Types of sprains
There are two primary types of ankle sprains: inversion or ‘lateral ankle sprains’ are the most common which occurs when your foot twists inwards and a sudden stretch of the ligaments is experienced. Although less common, it is possible to sustain an eversion ankle sprain in which the opposite occurs, and the ligaments on the inside (medial) ankle are injured.
 
Injured ligaments
The most commonly sprained ligaments, located on the outside of the ankle, are the:

• Anterior talofibular ligament (ATFL)

• Calcaneofibular ligament (CFL)

• Posterior talofibular ligament (PTFL)

​
On the inside of the ankle, we have the strong deltoid ligament, which is comprised of the:
​

• Tibiotalar ligament (TTL)

• Tibiocalcaneal ligament (TCL)

• Tibionavicular ligament (TNL)

 
One of the reasons that it is uncommon to sprain the ligaments on the inside of the ankle, aside from the strength of the deltoid ligament, is that the fibula (the thinner bone that runs alongside the shin bone - tibia) tends to prevent the excessive eversion of the ankle. It also means that when eversion sprains do occur, the head of the fibula may fracture from the impact.

You’ll almost certainly know when you’ve sprained your ankle as the damaged ligaments quickly result in significant pain that may impair your ability to walk or bear weight on the injured ankle. You may also experience:

• Swelling

• Bruising

• Restricted movement in the ankle

• Tenderness when touching the ankle or moving the foot from side to side

• Instability when walking on the ankle, like it is giving way

If the ankle sprain is severe, or it was associated with a fall, there is a chance you may also have fractured or injured a bone in your foot. In this instance, x-rays will be useful to assess the extent of the bony damage, and ultrasounds can evaluate the integrity of the ankle ligaments.

Ankle sprains are an injury caused by a sudden force that makes the ankle roll inwards or outwards. This may be from:

• Walking on an unstable or unbalanced surface

• Playing sports that have quick changes in direction, e.g. basketball, soccer and tennis

• Awkwardly planting your foot on the ground following a jump, or landing on an unexpected uneven surface

• Getting hit on the inside of the ankle with a soccer ball (causing you to roll out and twist the ankle inwards)

If a previous injury has caused some weakening in your ankle ligaments, then you are more likely to have another ankle injury. It’s important to see your Podiatrist if this is the case.

As soon as the sprain occurs, it’s essential to avoid walking and bearing weight on the ankle. This is because ligament injuries can get worse - a strain can progress to a tear, and a small tear can progress to a larger tear.

Protect the ankle
Protect the ankle from further injury, avoid doing activities that cause you pain.

Rest
Rest the ankle to allow it to heal. Once some time has passed and the healing process has begun, you may start to mobilise the ankle (gently and slowly move it), but stop immediately if this is causing you pain.

Ice
Cover the ankle with an ice pack - or use a cold bath. This works to reduce swelling, thereby reducing pain. Only use cold exposure for 10-15 minutes at a time to protect the skin. If you experience any rashes or the skin becomes raised, stop immediately. Redness will likely be present when icing but should settle within 5 minutes of removing the ice. Within the first few days of your injury it is useful to ice your ankle for 10-15 minutes every few hours if possible.

Brace or Strap
Brace or strap the foot to limit movement. Bracing / strapping combined with an exercise programme prescribed by your Podiatrist has shown to deliver best outcomes in clinical studies. This programme must be prescribed by your Podiatrist and we do not recommend commencing any physical therapy unless under supervision.
 
You must be careful when taking anti-inflammatory drugs as while they can be used to reduce pain and swelling, they may delay the healing process.

When ankle sprains aren’t effectively managed, they can lead to long-term ankle weakness and chronic instability. If your sprain is causing you pain while walking, it is likely more severe and we recommend that you see your Podiatrist as soon as you’re able. Ideally, this will be within the first 24 - 48 hours.

Your Podiatrist will start by assessing the extent of your injury to know how to best direct treatment. If it is suspected that you have subsequently injured a bone during the sprain (such as your fibula), you may be referred for an x-ray and ultrasound to assess both the bony damage and the integrity of your ligaments. Your Podiatrist may then:

​

• Strap, splint or provide compression for your ankle

• Discuss footwear options that will optimise and not impair your recovery

• Provide timely and appropriate stretching and strengthening for your ankle (note: if you start this too early, you may risk further damage to the ligaments. It is important to carefully follow the guidance of your podiatrist as this is assessed on a case-by-case basis depending on the severity of the your injury

• Help identify the cause of your sprain and discuss how you can help prevent it in the future

• Work to reduce the risk of complications like chronic ankle instability

Surgery is generally not required and should only be considered when the ankle sprain does not respond to the above treatments.

​

Need a trusted Podiatrist in your area that can help? click here