The ankle is mainly fixated by four ligaments. The lateral ligaments are anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL). As inverted ankle sprain accounts for 80% of ankle sprain, these ligaments are commonly injured. The medial ligament is the deltoid ligament. According to the severity of the injury, it can be divided into the following 3 grades:

1. Minor sprain or tear of the ligament, no joint instability

2. One or more of the ligaments are partially torn, and the joints are slightly unstable.

3. Completely torn. There may be fracture, and the joints are unstable

 Self File | 咬柴ankle sprain1



It is usually injured when landing or by a quick turn. If the ankle joint is too loose (congenital instability or previously injured), it is more likely to be sprained. It is generally believed that an ankle sprain is fully recovered if the pain disappears, so the swelling control and the stability training of the ankle joint will be overlooked. In fact, when the ligaments are not fully recovered, the proprioception (the sense of joints) will be diminished, and they will often produce an inappropriate response and are easy to be re-injured again.

Self File | Sprain Ankle 足踝扭傷 Ankle Pain Causes, Physiotherapy Treatment



Risk Factors
  • Insufficient rehabilitation after previous sprain

  • Ankle weakness

  • Lack of recovery after training.

  • The training field is uneven or has many obstacles.

  • Old sports shoes or high heel



Common Symptoms
  • Redness, swelling, warmth and pain in the affected area
  • Difficulty in walking; the pain becomes noticeable when turning; in severe cases, severe pain will elicit even one only put weight on his ankle during standing
  • Joint instability when seriously injured




When injured, one should stop moving the affected area immediately. If it is a grade 1 or 2 tear, one should use sports tapes to support and control the swelling as soon as possible and apply ice for around 20 minutes to reduce pain and swelling. When resting, elevate the feet helps alleviate the swelling. Manual therapy and electrophysical therapy can promote the healing of soft tissues.


If you suspect a severe sprain with bone injury and unable to stand even resting for a while, you should consult your ortho-surgeon or physiotherapist immediately.


Generally, you can walk quite normally with some pain if you suffer from a mild sprain.


If you need to resume sports or training, you should use non-elastic tapes to restrict the over-ranged ankle movements. At the same time, it is necessary to strengthen the ankle muscles, especially the lateral tibial muscles.


When there is no pain in the affected area, more proprioceptive (balance) training should be performed on uneven surfaces to help improve the stability of the joints. In the later period of rehabilitation, joint flexibility and agility can be implemented, such as rapid steering, jumping sideways, running back and forth and figure-of-eight training to ensure that the joint's sensing ability is fully recovered.

Self File | 咬柴ankle sprain2


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Self File | 咬柴ankle sprain6



Preventive Measures

Do not neglect the training of joint stability and flexibility, especially in the rehabilitation training after the first injury. It can effectively prevent re-injury. Besides, after complete recovery, excessive reliance on protective taping should be avoided, although preventive sports taping is still necessary for high-risk sports (such as dancing, gymnastics, orienteering, rugby etc.).






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