Ankle sprains occur frequently and affect different parts of the ankle joint. Understanding whether you have a medial or lateral ankle sprain can help you better manage your recovery and know what to expect during treatment.
What is Ankle Sprain?
An ankle sprain happens when the strong bands of tissue (ligaments) that support the ankle are stretched or torn, usually due to twisting or rolling the ankle.
Types of Ankle Sprain
The ankle has ligaments on both the inner and outer sides. The type of sprain depends on which ligaments are affected:
Lateral Ankle Sprain: The most common type, involving the ligaments on the outer side of the ankle. These ligaments connect the smaller leg bone (fibula) to the foot and are more prone to injury.
Medial Ankle Sprain: Less common, this affects the ligaments on the inner side of the ankle, known as the deltoid ligament complex. These ligaments are thicker and stronger, making this type of sprain less frequent.
Medial Vs Lateral Ankle Sprains
Causes and Injury Mechanisms
The way each type of sprain occurs depends on how the foot and ankle move at the time of injury.
Lateral ankle sprains (outer ankle): occurs when the foot rolls inward, known as an inversion injury. This is the most common type of ankle sprain and often occurs during walking or running on uneven ground or while participating in sports that involve jumping, sudden direction changes, or missteps.
Medial ankle sprains (inner ankle): occurs when the foot rolls outward, referred to as an eversion injury. This type of sprain typically results from incidents that apply much greater force to the ankle, such as high-impact accidents, contact sports, or falls that force the ankle outward.
Symptoms and Presentation
Both types of sprains cause pain, swelling, and difficulty walking, but their location and severity differ.
Pain Location: Lateral ankle sprains typically cause pain on the outer side of the ankle. In contrast, medial ankle sprains result in pain along the inner side of the ankle, often near the arch of the foot.
Swelling: With a lateral sprain, swelling commonly develops around the outer ankle bone. For medial sprains, swelling tends to appear along the inner side of the ankle and may extend towards the arch.
Bruising: Bruising from a lateral sprain usually appears on the outer side of the foot. In medial sprains, bruising can extend along the inner ankle and may even spread upwards along the lower leg.
Weight-bearing Ability: Both types of sprains can make it difficult to put weight on the affected foot. However, medial sprains often cause more immediate and noticeable difficulty walking due to the involvement of stronger, deeper ligaments.
Treatment Approaches for Ankle Sprains in Singapore
Treatment for ankle sprains is guided by the type and severity of the injury, and should be assessed by a qualified foot and ankle specialist.
Non-Surgical Treatment
Most mild to moderate lateral and medial sprains can be effectively managed without surgery.
Initial Management (R.I.C.E. Protocol)
- Rest: Avoid activities that strain the ankle
- Ice: Apply cold packs to reduce swelling
- Compression: Use bandages or ankle braces for support
- Elevation: Keep the ankle raised to minimise swelling
Medication: Anti-inflammatory medications may be prescribed to relieve pain and reduce swelling.
Ankle Bracing or Support: An ankle brace or supportive footwear may be recommended to stabilise the joint during recovery.
Physiotherapy: A personalised rehabilitation programme focuses on:
- Strengthening muscles around the ankle
- Improving balance and joint stability
- Gradual return to sports or daily activities
Surgical Treatment for Ankle Sprains in Singapore
Surgery may be recommended for severe sprains or when conservative treatment is unsuccessful:
Ligament Repair or Reconstruction: In cases of torn ligaments, surgical repair or reconstruction may be necessary to restore ankle stability.
Arthroscopic Debridement: Minimally invasive procedure to remove loose fragments or damaged tissue within the joint.
Tendon Transfer: In situations where primary ligaments are irreparable, nearby tendons may be repositioned to compensate for lost stability.
Recovery Considerations
Strengthening Exercises: For lateral ankle sprains, the focus is on strengthening the outer ankle muscles to improve stability and reduce the risk of future sprains.
In medial ankle sprains, exercises target the arch and inner ankle support structures to restore strength and prevent further injury.
Balance Training: Essential for both types but tailored to the affected side to prevent re-injury.
Footwear: Supportive shoes can help during recovery and reduce the risk of future sprains.
Activity Modification: Return to sports or work depends on healing progress, symptom control, and ankle stability.
When to See An Orthopaedic Surgeon
While mild ankle sprains often improve with basic care, certain signs indicate the need for prompt medical evaluation by an orthopaedic specialist in Singapore:
Inability to Bear Weight: You cannot stand or take more than a few steps on the affected ankle immediately after the injury.
Severe Pain and Swelling: Pain or swelling that does not improve with rest, ice, or basic first aid.
Numbness or Tingling: Loss of sensation or a tingling feeling in the foot or ankle area, which may indicate nerve involvement.
Possible Fracture Signs: Deformity, visible misalignment, inability to move the ankle, or severe tenderness over the ankle bones.
Conclusion
Medial and lateral ankle sprains differ in their causes, symptoms, and recovery. Recognising the type of sprain can help guide proper treatment. If you have significant pain, swelling, or difficulty walking after an ankle injury, schedule a consultation with our orthopaedic specialist for a thorough assessment and personalised care.
