Ankle sprain: What do we need to know?

By Roberto Fernandez Sanchez, Physiotherapist and Clinical Lead. 

Today, we are going to review one of the most common injuries in sport – Sprained Ankle. 

When we trip or step on something unstable, our ankle gives way and we feel an acute pain, sometimes followed by a clunk or a crack. 

Then comes the swelling and pain which can last for a few days, occasionally even weeks.

Recently, the guidelines about lateral ankle sprains have been updated, thanks to a meta-analysis and a systematic review of hundreds of articles. 

So, here’s a short summary of some key points regarding Lateral Ankle Sprains:

  • About 40% of ankle sprains are sports related. 
  • 50% of people who get an ankle sprain do not seek medical help, resulting in a large amount of ankle sprains becoming chronic condition (long-term pain and instability).
  • Predisposing factors of the lateral ankle sprains are:
  1. Intrinsic factors: New factors have been included like BMI, not only obesity but also a low BMI affects negatively. 
  2. Movement restriction and poor proprioception are predisposing factors, and they should be included in the re-education, rehabilitation and prevention of the ankle sprain.
  3. Extrinsic factors: Different kinds of sports, especially those involving high impact or contact sports like basketball, football , rugby and trail running.
  • Around 40% of ankle sprains become chronic (Long term) causing pain and instability which then leads to a higher chance of recurrence. This is why physiotherapy is so important in the early stages to help with a full recovery.
  • The importance of a good diagnosis is to know the seriousness of the ankle sprain. The anterior drawer test is important to assess if the ligament has been damaged, even more if the diagnosis is not immediate and has been delayed more than 4-5 days from the injury.
  • There is no evidence to say that the RICE method (rest, ice, compression, elevation) or the application of its elements separately, is effective. Instead, RICE combined with progressive exercise helps to reduce swelling and pain; and increases ankle range of movement achieves the best results.
  • NSAID´s have the same effect than other analgesia to reduce pain after an ankle sprain. But they can also interfere and delay the natural healing process.
  • Early mobilisation is better than short period (around 4 weeks) immobilisation. Functional taping or ankle supports can help to reduce symptoms, and also can facilitate ankle movement giving support to the injured ligament.
  • It has been proved that with active exercise combined with manual therapies we can obtain a better outcome and reduced post-injury convalescence after a lateral ankle sprain. The healing process and return to work/sports period is also shortened by this kind of treatment.
  • Prevention and neuromuscular training once the ankle sprain is healed is essential to avoid recurrence.

For more information, you can read the latest research from the BJSM about ankle sprains:


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Call: 01732 666050