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Lateral Ankle Sprains and Instability

Lateral Ankle Sprains and Instability

Written by Alex Phan, Osteopath | 16th October 2023

Lets talk about lateral ankle sprains and instability.

The ankle complex is composed of the talocrural joint, subtalar joint and tibiofibular syndesmosis joint.

The main contributors to stability come from the: articular surfaces, ligamentous complex, and musculature, which all allow for dynamic stability of the ankle joint. The lateral ankle is supported by the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL) and the posterior talofibular ligament (PTFL).

Lateral instability can result from either:

  • Functional instability – feeling of ankle instability or recurrent, symptomatic ankle sprains due to proprioceptive deficits.
  • Mechanical instability – acute injury or chronic repetitive stress which leads to alterations of the mechanical structures in the ligaments.

Lateral ankle sprains are commonly caused by rolling of the ankle or when the foot is planted and rolled over an inverted ankle (when the sole of your foot is faced inwards). This commonly injures the ATFL, followed by the CFL and then the PTFL.

Lateral ankle sprains can also be caused by hereditary ligamentous laxity associated with conditions such as: Ehlers-Danos syndrome, Marfans syndrome and Turners syndrome.

Lateral ankle sprains are one of the most common injuries during sporting events such as athletics, basketball and soccer. Patients usually present with a history of recurrent or recent ankle sprains, episodes of the ankle giving way or feeling of looseness, cautiousness or mindfulness with activities that may have potential for injuries.

Treatment and Management

Patients who sustain a lateral ankle sprain or recurrent sprains will usually manage their condition with conservative functional rehabilitation which consists of; rest, ice, elevation, compression, progressive weight-bearing and physical therapy. Surgery is also another option which involves reconstruction of the tendons surrounding the ankle complex to provide stronger stability. It’s important to note that even with proper functional rehabilitation, patients will develop chronic ankle stability following acute ankle sprains.

Here are some exercises to help with rehabilitation of the ankle following an acute ankle sprain or if you have chronic ankle instability:

1. Ankle alphabets

Draw the alphabet with your foot but making sure the movements are controlled. Perform 2 sets, once a day.




2. Calf raise

From a flat ground, stand with your feet close together, raise your heels off the ground by planting your toes down and bearing all your weight on your toes. Lower your heels back down to the ground. Perform 3 sets of 12, three times a week.


3. Static balance

Stand on one leg with your arms crossed across your chest. Perform 3 sets of 60 second holds, three times a week.



If you are finding that these exercises are not providing enough support or need some assistance with performing them, come down and see one of our many osteopaths at Canterbury Health Hub where we can perform a thorough assessment on your requirements and assist you in making a management plan.