Dear Doctors: I sprained my ankle playing soccer. It’s not the first time, and I thought I knew what to do. But as soon as I started to wrap it, I got a bunch of conflicting advice: use ice; use heat; alternate ice and heat; walk on it right away; stay off of it for a week. How do you take care of a sprain?

Dear Reader: A sprain occurs when movement causes a joint to strain or overextend. This stretches or tears the ligaments that hold and stabilize the joint. In more serious sprains, the joint capsule itself can be damaged.

Sprains often occur during sports activities, but they can result from any movement that stresses a joint. Symptoms include pain, swelling, bruising, stiffness and reduced function. If you can’t move the joint, if the area becomes numb or if it can’t bear weight at all, the injury may be more serious than a simple sprain. In that case, it is important to seek medical care.

An ankle sprain that is mild to moderate can be treated at home. The approach is a combination of steps summed up in the acronym PRICE. That is: protection, rest, ice, compression and elevation. Wrapping the ankle with a flexible bandage can help stabilize the joint and create compression, which reduces swelling. Take care that the wrapping isn’t too tight, as that can impede circulation. It is recommended that you rest the sprained joint for the first 72 hours after the injury. You’ll also want to keep it elevated as much as possible during this time, which helps with swelling.

Icing a sprained joint in 10- to 15-minute sessions during the first few days was once standard advice. However, the thinking on this is changing. Cold therapy does ease swelling, but it also reduces blood flow to the region, which is now believed to actually slow the pace of healing. If icing a sprained ankle helps with pain, then feel free to do it. Just be sure to keep each session brief, and never place an ice pack directly on bare skin. Using heat increases blood flow to the area, which can help ease stiffness. Over-the-counter anti-inflammatories should be adequate for the pain of a mild to moderate sprain.

Advice regarding a prolonged period of rest has also shifted a bit. Studies show that a gradual resumption of activity after the first 72 hours, rather than complete rest, promotes faster healing. This typically involves the use of supportive devices such as crutches, a walking cast or a walking boot. The key word here is “gradual.”

Getting back on your feet takes anywhere from a few days to a few weeks, depending on the severity of the sprain. Overstretched ligaments may need just a week or so to recover. But when ligaments have sustained tears, healing can take a month or more. Whatever the degree of a sprain, it is important not to rush things. Unless you give your body enough time to fully heal, you put yourself at increased risk of a repeat injury.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: I just read that adding honey to yogurt is good for your gut microbiome. Is that true? I avoid added sugar, so I buy plain yogurt and have it with fresh berries. But I’m eating the yogurt to support my gut microbiome. How does the honey help? How much do you need?

Dear Reader: When you eat yogurt, which is a live culture, you’re adding to the diversity of the vast and complex communities of bacteria, yeasts and fungi that make their home in our intestines. It’s a smart move because these trillions of microbes, now collectively referred to as the gut microbiome, play key roles in our physical, mental and emotional well-being.

To reach the gut alive, microorganisms must survive a trio of hostile environments: the mouth, stomach and intestines. Each is equipped with enzymes that aid in the digestion and absorption of nutrients. However, these same enzymes, particularly those in the stomach and intestines, reduce the viability of the live bacteria contained in yogurt. This led researchers at the University of Illinois to wonder if honey, which is often paired with yogurt in the Mediterranean diet, might have a protective effect.

In the first of three studies, the researchers recreated the chemical composition of saliva, stomach acid and intestinal bile in a series of petri dishes. They then simulated the digestion of B. animalis, which is the microbe contained in yogurt. They found that the addition of honey had a significant protective effect on the yogurt microbe during the intestinal phase of digestion. Of the four types of honey they tested -- clover, buckwheat, orange blossom and alfalfa -- clover honey had the best outcome.

The next step was to test these results in a real-world setting. A group of 66 healthy adults was asked to eat one serving of commercial-grade yogurt mixed with 21 grams (about 1 tablespoon) of clover honey each day for two weeks. After a month off to clear their systems, they were then asked to eat a serving of plain yogurt each day for two weeks. Analysis of stool samples showed the clover honey had the same protective effect on the beneficial bacteria in the yogurt that had been observed in the laboratory experiment. A small third study found that the addition of sugar to the servings of yogurt did not protect the bacteria from being degraded by the digestive enzymes.

The researchers also asked the study participants to track their bowel movements and to fill out questionnaires about their mood, cognition and general sense of well-being. The responses revealed that the enhanced survival of B. animalis during digestion did not translate into improvements in mood, cognition or general health. However, four weeks may be too short a period of time for those types of improvements to become evident.

The takeaway here is that, yes, it appears that honey can help the bacteria in yogurt reach their destination in the large intestine. But honey is an added sugar, which must also be taken into account.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: My boyfriend and I started a landscaping business. It means we lug around plants and trees and sacks of soil. He’s strong and doesn’t pay much attention to technique, but I worry it’s going to catch up with him. Can you please talk about how to be safe when lifting heavy stuff?

Dear Reader: When lifting heavy or bulky objects, it’s all too easy to rely just on your back to handle the bulk of the load. But because of the somewhat fragile architecture of the spine, this leaves you prone to injury. Although this is particularly true when heavy lifting is a part of your daily routine, even a one-time lift, when done with poor form, can end badly.

The most common injury sustained in heavy lifting is muscle strain in the lumbar region, which is the lower back. More serious injuries, such as strained or torn ligaments, or herniated discs in the spine, are also possible. Symptoms of a back injury include sudden pain, muscle cramps or spasms and a compromised range of motion. Even a mild spinal injury can put you out of commission for several days. More serious injuries can take weeks to heal. And while less common than lumbar injuries, damage is possible to the middle and upper back, and also the neck, during heavy lifting.

The good news is that proper technique reduces the risk of getting hurt. For that, we turn to the field of ergonomics. The first -- and often ignored -- step is to plan ahead. Assess the shape and weight of the object, and know the specific path to its final destination. Next, position the object so it is centered in front of you. To keep from twisting as you lift a heavy weight, which you should never do, plant your feet on either side of it, shoulder width apart. Crouch down, keeping the spine upright and the core muscles engaged. You’re going to use your arms and hands to secure the load and let the powerful leg and butt muscles do the bulk of the lifting. Engaging your core as you lift reduces the stress on the spine.

Avoid carrying a heavy load on one side of the body. If necessary, as when a parent carries a child, be sure to regularly switch sides. The ideal position when carrying a heavy load is to keep it between your thighs and shoulders. When something is too heavy for this, keep it suspended between your bent knees, with your back upright, as you walk. But in this case, you may want to break up the journey into increments. Bulky objects can make these precautions difficult to follow. In those cases, get another person to help. If possible, alternate light and heavy loads.

Using a back belt can aid stability and add a measure of protection. However, these can also cause a false sense of security. If you do use a back belt, be sure to always follow ergonomic procedures. It takes just an instant to injure your back, but days, or even weeks, to recover.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)