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Ankle Sprains and Instability

The bones of the ankle joint are held together by strong ligaments which, along with muscles that are attached to the bones of the foot, help to keep the joints stable.

One of the most common soft-tissue injuries, an ankle sprain, is when the ligaments of the ankle are suddenly twisted or stretched beyond their limit, resulting in a partial or complete tear. Most sprains affect the lateral ankle ligament. If it’s not treated correctly, an ankle sprain can lead to long term ankle instability.

What causes an ankle sprain?

Lateral ankle sprains usually happen during an ‘inversion injury’ where the sole of the foot is suddenly forced inwards. Without correct treatment a serious sprain that causes a complete tear can cause long term weakness and instability, making the ankle more likely to ‘give way’ and be injured again. If the sprain is serious, small fragments of bone can also break off where the ligament is attached.

Sprains can happen as a result of exercising on uneven ground, falling, or twisting the foot during sport.

What are the signs of an ankle sprain?

Signs include:

  • Pain, swelling and bruising although you may still be able to put some weight on your foot
  • A sensation of the ankle ‘catching’ or locking
  • Ankle instability, where the ankle ‘gives way’ regularly

A sprain may also lead to ankle instability, dislocation or osteochondral injury (injury to the smooth surface on the end of the bones).

How is ankle sprain diagnosed?

If you have a sprain, you may be given an X-ray to rule out a fracture. At your consultation Mr Heidari may arrange for an MRI scan to check for injury to the ligaments, peroneal tendon problems, or fragments of loose bone.

How is ankle sprain treated?

Most people with ankle sprain don’t need to have surgery. However, you may be advised to rest the ankle, raise it above the level of your heart as much as possible, and regularly apply an ice pack to reduce swelling during the first few days.

Depending on how serious your sprain is, it can also be helpful to apply compression dressings or a removable boot to immobilise and support the joint. You may also be advised to take anti-inflammatory painkillers and begin a gentle exercise programme to prevent stiffness (working with one of our physiotherapists), helping to strengthen the joint so that you can return to your normal activities as quickly as possible.


If your ankle doesn’t regain stability after a few months, or it is still very painful, Mr Heidari may carry out arthroscopy (keyhole surgery) to examine the joint in more detail and repair any damage; or carry out ankle ligament reconstruction surgery (lateral ankle sprain surgery) to repair the torn ligament. Surgery is followed by a personalised rehabilitation programme, working with one of our physiotherapists to restore strength, range of movement and balance.

This information is written as a guide to your treatment but it is not intended to replace the advice of your doctor. Please contact us for advice if you are worried about any aspect of your health or recovery.