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A child's ankle brace: when it helps and how to choose one that fits
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- Youth lace up ankle brace with straps. Best for: Older children and teens returning to sport. See options on Amazon
- Pediatric stirrup ankle brace. Best for: Younger children walking after a sprain. See options on Amazon
- Kids ankle compression sleeve. Best for: Mild swelling once the child is walking comfortably. See options on Amazon
- Reusable child-size cold pack with cover. Best for: The first two to three days of home care. See options on Amazon
Get it checked first when
The Royal Children's Hospital Melbourne advises seeing a doctor if:
- Pain has not improved after a few days.
- Your child cannot put weight on the ankle immediately after the injury.
- There is tenderness over the ankle bones.
- You cannot control the pain.
Children's bones have growth plates near the ends, and doctors once assumed many ankle injuries with normal X-rays were hidden growth plate fractures. A SickKids study published in JAMA Pediatrics looked at 135 children with outer ankle injuries and normal X-rays and found only four, about 3 percent, had a growth plate fracture on MRI. Most were sprains, and both kinds healed in the same amount of time.
Brace, boot or cast?
| Option | When it is used | What the sources say |
|---|---|---|
| Compression bandage | First days, for swelling | Royal Children's Hospital: firm but not too tight, from just above the ankle to the foot, toes uncovered |
| Removable ankle brace | Most low-energy injuries | POSNA OrthoKids: can treat these effectively |
| Walking boot | More painful injuries | POSNA OrthoKids: an effective option alongside a brace |
| Cast | Uncommon | POSNA OrthoKids: usually not required, and short if used |
The SickKids team advocates a removable splint strategy that minimizes discomfort, and notes that casting may slow recovery. Crutches may help at first, but OrthoKids says not for long, and early ankle movement is encouraged.
Choosing a brace that fits a child
- Youth or pediatric sizing. Adult XS braces can still be too long or too loose for small feet. Look for a youth size chart by shoe size or ankle measurement.
- Simple closures. Hook and loop straps or a single lace panel are easier for kids and coaches to put on correctly.
- Fits their shoe. Try it with the sneakers they actually wear.
- Soft edges. Children are quick to stop wearing anything that rubs.
- Correct side. Some braces are left or right specific.
For older children back in sport, the same styles adults use apply. See lace up ankle brace and stirrup ankle brace.
Home care in the first days
- Ice: Royal Children's Hospital suggests 10 to 15 minutes, wrapped in a tea towel, every two to four hours for two to three days while your child is awake. Never put ice straight on the skin.
- Elevate the ankle when possible.
- Avoid heat, massage and re-injury for the first two to three days.
- Start gentle exercises such as tracing the alphabet with the foot and foot circles, and begin walking after two to three days if pain is bearable.
- Medicine: paracetamol is usually enough; ask a GP or pharmacist about anti-inflammatories, which are not suitable for every child.
Royal Children's Hospital says most children fully recover in one to two weeks, depending on age, health and severity.
Back to sport
The American Academy of Pediatrics describes rehab in phases: protecting the ankle, restoring motion and strength, then balance work, sport drills, and finally a return to practice. It says it is difficult to give an exact date when return will be safe, so progress is measured by those steps.
OrthoKids says a child should have no pain or tenderness before getting back into sports and should walk and run without a limp. A brace for practices and games is reasonable during the first return. If a child keeps spraining the same ankle, OrthoKids advises re-examination by a physician; Royal Children's Hospital notes some children get repeat sprains because they have loose joints.
What to look for when you buy
Youth lace up ankle brace with straps
Best for: Older children and teens returning to sport
Gives firm side support inside a sneaker, useful during the first weeks back at practice once pain and limp have gone.
Watch out: Check the youth size chart; adult XS may be too big. Lacing must be snug but not tight.
See options on AmazonPediatric stirrup ankle brace
Best for: Younger children walking after a sprain
Side shells limit rolling while allowing walking, matching the removable brace approach POSNA describes for low-energy ankle injuries.
Watch out: Usually left or right specific. Make sure it is a true pediatric size.
See options on AmazonKids ankle compression sleeve
Best for: Mild swelling once the child is walking comfortably
A soft sleeve gives light compression with little bulk and is easy for a child to pull on.
Watch out: Will not protect against another roll. Take it off if toes tingle or change color.
See options on AmazonReusable child-size cold pack with cover
Best for: The first two to three days of home care
Royal Children's Hospital suggests ice for 10 to 15 minutes every two to four hours, wrapped in cloth.
Watch out: Always keep a cloth between the pack and skin and watch the skin during icing.
See options on AmazonQuestions people ask
- Should my child wear an ankle brace after a sprain?
- Often, yes. POSNA says low-energy ankle injuries in children can be treated effectively with a walking boot or an ankle brace.
- How long does a child's sprained ankle take to get better?
- Royal Children's Hospital says most children fully recover in one to two weeks, and POSNA says low-energy ankle injuries usually recover within 2 to 6 weeks.
- Could it be a growth plate fracture?
- It is possible but uncommon. In a SickKids study of 135 children with normal X-rays, about 3 percent had a growth plate fracture on MRI. A doctor can decide whether imaging is needed.
- Does my child need a cast?
- Usually not. POSNA says a cast is not usually required for low-energy ankle injuries and is short if used.
Sources
- Low-energy Lateral Ankle Injuries (orthokids.org), OrthoKids (Pediatric Orthopaedic Society of North America)
- Kids Health Info: Ankle sprains (rch.org.au), The Royal Children's Hospital Melbourne
- Growth plate fractures in children's ankle injuries are much rarer than previously thought (sickkids.ca), The Hospital for Sick Children (SickKids)
- Ankle Sprain Treatment (healthychildren.org), HealthyChildren.org (American Academy of Pediatrics)