Ankle Sprains

What are Ankle Sprains

Ankle sprains are one of the most common injuries that we see at the clinic. It is most commonly reported as a sporting injury – such as a bad landing from a jump, or a twist during a fast change of direction. However, there is the occasional story of someone tumbling off a step, or tripping over a curb. In any case, an ankle sprain is painful and can debilitating.

What Cause Ankle Sprains

The ankle joint is made up of 3 bones – namely the talus, the fibula (the protruding bone on the outside of the ankle) and the tibia (the protruding bone on the inside of the ankle).  Ligaments are responsible for holding these bones together i.e. they are the primary stabilizers of the ankle.

ankle sprain 1

On the inside of the ankle, joint stability is provided by the deltoid ligament which is thick and strong. Injury to the deltoid ligament can happen when the foot is twisted outward – an eversion sprain. 


ankle sprain 2

On the outside of the ankle, joint stability is provided by 3 small separate ligaments – the anterior talofibular ligament (ATFL) , the posterior talofibular ligament (PTFL) and calcaneofibular ligament (CFL). Injury to any of these ligaments happens when the foot is twisted inwards – also known as an inversion sprain.  An inversion sprain accounts for 80% of all ankle sprains, and the ATFL is the most commonly injured ligament.

ankle sprain 3

 How Do I Know If I Have An Ankle Sprain

Symptoms of an ankle sprain:

  • Pain either on the inside or outside area of the ankle
  • Increasing difficulty in walking / putting weight on that foot
  • Swelling and redness
  • Bruising

The severity of the injury can be determined by the degree of disability immediately and subsequently after injury, and by the degree of swelling and bruising.

How can Physiotherapy help?

An initial assessment by your physiotherapist can help determine the severity of the ligamentous injury, the instability of the ankle joint, and to exclude damage to other structures in the ankle joint. Management of ankle sprains follow the same principles – reduce pain, manage swelling, restore range of movement, improve muscle strength and to improve joint proprioception and balance. The initial management of RICE (Rest, Ice, Compression, and Elevation) and restricted weight-bearing in the acute stage of injury is important. Treatment may consist of soft tissue release, joint mobilisations, exercises, taping and ultrasound therapy. A sport-specific rehabilitation program will be implemented so as to facilitate return to sport.