Lateral Ankle Sprain

Ankle sprains are so common among athletes and the reinjure of those sprains is as well. Depending on the sprain it can put you out for weeks to months at a time. An ankle sprain is the tearing of the fibers in a ligament of the foot. Of all the ankle injuries the lateral or inversion ankle sprain is the most common. Whether it is mild to severe or armature to professional athletes… everyone gets this injury. Here is some more information on the anatomy, risk factors, causes and treatment of lateral ankle sprains.


The foot is made up of 26 bones, 33 joints and 107 ligaments. Ligaments are the connective tissue that connects two bones together. When a lateral ankle sprain occurs there are three ligaments that may be damaged. The ATFL which connects the talus to the fibular, the CFL which connects the fibular to the calcaneus, and the PTFL which connects the same bones as the ATFL but is located further back in the foot.

foot ligaments

Risk Factors

The type of sport and the movements required of that sport are one of the biggest risk factors. Sports like basketball and volleyball that require a lot of jumping and the possibility of coming down on another person’s food are of higher risk. It also depends on the playing surface; rough uneven surfaces will increase the chance of injuring your ankle.

Lack of strength, proprioception, and balance will increase the risk on a lateral ankle sprain. Proprioception is the body’s awareness of your limbs in space. The better idea your brain has about a joint, the better it can react to sudden movements. Some people also have hind foot varus which means that the feel is slightly turned inward making it easier to twist inward.

Symptoms, Signs and Causes

The weakest position and therefor the most common position for an injury is when the foot is plantarflexed. If there is then a strong inversion force it can easily lead to a sprained ankle. Cutting quickly, changing direction, or coming down on another players foot are common causes.

plantar flexion

The immediate symptom of pain will be present. Athletes will also see bruising over the lateral ligaments, so on the outside of the foot. They will show pain with weight bearing on that foot as well as poor balance. The range of motion especially through dorsiflexion (pointing your toes to the ground) will be limited and elicit pain. All of these symptoms will range from mild to severe based on the severity of the sprain.

Lateral Ankle Sprain Grades

A grade one sprain will only have a slight stretching to the fibers of the ATFL. Grade one sprains will have a mild amount of pain and have a smaller effect on your balance and range of motion. Swelling wil be minimal and barely any functional loss

A grade 2 lateral ankle sprain is a complete tear of the ATFL and partial tear to the CFL. Symptoms will be a moderate amount of pain, minor bruising, swelling and stiffness. The player will most likely not be able to return to sport immediately.

A grade three sprain is classified by a complete tear of the ATFL, CFL, and a partial tear to PTFL. Players will be in a lot of pain and there will be a complete loss of range of motion. Player will not be able to return to sport and should receive an x-ray to ensure no bones were broke.

grade three sprain


The initial step should be to follow the RICE protocol (rest, ice, compression, and elevation). Ice should be applied for only 10-15 minutes at a time so that you don’t restrict blood flow going to your ankle. Depending on the severity on the ankle sprain, initially you should avoid weight barring. It is good to try and maintain range of motion in the ankle.

Seeing a physiotherapist to assess your ankle is a great idea. The physio will suggest exercised to help strengthen and increase range of motion. An ankle brace will also be a great way to protect your ankle once you’ve returned to sport. The brace provides warmth and compression to support the damaged ligaments in the ankle.