Lateral Ankle Sprain

Ankle sprains are the most commonly documented musculoskeletal injury in those who are physically active. They’ve become so common that many people are quick to shrug off an ankle sprain, instead of taking it seriously and treating it promptly. We take ankle sprains very seriously because we know that ankle sprains can have significant long-term consequences for a person’s activity levels, livelihood and future injury risk.

Having a lateral ankle sprain means that you’ve damaged at least one of the three primary ankle stabilising ligaments located on the outside of the ankle. These ligaments become damaged when they are stretched and forced beyond their limits to the point of injury. While lateral ankle sprains account for the high majority of all ankle sprains, a medial ankle sprain may also occur, where you roll down on the inside of the ankle and damage one of the two stabilising ligaments on the inside of the ankle joint.

Lateral ankle sprains are typically difficult to miss, with a notable rolling out or giving way of the ankle. This action may be followed by:

• Mild to severe pain and tenderness
• Redness on the outside of the ankle that may turn into dark bruising
• Swelling on the outside of the ankle
• Difficulty bearing weight or walking on the affected ankle.

Your level of pain can vary depending on how severe your ankle sprain is. At its worst, the ligaments may not just become damaged but may also rupture. Sometimes, other muscles that cross the ankle joint may also get injured in the sprain, with very similar symptoms. This is why it’s important to have your injuries checked by a podiatrist.

Ankle sprains occur when the outwards rolling movement of your ankle forcefully stretches the supporting ligaments, causing them to sprain and become damaged. The reason for your ankle rolling out can vary greatly, and could be associated with:

• Ankle joint weakness
• Wearing shoes that don’t offer much stability (like high heels), mechanically rolling your foot out
• Wearing shoes that offer far too much arch support for your foot type, which then pushes your foot outwards and increases your risk of a sprain
• Walking or exercising over uneven ground
• Playing sports that have high demands on your lateral (side-to-side) movement and fast transitions, such as soccer, tennis, basketball and more
• Having a previous ankle injury

Chronic ankle instability

When repeated sprained ankles are ignored and left untreated, this can cause the ligaments to permanently weaken over time. This is known as chronic ankle instability because it makes the ankle less stable and more vulnerable to more ankle sprains in the future. Chronic ankle instability has also been linked to early onset osteoarthritis of the ankle joint, relating back to the trauma sustained during the sprain. 

Our podiatrists work extensively with those with chronic ankle instability to best support and strengthen their ankles to reduce their risk of sprains and support them through their sporting and lifestyle endeavours.

As with any injury, the best approach to care for your ankle is dependent on the severity of your sprain, how many ligaments have been involved and whether there have been any ligament tears or ruptures, if other tissues or tendons have been involved, and various other factors. While managing your sprain conservatively at home:

• Apply ice to your ankle through a cloth or tea towel for no more than 20 minutes at one time, 4-5 times a day. This will help reduce swelling and pain, and may help limit bruising.
• Rest your ankle and keep it elevated
• Avoid any movements that twist your foot inwards on your ankle, like when the soles of the feet and pointed in to face one another. This will put strain on the ligaments on the outside of the ankle and cause pain
• Strap your ankle: you can have your podiatrist teach you how to do this during your appointment, but before then, you can follow this video tutorial for lateral ankle strapping.

At Matt Raden Podiatry, we’ll perform a comprehensive assessment and understand exactly how and why your sprains are occurring. We’ll then create a unique treatment plan that will let your ankle heal the right way, while minimising your risk of developing chronic ankle instability. This may include:

• A tailored ankle strengthening programme to best support your recovery and future ankle health
• Recommending specific footwear for sports and work, such as those with a deep heel cup and a higher lateral side of the shoe to keep your ankle stable and supporting while helping reduce your risk of another sprain
• Discussing whether custom foot orthotics with specific anti-sprain features could be right for you in supporting the position and stability of your ankle as you walk and engage in physical activity
• Using a medical ankle brace to better support your ankle inside your regular shoe
• Using a moon boot to immobilise the ankle in more severe cases

Most ankle sprains do not require surgery, but in rare cases it may be indicated if there are significant ligament tears or ruptures, or if conservative treatment approaches have failed to yield a satisfactory result.