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LOW ANKLE SPRAIN                                                    KANDILNOTES


  • A low ankle sprain is an injury to two major ligaments responsible for ankle stability

  • The two ligaments are the calcaneofibular ligament (CFL) and anterior talofibular ligament (ATFL)

  • A sprain is a partial tear of the ligaments and the severity of the tear determines the grade

  • Grade 1: Mild stretching of the ligaments

  • Grade 2: Moderate tearing of the ligaments

  • Grade 3: Full thickness complete tearing of the ligaments

  • Low ankle sprains are completely different entities from high ankle sprains and a correct diagnosis is essential for optimal treatment results

  • 90% of ankle sprains are low ankle sprains


  • A low ankle sprain usually occurs when one mis-steps or twists their ankle

  • It is usually an inversion injury where the foot rolls inward


  • Pain and swelling in the outer part of the ankle 

  • If grade 3, there is often gross instability of the ankle joint


  • The first line of treatment always involves a period of rest, ice, compression, and elevation (RICE) protocol. This is often followed by a home exercise program focused on early functional rehabilitation with exercises focusing first on stretching and range of motion, followed by strengthening, then proprioception. Finally, activity-specific drills are added to facilitate a return to activities and sport

  • Anti-inflammatories such as ibuprofen are oftentimes helpful as an adjunct to other treatments

  • Lace-up ankle brace

  • Surgery is reserved for cases that don’t improve after a course of conservative management if symptoms are significantly affecting activities of daily living and quality of life. Surgery is usually arthroscopic-assisted with a mini-open portion to repair the tendons back to the bone.


  • The best way to prevent this condition is to strengthen the dynamic stabilizers of the ankle joint such as the peroneal muscles

  • Lace-up functional ankle brace can help decrease the incidence of low ankle sprains

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