to give it a little PEACE & LOVE.

And remember that feeling better and functioning better aren't always quite the same thing.

If you've had an ankle sprain that's never felt quite right, we can explore how your ankle is moving and whether chiropractic care may be appropriate.

Aceso Chiropractic | Buckingham

Clear, considered chiropractic care to help you move with greater confidence.