An ankle sprain occurs when the foot suddenly twists or rolls and forces the ankle out of its normal position. In addition to pain, a patient may experience swelling, bruising, and additional discomfort when they put weight on their foot.

Ankle anatomy

There are three levels of ankle sprain:

Grade I Sprain (Mild)
• Slight stretching and microscopic tearing of the ligament fibres
• Mild tenderness and swelling around the ankle

Grade II Sprain (Moderate)
• Partial tearing of the ligament
• Moderate tenderness and swelling around the ankle
• When the ankle moves in certain ways, there is an abnormal looseness of the ankle joint

Grade III Sprain (Severe)
• Complete tear of the ligament
• Significant tenderness and swelling around the ankle
• When the ankle moves in certain ways, substantial instability occurs

Chronic ankle instability is usually caused by multiple ankle sprains. Symptoms include:
• Pain on the lateral (outer) side of the ankle
• Constant dull achiness
• Difficulty walking
• A feeling that the ankle will “give way” (instability)
• Swelling
• Stiffness
• Tenderness

Fortunately, most ankle sprains can be treated without surgery. Even a complete ligament tear can heal without surgical repair if it is immobilized appropriately.

A three-phase programme guides treatment to aid all ankle sprains - from
mild to severe:
Phase 1 includes resting, protecting the ankle and reducing the swelling.
Phase 2 includes restoring range of motion, strength and flexibility.
Phase 3 includes simple ankle exercises to help strengthen ligaments and muscles while working on range of motion and flexibility. Gradually return to activities that do not require turning or twisting the ankle can be introduced, building over time to activities that require sharp, sudden turns, such as tennis or football – often with the support of a brace.

Ankle braces