Inversion Ankle Sprain

An inversion ankle sprain occurs when the athlete rolls onto the outside of the foot, stretching the stabilizing ligaments beyond their normal limits. This is the most common type of ankle sprain, and is one of the most common orthopedic injuries among athletes.  While ankle sprains are painful, and the swelling and bruising may look scary, it is very rare for there to be an associated fracture and most of the time an x-ray is not necessary.

An inversion ankle sprain typically occurs when cutting or when landing on an uneven surface (opponent’s foot, uneven field, etc.), but it can also occur with activities of daily living (walking, trip over rug/toy, etc.).

Uneven terrain

– Poor neuromuscular control of the ankle

– Poor ankle mobility

– Lower body weakness

– Poor footwear

Pain on the outside of the ankle with movement

– Loss of range of motion

– Stiffness in the ankle joint

– Swelling/bruising

– Difficulty walking

At Home Diagnostic Tests

– Ottawa Ankle Rules (see video).

If you test positive for any of the signs listed below, radiography may be recommended.

  1. Inability to weight bear (<4 steps) both immediately after injury and in Urgent Care facility.
  2. Bony tenderness on posterior 6cm of Lateral Malleolus.
  3. Bony tenderness on posterior 6cm of Medial Malleolus.
  4. Tenderness at base of 5th Metatarsal.
  5. Pain at Navicular Bone.


At Home Care

– Compression

– Elevation

– Ankle circles, ABCs

– Comfort care — ice, NSAIDs. 


When to Seek Help

Contact your physical therapist immediately after an ankle sprain.  A few simple tests in the clinic can determine if an x-ray is necessary – most of the time it isn’t!  They can also provide immediate treatment (most effective within 24-48 hrs of injury) to get you back in the game weeks ahead of typical treatment protocols.


Inspired Athletx Treatment

We do ankle sprains (without associated fracture) differently at Inspired Athletx.  No crutches.  No boot.  Just high quality manual therapy and active rehab that gets you back in the game before most protocols will have you out of a boot.  Why do we avoid long term immobilization?  The negative effects of immobilization (stiffness, weakness, decreased balance and neuromuscular control) for mild-moderate sprains far outweigh any benefits.  We liken it to putting an ACL repair patient in a cast for 4 weeks (like they used to back in the 80s and 90s) – in 20 years, our style of treatment will be the norm.  Until the rest of the orthopedic world catches up, we’ll keep getting you back to activity in half the time!