Acute Ankle Injury

Winter sports are starting back up, pre-season training has now been happening for a number of weeks and competitions are about to kick off…

This is often a time where injuries can happen with a change in load on our body tissues with our bodies not necessarily being conditioned to the demands of our sports or activities, particularly after what was such a disruptive 2020/2021 period.

One of the most common musculoskeletal injuries that occur in physically active individuals are acute ankle sprains, which we see in the clinic as physiotherapists frequently over the winter period. Additionally, acute ankle sprains have a high recurrence rate with up to 70% of individuals developing long-term physical disability such as ankle instability or issues with impingement if not treated correctly (Herzog et al., 2019).

Persistent pain or stiffness should not be ignored as this can lead to abnormal or compensatory movement patterns that can worsen the injury or lead to other overuse issues.

What are the different types of ankle sprains?

  • Inversion or Lateral ankle sprain – the most common type of ankle sprain resulting in over-stretch or trauma of the ligaments* on the outside of the ankle (lateral ligament complex) as the foot rolls inwards.
  • Eversion or Medial ankle sprain – results in strain or trauma to the ligaments on the inside of the ankle (medial ligament complex) as the foot is forced outwards, or the ankle inwards.
  • High ankle sprain – injury or trauma to the ligaments that connect our two shin bones (the tibia to the fibula) just above the ankle. These ligaments are commonly referred to as the ‘syndesmosis complex’ in the physio world. These injuries are less common and typically caused by a combination of rolling the foot inwards whilst pointing the toes. They usually result from a sudden twisting or turning motion and take a longer period of time to settle.

*Note: ligaments are dense bands of tissue that connect bone to bone to give our joints support.


How can you best manage an acute ankle injury?

In the initial phase of recovery immediately after injury R.I.C.E (Rest, Ice, Compression, Elevation) is recommended. Be sure to ice for no longer than 15 minutes at a time, elevate above the level of the heart, and encourage light movement of the ankle as tolerated to ensure you are not losing too much range of motion of the ankle joint and foot.

NOTE: If you are unable to weight bear immediately after injury, imaging is required to rule out fractures of the ankle and foot.

The next step is to get yourself along to your local physiotherapist sooner rather than later.


What can a physiotherapist do?

  • Individualised assessment of the ankle, your biomechanics and movement patterns, including identifying any weaknesses that may need to be addressed to prevent re-injury in the future.
  • Guidance to whether taping or immobilisation is required or whether we want to get the ankle moving as much as possible in the early stages to prevent loss of range of motion.
  • Advice regarding pain and swelling management.
  • Referral for further imaging as required.
  • Hands-on treatment.
  • Individualised rehabilitation including strengthening of the hip, knee, and ankle, balance retraining, relearning correct movement patterns, and return to sport specific rehabilitation to get you back doing what you love the most.


What can you do to prevent an ankle injury this season?

Although we cannot completely prevent the risk of first-time ankle sprains, we can reduce the risk of recurrent sprains especially within the first year.

A couple of exercises you can do to prevent injury include:

  • Evidence suggests that the ability to perform 25+ repetitions of good quality single calf raises (rising up on to the toes and lowering with control) reduced the risk of injury significantly. You may need to build up to this number.
  • Single leg balance on an unstable surface (e.g. a cushion) for 1 minute each side. To further challenge either close your eyes or turn your head side to side.


Here at Inner Strength we treat a range of individuals with acute injuries from children through to the elderly. If you or a family member sustains an ankle injury this winter or you want some advice on how you can prevent an injury occurring, give us a call on 8555 4099 to book an initial appointment with one of our experienced physiotherapists.

By Laura Cook / Physiotherapist