Acute Ankle Sprain


What is it?
An acute ankle sprain is one of the most common injuries affecting sports players. It involves the partial or complete tearing of one or more ligaments that connect bone to bone and help stabilise the ankle joint. An ankle sprain can be classified as grade 1 (mild), grade 2 (moderate) or grade 3 (severe) according to the degree of tearing to the ligaments.

How does it occur?
Lateral ankle sprains, or inversion sprains typically occur in sports that require jumping, turning and twisting movements. Injury is likely to occur during an explosive change in direction or sudden side-stepping action as the body’s centre of mass is rapidly shifted over the weight-bearing foot. This action forces the ankle to roll outwards while the foot turns inwards (inversion), causing the ligaments on the outside of the ankle (lateral side) to stretch and in some cases tear. The most commonly injured ligament is the anterior talofibular ligament (ATFL).

Medial ankle sprains, or eversion sprains, are far less common and involve the tearing of a thick, strong ligament on the inside of the ankle joint (medial side) called the deltoid ligament. This occurs when the ankle joint rolls inwards while the foot twists outwards (eversion).

Initial management:
The RICER method (Rest, Ice, Compression, Elevation and Referral) can be used initially for up to 72 hours post injury to reduce damage to the joint, ease pain and speed up the healing process. The ankle should be rested in an elevated position with an ice pack applied for 20 minutes every 2 hours. A compression bandage can be applied to limit bleeding and swelling within the ankle joint.

The No HARM protocol (no heat, no alcohol, no running and no massage) should also be applied.

Physiotherapy management:
Depending on the severity, most acute ankle sprains heal within 2 to 6 weeks while more severe ankle sprains may take up to 12 weeks to heal. Physiotherapists use a range of techniques to assess a sprained ankle and will provide a comprehensive rehabilitation program including strength training, mobility exercises, balance and sport specific exercises to promote recovery and reduce the chance of the injury reoccurring.