What should I do immediately after rolling my ankle?

I received this DM from a sweet concerned woman.

I was walking in the grocery store parking lot towards where I thought my car was when I realized I was walking the wrong direction. Naturally I turned around to go towards my car. Unfortunately, I wasn't paying any attention to where I was walking and I turned around right after walking over a road hump. So when I turned around my foot landed awkwardly on the side/top of the road hump. I was able to ungracefully stop my fall however, my ankle is killing me now. I most certainly rolled my ankle. What do I do right now to stop it from getting really bad ie ugly and swollen?  

I told her that the answer was a little long so I asked if I could call her. After talking with her I thought I would share a summary of the information I told her.  

I’m so sorry you hurt your ankle. I know this was not in your plans for today. The good news is all you need immediately after rolling your ankle is an ace wrap or ankle brace, ice and a few pillows. The ankle wrap/ brace is used to compress and stabilize your ankle. I would continue wearing the ankle wrap or brace for 2-3 weeks while your ankle is still swollen.  Start icing your ankle as soon as possible for 10 minutes multiple times a day preferable with your foot elevated above your heart.  If it hurts to put weight on your foot then I would recommend using crutches. 

But those steps only get you through step 1 of recovering from an ankle sprain. Step 2 is restoring your ankle strength and range of motion and step 3 is making sure you don’t keep reinjuring your ankle. 

If your ankle sprain is bad enough to have significant swelling and bruising you should come in to have me look at your ankle to determine the severity of the ankle sprain and to help you properly heal the ligaments. 

Most of us have rolled our ankles at least once, stepping off a step, tripping over our own shoe.  You don’t necessarily need anyone to help you recover from those minor injuries. However, when the ankle sprain is severe enough that bruising is present that means you’ve damaged a ligament. Most ligament tears are minor meaning there is only a mild change in the stability of your ankle versus a complete tear which requires surgery to fix. It is always a good idea to have someone look at your ankle to make sure it will heal properly without surgery. 
To make sure you don't have continued problems with your ankle I will complete a physical exam of your ankle and get a little history from you. 

For instance: 
How many times have you rolled your ankle? 
Do you have problems with your hips, knees or lower back?  

Simple questions like these can help discover if there was another reason for you rolling your ankle. 

Many people simply brush off rolling their ankle since the pain goes away quickly. However, bruising means a ligament was torn some amount. Yes the pain and swelling may go away without you seeing me. However, to fully and completely heal (i.e. to prevent consistently re-injuring your ankle) we need to restore your ankle strength, balance and range of motion. In addition to looking at your ankle I see how you walk and move in your environment to make sure that your whole body is working well together. That is the secret sauce. Looking at each of my clients as a whole person, not just one injured area, allows me to find the root cause of all injuries while preventing new ones. Sometimes it really is the road hump that you tripped over but sometimes your current injury is a symptom of something else.  

If you recently rolled or sprained your ankle and this is the type of care you are looking for Click this link if you to ask about cost and availability
If you have questions about your specific injury and you’d like to talk to a foot and ankle specialist Click this link to talk to a PT