Ankle Sprains/Instability

An ankle sprain is a common injury in people of all ages and occurs when the strong ligaments that support the ankle stretch beyond their limits and tear. Most sprained ankles occur in the lateral ligaments on the outside of the ankle, ranging from tiny tears to complete tears through the tissue. 


Ankle sprains can be categorised into different grades: 

  • Grade 1 – slight stretching and small tears in the ligament fibres accompanied by mild tenderness and swelling around the ankle
  • Grade 2 – partial tearing of the ligament accompanied by moderate tenderness and swelling around the ankle, and there may be an abnormal looseness of the ankle joint
  • Grade 3 – a complete tear of the ligament accompanied by significant tenderness and swelling around the ankle with substantial instability

Apart from experiencing pain, other common symptoms of an ankle sprain include:

  • Swelling
  • Bruising
  • Tenderness to touch
  • Instability of the ankle



Some common causes of an ankle sprain include:

  • Walking or exercising on an uneven surface
  • Falling down
  • Participating in sports that require jumping, cutting actions or rolling and twisting of the foot, such as basketball, tennis, football, and soccer



Your orthopaedic specialist will start off with a physical examination to check your ankle for areas of swelling and tenderness, and determine the range of motion. He or she will also do specialised stress tests to determine which ligaments are injured.


You may be required to undergo an X-ray to rule out bony injuries, and an MRI scan to check for ligamentous or cartilage injuries.


Most simple ankle sprains can be treated without surgery and treatments are usually separated into three phases:

  • Phase 1 – RICE therapy. This involves resting, icing, protecting the ankle (with an ankle guard or brace), and elevation to reduce the swelling. Anti-inflammatory and pain medications will be prescribed.
  • Phase 2 – restoring range of motion, strength and flexibility through physical therapy
  • Phase 3 – doing maintenance exercises and gradually returning to activities that do not require excessive turning or twisting of the ankle


For severe ankle sprains with multiple ligaments injuries, gross or recurrent ankle instability, or for high functioning athletes who need early return to sport, surgical repair may be offered. This can be done through arthroscopic (keyhole) surgery. Severe ankle instability may require open ligament reconstruction using a tissue graft.


Every case is different; hence it is best to consult an orthopaedic specialist for an accurate diagnosis so that you can obtain the best treatment option that is most suitable for you. Reach out to us today if you are suffering from an ankle sprain and let us help you enjoy a better quality of life.