The ABCs of Ankle Sprains and the Role of Physiotherapy

Have you ever twisted your ankle while playing sports or simply walking on an uneven surface? If so, you’re not alone. Ankle sprains are one of the most common musculoskeletal (MSK) injuries. While athletes often grab the spotlight, ankle sprains can happen to anyone, at any age. Understanding these injuries, from causes to treatments, can help you get back on your feet faster and stronger.

The Ins and Outs of Ankle Sprains

An ankle sprain is an injury to the ligaments supporting the ankle complex. It’s like the body’s very own elastic band stretching a little too far, sometimes even snapping. There are three main types:

Lateral Sprain: Occurs when the ankle rolls outward, causing an awkward and forceful inversion and plantarflexion. Think of it as your foot taking a surprising turn while the rest of you keeps going straight.

Syndesmotic Sprain: This ‘high ankle’ sprain typically happens when the ankle experiences a forceful external rotation. Picture your foot planted firmly on the ground, then twisted out of position.

Medial Sprain: Often the result of an awkward fall leading to an excessive outward roll (eversion) of the foot, or simply the gradual wear and tear of the medial ligaments.

Anatomy of an Ankle Sprain

When you sprain your ankle, the ligaments stretch or even tear completely, an event graded as 1st, 2nd, or 3rd degree sprains. These sprains can bring some uninvited guests like edema (swelling), hematoma (bruising), and pain, making simple activities like walking or standing on tiptoes a challenge. 

The ligaments involved depend on the type of sprain:

Lateral Sprain: Targets the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), or the posterior talofibular ligament (PTFL).

Syndesmotic Sprain: interrupts the anterior, posterior, and transverse tibiofibular ligaments, along with the interosseous membrane.    

Medial Sprain: Affects the fan-shaped deltoid ligament, which includes multiple ligament structures.

The Physiotherapy Game Plan

Physiotherapy plays a starring role in navigating the road to recovery from an ankle sprain. It’s all about personalized care, strategically staged:

Acute Phase

Your physiotherapist will help you protect the joint while minimizing pain, inflammation, muscle weakness, and loss of joint motion – think of it as setting up a safe recovery zone.

Subacute Phase

Here, the aim shifts to regaining normal joint motion, strength, and control. Techniques like joint mobilizations and soft tissue techniques shine at this stage.

Advanced Phase

With the goalpost of full activity return in sight, your physiotherapist will introduce more advanced training, agility drills, and sport-specific tasks.

A variety of exercises, from pain-free active range of motion to resisted range of motion, and strength training, to balance and proprioception work, and eventually sport-specific tasks, form the backbone of rehabilitation.

Manual therapy techniques, including stretching, joint mobilizations, massage, and soft tissue techniques, may also form part of your physiotherapy arsenal, depending on your specific situation and needs.

An ankle sprain might seem like a small bump in the road, but it’s essential to address it correctly and promptly to prevent future issues like chronic instability or recurrent sprains. At Connect Physiotherapy & Exercise, we’re here to help you understand your injury and tailor a recovery plan that fits your unique needs. Our trained professionals offer an accurate diagnosis and personalized management plan to ensure your safety and optimize your recovery, returning you to your usual activities as swiftly as possible.

*Remember, while knowledge is power, self-diagnosis and treatment can be risky. While this blog provides useful information, it’s essential to see a trained professional for proper diagnosis and management. Every person is unique, and so is their recovery journey. At Connect Physiotherapy & Exercise, we’re all about personalized care. Let us help you navigate your path to recovery.


Williams, G.N., Allen, E.J. (2010). Rehabilitation of syndesmotic (high) ankle sprains. Sports Health, 2(6), 460-470
Tiemstra, J.D. (2012). Update on acute ankle sprains. American Family Physician, 85 (12), 1170-1176.
Puffer, J. C. (2001). The sprained ankle. Clinical Cornerstone, 3(5), 38-49.

Ruben San Martin Headshot
Ruben San Martin

Ruben, MScPT, CSCS, NCCP Level 1 Olympic Weightlifting, is a physiotherapist uniquely blending research expertise in applied anatomy with a certified strength and conditioning coach background. Specialized in manual therapy, back disorders, exercise, and osteoarthritis, he is also a certified Olympic weightlifting coach. Prioritizing exercise therapy and hands-on manual techniques, Ruben emphasizes client education for active engagement and informed recovery. His writing aims to help clients return to an active lifestyle, optimize performance, and prevent injuries.