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What Is a Lateral Ankle Sprain?

A lateral ankle sprain occurs when the foot rolls inward (inversion), overstretching the outer ankle ligaments.

The most commonly injured ligaments are:

• Anterior talofibular ligament (ATFL)

• Calcaneofibular ligament (CFL)

• Posterior talofibular ligament (less common)

Injuries are graded based on severity:

• Grade I – mild ligament stretch

• Grade II – partial ligament tear

• Grade III – complete ligament rupture

Most ankle sprains respond well to structured rehabilitation.

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Symptoms of a Lateral Ankle Sprain

You may have a lateral ankle sprain if you experience:

• Sudden rolling of the ankle

• Immediate pain on the outside of the ankle

• Swelling

• Bruising

• Difficulty weight-bearing

• Feeling of instability

If you cannot bear weight or pain is severe, medical imaging may be required.

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Do I Need an X-Ray?

X-rays are guided by the Ottawa Ankle Rules.

Imaging may be required if:

• There is bone tenderness at specific locations

• You cannot take four steps after injury

• Pain is severe

Most ankle sprains do not involve fractures.

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Modern Treatment for Ankle Sprains

Current clinical practice guidelines strongly recommend:

• Early protected movement

• Progressive weight-bearing

• Structured rehabilitation

Prolonged rest or unnecessary immobilisation is not recommended for most cases.

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Phase 1 – Acute Management (First 3–7 Days)

We use a PEACE & LOVE approach:

• Protect (short-term bracing if required)

• Elevate

• Avoid anti-inflammatories early if possible

• Compression

• Education

Early gentle movement is encouraged.

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Phase 2 – Restore Movement & Strength

Key focus areas include:

• Regaining ankle range of motion

• Calf strengthening

• Peroneal muscle strengthening

• Balance retraining

• Progressive weight-bearing

Early rehabilitation reduces recurrence risk.

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Phase 3 – Return to Sport Rehabilitation

Ankle sprains have a high recurrence rate if not properly rehabilitated.

Return-to-sport criteria may include:

• Single-leg hop symmetry

• Calf strength symmetry

• Dynamic balance testing

• Sport-specific drills

• Cutting and landing control

Return is criteria-based — not simply time-based.

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Why Ankle Sprains Become Chronic

Up to 30–40% of ankle sprains develop into chronic ankle instability.

Risk factors include:

• Inadequate rehabilitation

• Early return without strength restoration

• Poor balance retraining

• Persistent swelling

• Repeated sprains

Proper rehab significantly reduces recurrence.

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Should I Wear an Ankle Brace?

Bracing may be helpful:

• In early stages

• During return to sport

• For high-risk sports

However, strengthening and neuromuscular retraining are more important long-term.

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How Long Does an Ankle Sprain Take to Heal?

Typical timelines:

• Grade I: 2–4 weeks

• Grade II: 4–6 weeks

• Grade III: 8–12+ weeks

Timelines vary depending on severity and adherence to rehab.

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Ankle Sprains in Runners & Field Athletes

For runners and field athletes, rehab includes:

• Running reintroduction progression

• Plyometric retraining

• Cutting and deceleration drills

• Trail-specific stability training

At Omnia Physio, we integrate performance-specific progression.

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Frequently Asked Questions

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Should I completely rest my ankle?

No. Early controlled movement improves outcomes.

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Is swelling bad?

Swelling is normal early but should progressively reduce.

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Can I keep training?

Modified training is often possible.

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Are ankle sprains serious?

Most recover well, but inadequate rehab increases recurrence risk.

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Book Ankle Sprain Physiotherapy

If you’ve rolled your ankle or are struggling with ongoing instability:

Omnia Physio – Potts Point, Sydney
Specialising in sports and performance rehabilitation.

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