Inversion Ankle Sprain

Category: Education

What is an Inversion Ankle Sprain?

An inversion ankle sprain, a lateral collateral ligament sprain, or anterior talofibular ligament (ATFL) sprain, can cause pain on the outside of the ankle, and negatively affect stability or balance when walking. The lateral collateral ligament of the foot is made of tough bands of tissue that attach the outside edge of your foot to your fibula, holding it in place. Usually, these injuries are classified by severity, from grade I being the least severe to grade III being the complete rupture of a ligament.

Why does it happen?

These sprains are caused by a movement which forces the ankle to bend down and inwards. Ankle injuries are very common in athletic populations, as athletes often are rapidly changing directions and might ‘roll’ their ankles. However, it is important to know that the majority of ankle sprains (about 60%) occur in non-athletes! Some risk factors for ankle sprains include:

  • Poor control of ankle muscles
  • Reduced ankle muscle strength and joint flexibility
  • Previous ankle sprain

The aim of treatment will be to resolve pain and inflammation, restore strength and coordination to the muscles, and improve proprioception and balance. Since a history of ankle sprains is a good predictor of future sprains, a comprehensive rehab plan will include exercises to prevent recurrence of this injury.

The role of Physiotherapy

It is important to remember that pain and injuries often have manyuntitled-design-13 contributing factors. Your Physiotherapist will perform a thorough assessment and work with you to find the most effective treatment strategy. Some approaches for treating inversion ankle sprains are:

  • Education for self-management and prevention
  • Stretching, strengthening, and balance exercises
  • Manual therapies such as joint mobilization
  • Short-term supportive aids such as tape or ankle braces
  • Modalities such as ultrasound or low light laser therapy

Often a combination of techniques will be performed to treat the underlying cause(s) and to reduce your pain. Ankle sprains can affect stability and balance when walking, which will also be important in your treatment plan. Returning to previous activity levels will be goal-directed based on the severity of the injury.


Martin, R. L., Davenport, T. E., Fraser, J. J., Sawdon-Bea, J., Carcia, C. R., Carroll, L. A., Kivlan, B. R., & Carreira, D. (2021). Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. Journal of Orthopaedic & Sports Physical Therapy, 51(4), CPG1–CPG80.