Injury of the Month: Ankle Sprains

Welcome to our new monthly feature — “Injury of the Month.” Each month, we’ll highlight a common athletic injury, exploring what it is, how it happens, and how you can manage it safely at home or with the help of a qualified healthcare professional.

What Is an Ankle Sprain?

Ankle sprains are among the most common injuries in sports. They occur when the ankle is forcefully inverted, everted, plantar flexed or dorsiflexed, causing the ligaments surrounding the ankle joint to stretch or tear. These ligaments are responsible for providing stability and support to the bones of the ankle — so when they’re injured, movement and balance can be significantly affected.

Grading the Severity

Ankle sprains are typically classified into three grades based on severity. While these can help guide an athletic trainer’s initial evaluation, only imaging (like X-rays or MRI) can confirm the true extent of injury.

• Grade 1 (Low Grade): Mild pain or discomfort. Function in sport-specific movement may or may not be affected.

• Grade 2 (Moderate): Noticeable pain and loss of movement in both sport and daily activities.

• Grade 3 (Severe): Significant pain with complete loss of function due to major ligament damage.

Types of Ankle Sprains

• Lateral Ankle Sprains (Most Common)

  • Involve injury to one or more of the following ligaments:

    • Anterior talofibular ligament (ATFL)

    • Calcaneofibular ligament (CFL)

    • Posterior talofibular ligament (PTFL)

• Medial Ankle Sprains

  • Affect the deltoid ligament complex on the inside of the ankle.Less common due to the strength and thickness of these ligaments.

• High Ankle Sprains

  • Involve the anterior tibiofibular ligament (ATFL).Typically result from high-impact movements or excessive dorsiflexion and eversion.These are more complex injuries and often take longer to heal.

Managing an Ankle Sprain

Proper treatment is key to promoting recovery and preventing future instability. Here are some essential methods:

• Compression

  • Helps control swelling and provides light support. Elastic wraps or compression sleeves work best.

• Elevation

  • Keep the ankle elevated above heart level when possible. This helps improve circulation and reduce swelling.

• Heat

  • Apply heat after the first 48–72 hours, once initial swelling subsides. Heat encourages blood flow and promotes healing.

• Ice

  • Use ice if pain is severe or unbearable — primarily for pain control. Although it can reduce swelling temporarily, excessive icing may slow the healing process.

• Weight-Bearing and Range of Motion (ROM) Exercises

  • Begin gentle walking and ankle movements as tolerated. This prevents stiffness and helps restore mobility.

Exercises for Strength and Stability

Rehabilitation doesn’t stop at pain relief — regaining strength and balance is crucial to full recovery. Try incorporating these exercises:

1. Ankle ABCs- “Write” the alphabet with your foot to gently improve mobility.

   1. 3 sets

      1. Lowercase letters for an easier option

      2. Uppercase for more challenge

2. 4-Way Ankle Resistance- Using a resistance band, perform four motions: dorsiflexion, plantar flexion, eversion, and inversion.

   1. 3 sets of 8–10 reps

3. Single-Leg Balance (SL Balance)- Stand on one leg to enhance stability and proprioception.

   1. 3 sets of 30 seconds

   2. Progressions:

      1. Close one or both eyes

      2. Stand on an unstable surface (foam pad or BOSU ball)

      3. Catch a ball or turn your head while balancing

4. Calf Raises- Strengthen the muscles supporting your ankle.

   1. 3-Way Calf Raises: Toes-in, toes-out, and neutral (3 sets of 7 each)

   2. Elevated Calf Raises: Stand on a step with heels off the edge; lower and lift slowly. 

      1. Can be combined with 3-way variations (3 sets of 7)

Single Leg Balance

4-Way Ankle (Dorsiflexion)

4-Way Ankle (Eversion)

4-Way Ankle (Plantarflexion)

4-Way Ankle (Inversion)

A series of rehab exercises compiled for demonstration

Final Thoughts

Ankle sprains can range from mild to severe, but every case deserves proper care and attention. Early evaluation and a structured rehab program led by a Certified Athletic Trainer can make the difference between quick recovery and lingering instability.

Stay tuned for next month’s “Injury of the Month” feature as we continue to educate and empower athletes to take charge of their health, recovery, and performance.