Heat or ice for acute ankle sprain?

Abstract

For grade 3 and 4 ankle sprains, ice works better than heat to speed recovery (return to play) (strength of recommendation [SOR]: B, based on a single retrospective cohort study). No studies support faster return to play with the application of heat at any time after injury (SOR: B, based on head-to-head randomized trials). Ice therapy also reduces edema, but the clinical significance of this finding is unclear.