Ankle Sprains
Ankle sprains are among the most common injuries we see at Emerald Hill Podiatry, affecting everyone from weekend athletes to office workers who miss a step off a curb. Most sprains heal well with the right care, but an untreated or poorly rehabilitated sprain is one of the most common causes of chronic ankle instability.
At Emerald Hill Podiatry, we assess the grade of injury, rule out fracture, and build a recovery plan that gets you back on your feet without leaving the ankle weak or prone to rolling again.
What Is an Ankle Sprain?
An ankle sprain is a stretch or tear of the ligaments that hold the ankle joint together, most often on the outer (lateral) side. The ligaments most commonly affected are the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL), which stabilise the ankle when it rolls inward. Less commonly, the ligaments on the inner side of the ankle (medial sprains) or the ligaments connecting the shin bones above the ankle (high ankle sprains) are involved, and these tend to take longer to heal.
How the Ankle Rolls and Tears
A sprain happens when the foot twists or rolls beyond the ankle’s normal range of motion, forcing the ligaments to stretch further than they’re built for. This can happen in an instant:
- Landing awkwardly from a jump, with the foot rolling outward or inward on impact
- Stepping on an uneven surface, a curb edge, or another player's foot
- A sudden change of direction while the foot is planted
- Simply misjudging a step on stairs or uneven ground
The faster and more forcefully the ankle rolls, the more ligament fibres are affected, ranging from a mild overstretch to a complete tear.
Grades of an Ankle Sprain
Ankle sprains are graded by the extent of ligament damage:
- Grade 1: mild stretching of the ligament with microscopic tearing. Minimal swelling and the ankle remains stable.
- Grade 2: partial tearing of the ligament. Moderate pain, swelling, and bruising, with some looseness in the joint.
- Grade 3: complete rupture of the ligament. Significant swelling, bruising, and instability, often with an inability to bear weight.
Symptoms by Severity
Grade
Pain
Swelling & Bruising
Weight-Bearing
Stability
Grade 1
Mild, at the outer or inner ankle
Slight
Usually possible with discomfort
Stable
Grade 2
Moderate to significant
Noticeable swelling, bruising may develop
Difficult, often with a limp
Some looseness
Grade 3
Severe at the time of injury
Marked swelling and bruising
Very difficult or impossible
Joint feels unstable or gives way
Symptoms by Severity
- Grade
- Grade 1
- Pain
- Mild, at the outer or inner ankle
- Swelling & Bruising
- Slight
- Weight-Bearing
- Usually possible with discomfort
- Stability
- Stable
- Grade
- Grade 2
- Pain
- Moderate to significant
- Swelling & Bruising
- Noticeable swelling, bruising may develop
- Weight-Bearing
- Difficult, often with a limp
- Stability
- Some looseness
- Grade
- Grade 3
- Pain
- Severe at the time of injury
- Swelling & Bruising
- Marked swelling and bruising
- Weight-Bearing
- Very difficult or impossible
- Stability
- Joint feels unstable or gives way
Ankle Sprain vs Fracture
Because the symptoms overlap, you can’t always tell a severe sprain apart from a fracture without imaging. Signs that point towards a possible fracture rather than a sprain include:
- Pain directly over the bone rather than around the ligaments
- Inability to take more than a few steps immediately after the injury
- Visible deformity of the ankle
- Swelling and bruising that appear unusually quickly and severely
If any of these are present, an X-ray is needed to rule out a break before treatment can proceed.
When to See a Podiatrist
Most mild sprains can be managed initially with rest, ice, compression, and elevation. See a podiatrist if:
Pain or swelling hasn't improved within a few days
You're unable to bear weight comfortably
The ankle feels unstable or has "given way" more than once
You've sprained the same ankle before
You suspect a fracture based on the signs above
Left untreated, ligament laxity from a sprain can lead to recurring sprains and long-term instability, so an accurate diagnosis early on makes a real difference to recovery.
Get Your Foot Pain Properly Assessed
Consult a Podiatrist
Treatment is tailored to the grade of the sprain, with the aim of restoring full strength and stability so the ankle doesn’t remain prone to rolling.
Options include:
- Biomechanical Gait Assessment — identifies how you walk, run, and load the foot, and whether an underlying gait pattern contributed to the sprain
- Custom Orthotics — provide additional support and correct alignment issues that place uneven strain on the ankle ligaments
- Shockwave Therapy (ESWT) — supports healing in persistent ligament pain or slow-recovering soft tissue injury
- Strengthening and Rehab Program — a structured program to rebuild ankle strength, balance, and proprioception, reducing the risk of re-injury
- Surgical Referral — for grade 3 tears or chronic instability that doesn't respond to conservative treatment, we refer to an orthopaedic specialist and coordinate post-surgical rehabilitation
What to Expect at Your Assessment
Your podiatrist checks the ankle’s range of motion, tests ligament stability, and looks for tenderness over specific bony landmarks to help rule out fracture. Depending on the findings, we may arrange an X-ray or further imaging before confirming your treatment plan.
