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  /  Ankle   /  Understanding Ankle Sprains

Understanding Ankle Sprains

Every step we take, every jump, and every pivot involves our ankles, making them vital for our mobility. Despite being frequent, an ankle sprain may be unexpectedly debilitating. Whether you’re an athlete, a fitness enthusiast, or just going about your daily routine, understanding ankle sprains is crucial. This blog will clarify the confusing world of ankle sprains, delving into their definition, causes, symptoms, prevention methods, and effective treatments, both in terms of medications and physical therapy.


An ankle sprain occurs when the ligaments in your ankle are stretched or torn, often due to a sudden twist or turn of the foot. Ligaments are tough, flexible bands that connect bones and provide stability to joints. Ankle sprains can range from mild to severe, depending on the extent of ligament damage.


Ankle sprains commonly result from activities that involve quick changes in direction, such as sports, or uneven surfaces. High heels, inadequate warm-up, and weak ankle muscles can also contribute. In severe cases, ankle sprains may occur due to accidents or falls.


How does it feel? Here are the main symptoms that you may experience after an ankle sprain:

  • Pain in the affected area.
  • Swelling.
  • Inability to stand or walk on the affected foot.
  • Throbbing.
  • Stiffness.
  • Weakness.
  • A feeling of instability in the ankle joint.


Ankle sprains are categorized into different types based on the specific ligaments that are injured and the severity of the injury. The three main types of ankle sprains are:

  • Inversion Sprains: Inversion sprains are the most common type of ankle sprains. They occur when the ankle rolls inward, stretching or tearing the ligaments on the outer side of the ankle. Inversion sprains typically affect the lateral ligaments.
  • Eversion Sprains: Eversion sprains are less common and occur when the ankle rolls outward, injuring the ligaments on the inner side of the ankle. Eversion sprains affect the deltoid ligament, which is a strong, wide ligament on the inner side of the ankle. Eversion sprains are often associated with fractures due to the significant force required to cause this type of injury.
  • High Ankle Sprains: High ankle sprains involve injury to the ligaments that connect the tibia and fibula (the two lower leg bones) above the ankle joint. These ligaments are often injured during activities that involve a twisting motion. High ankle sprains are usually more severe and can take longer to heal compared to typical inversion or eversion sprains. 

Ankle Anatomy

An inversion sprain, which is the most common type of ankle sprain, occurs when the ankle rolls inward. To understand this better, let’s examine the underlying anatomy. The ankle joint comprises three bones: the tibia and fibula (bones of the lower leg) and the talus (a foot bone). Ligaments surround and connect these bones, facilitating movement while providing stability.

When the foot rolls inward, stretching or tearing the ligaments on the outer side of the ankle, injury occurs. This typically happens when the foot is planted awkwardly, the ankle is twisted, or there’s an uneven surface. In the process, the ligaments are stretched beyond their normal range; subjected to forces they aren’t designed to handle, leading to injury.

Grades of Ankle Sprains

  1. Grade I (Mild): Grade I sprains involve stretching or slight tearing of the ligaments. There might be mild pain and swelling, but you can still walk with minimal discomfort.
  2. Grade II (Moderate): Grade II sprains indicate a partial tear of the ligaments. Pain, swelling, and bruising are more significant, and walking becomes noticeably difficult.
  3. Grade III (Severe): Grade III sprains are characterized by a complete tear of the ligament. These are the most severe and often result in intense pain, swelling, bruising, and the inability to put weight on the affected ankle.


Preventing ankle sprains involves a combination of caution and strengthening exercises:

  1. Wear appropriate footwear: Choose shoes that fit well and provide proper support. Avoid high heels for extended periods, especially on uneven terrain.
  2. Warm-up and stretch: Prior to any physical activity, warm up your body and perform ankle-specific stretches to increase flexibility.
  3. Balance and strength exercises: Incorporate balance and strengthening exercises into your routine to enhance ankle stability. These can include calf raises, ankle circles, and resistance band exercises.
  4. Be cautious: Watch your step, especially in unfamiliar or uneven environments. Take extra care during physical activities, particularly those involving rapid changes in direction.


