Lateral ankle sprains

Authored by Sally Naylor.

Lateral ligament sprains are a common injury in sports, especially those that involve changing direction or jumping and landing.

Mechanism of Injury

These ligaments are placed under stress and subsequently injured when the foot is inverted. Often this will occur when someone stands on another player’s foot or lands on an uneven part of ground. They will then feel pain on the outside of the ankle. Depending on the severity (grade 1-grade 3) there will be swelling, bruising, and difficulty weight bearing through the injured ankle.

Initial Management

“RICE” the ankle- Rest, Ice, Compression and Elevation. This protocol is followed for the first 72 hours post injury.

  • Rest from aggravating activities e.g. running, walking (if severe).
  • Ice: 20 minutes every couple of hours.
  • Compression- evidence suggests semi-rigid ankle braces provide the best compression, with less long-term ankle instability and quicker return to sport rates.
  • Elevate: above the level of the heart.
  • Crutches may be required if unable to weight bear. However, the evidence favours functional mobilization rather than immobilization for earlier return to sport.

Do I need an X-ray?

There are specific guidelines that physiotherapists use to determine whether an x-ray is required, including specific points of tenderness and ability to weight bear. It is recommended that you see your highly skilled physiotherapist at Lifecare Malvern Sports Medicine who can assess and refer for an x-ray if necessary.

When can I return to sport?

Your physiotherapist will prescribe a rehabilitation program focusing on improving range of motion, ankle strength, balance and other biomechanical/strength deficits. This will reduce your risk of re-injury when returning to sport. Depending on the severity, return to sport can be between 3-6 weeks, however severe sprains can take even longer. It is recommended that the athlete return to sport wearing an ankle brace to provide further stability to the ankle.


Peterson, W., Rembitzki, IV.,Koppenburg, AG., Ellerann, A., Liebau, C., Bruggemann, GP., Best, R. (2013). Treatment of acute ankle ligament injuries: a systematic review. Archive of Orthopaedic and Trauma Surgery, 133, 1129-1141.doi:10.1007/s00402-013-1742-5

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