  1. Medication
    • Pain Relievers: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and reduce inflammation.
    • Topical Analgesics: Creams or gels containing menthol or NSAIDs can provide localized relief.
  1. Physical Therapy 
    • Manual Therapy: Physical therapists may employ techniques like massage and joint mobilization to enhance healing and reduce pain.
    • Range of Motion Exercises: Gently move your ankle in different directions to restore flexibility.
    • Strengthening Exercises: Focus on exercises that target the muscles around your ankle, such as plantarflexion, dorsiflexion, eversion and inversion exercises 
    • Balance Exercises: Balance boards and stability exercises can improve proprioception and prevent future injuries.
    • Boost your endurance: It’s critical to rebuild your leg and ankle muscles’ endurance following an injury. You will learn the proper endurance-building exercises from your physical therapist, allowing you to resume your regular activities. You could be required to use cardio workout machines like treadmills or stationary bikes.
    • Bring agility back: In sports and many daily tasks, leg movement speed and precision are essential. To assist you get ready to resume sports and your regular routine, your physical therapist will help you restore these abilities.

In more severe cases, a brace or cast might be necessary to immobilize the ankle temporarily. Always consult a healthcare professional for proper diagnosis and guidance on the most suitable treatment plan for your situation.

Strengthening Exercice : Toe Raises 

Strat Position

Middle Position

End Position

  • Start with your feet placed firmly on the stepper.
  • From a stretch position, gradually raise your heel, lifting your body onto your toes.
  • Maintain a slow and controlled movement, ensuring it’s pain-free.
  • Return to the starting position.
  • Repeat this exercise 15 times, focusing on the full range of motion.

This exercise helps strengthen your calf muscles and improve balance and ankle stability.

Balance Exercise : Single Leg Stability

Start Position

Front Kick

Side Kick

Back Kick

  • Begin by balancing on one leg next to a set of cones placed on the ground.
  • Slowly lift your free leg and perform a front kick, aiming to reach one of the cones without causing pain.
  • Lower your leg and regain your balance on one leg.
  • Next, perform a side kick towards another cone, keeping the movement slow and pain-free.
  • Lower your leg again, maintaining your balance.
  • Finally, execute a back kick toward a different cone, focusing on control and comfort.
  • After completing the kick sequence, balance on one leg for a moment.
  • Repeat this set of front, side, and back kicks 8 to 10 times, ensuring you move slowly and without experiencing any discomfort.

This exercise enhances strength, stability, and flexibility.

Mobility Exercise: Ankle Drive With Resistance

Start Position

End Position

  • Begin by kneeling on one knee, with your opposite leg positioned forward.
  • Attach an elastic band to a sturdy anchor or point and secure it around your ankle.
  • Maintain an upright posture with your hands on your hips or for support.
  •  With your toes pointed forward, slowly flex your ankle and drive your foot forward against the resistance of the elastic band.
  • Continue this motion, ensuring it’s slow and controlled, and then return your foot to the starting position.
  • Repeat the ankle drive movement 15 times, all while moving slowly, and make sure you don’t experience any discomfort.

This exercise helps strengthen the muscles & improving flexibility and stability.

Treatment Options Based on Grades:

  1. Grade I:
    • Rest and Ice: Rest your ankle and apply ice to reduce swelling. Ice should be applied for 15-20 minutes every 2-3 hours during the initial 48 hours after the injury.
    • Compression: Use a compression bandage to control swelling and provide support to the injured area.
    • Elevation: Keep your ankle elevated above the level of your heart whenever possible to minimize swelling.
  1. Grade II:
    • Immobilization: Your healthcare provider might recommend a brace, splint, or cast to immobilize the ankle and allow the ligament to heal.
    • Physical Therapy: Physical therapy exercises are essential to regain strength and stability. These include resistance exercises, balance training, and range of motion exercises.
    • Pain Management: Over-the-counter pain relievers or prescription medications can help manage pain and inflammation.
  1. Grade III:
    • Immobilization: Severe sprains often require a cast or walking boot to immobilize the ankle completely. In some cases, surgery might be necessary to repair the torn ligament.
    • Physical Therapy: After the initial healing period, physical therapy becomes crucial for rehabilitation. Therapists guide you through exercises to regain strength, balance, and flexibility.
    • Long-Term Care: Grade III sprains may require prolonged rehabilitation and careful monitoring to prevent chronic instability and recurring injuries.

Remember, regardless of the grade, it’s crucial to follow your healthcare provider’s advice diligently. Proper care, timely treatment, and rehabilitation exercises play key roles in ensuring a full recovery and reducing the risk of future ankle sprains. So, if you ever find yourself nursing a sprained ankle, don’t hesitate to seek medical attention and embark on the path to healing and recovery.


Ankle sprains are not only painful but can also disrupt your daily activities. By understanding their causes, implementing preventive measures, and seeking appropriate treatment, you can significantly reduce the risk of ankle sprains. Remember, taking care of your ankles is an investment in your overall mobility and well-being. So, lace up your shoes, warm up properly, and take those steps mindfully – your ankles will thank you for it!