Lateral Ankle Sprains: Understanding, Managing and Rehabilitating – Part 1

A sports therapist is assessing a lateral ankle sprain at seventy9 Sports Therapy, a sports injury clinic in Guildford, a sports therapy clinic in Guildford, sports therapy in Guildford, sports massage in Guildford, sports therapy clinic in Guildford, sports massage clinic in Guildford

Lateral ankle sprains are a common injury seen at seventy9 Sports Therapy, a leading sports therapy clinic in Guildford, where we provide comprehensive care for such injuries. They affect athletes and individuals of all activity levels, therefore this three-part blog series will delve deep into the world of lateral ankle sprains. Part 1 will focus on how these injuries occur, highlighting both their mechanism and causes.

Part 1: How Lateral Ankle Sprains Occur

Lateral ankle sprains are sometimes referred to as “rolled” or “twisted” ankles. They happen when the foot is turned inwards (inversion) abruptly under load, causing damage to the ligament structures on the outside (lateral) of the ankle. They don’t just happen in the athletic population however! At our sports therapy clinic in Guildford, we also see this injury occur during daily tasks, such as walking down a kerb or tripping on uneven ground. Here’s a closer look at the mechanisms and common causes:


Lateral ankle sprains occur during forced and loaded inversion, i.e. when the foot is suddenly turned inwards without control under load. This sudden twisting motion places excessive stress on the lateral ligaments causing damage and therefore a sprain. This is typically combined with the ankle being in a certain amount of flexion or extension, causing injury to one or more of the three lateral ligament structures. The typical mechanism of injury is a combined plantarflexion (toes pointed) and inversion, causing stress and injury to the anterior talofibular ligament (ATFL). 

Common Causes:

Sports and Physical Activity: Lateral ankle sprains often occur during sport and exercise that involve cutting, pivoting or rapid changes in direction, such as basketball, tennis and football. Adding in other players – and therefore an increased chance of contact/collision – can further increase the incidence of lateral ankle sprains. Playing sports on uneven surfaces can also injury incidence.

Uneven Terrain: Walking or running on uneven terrain – such as trail running or walking in the mountains – can increase injury incidence due to the inconsistency and changing nature of the ground under your feet. The risk of injury also increases under fatigue.

Improper Footwear: Inadequate footwear can sometimes lead to increased injury risk, however this is usually part of a number of reasons for injury, such as also running over uneven terrain.

Instability and/or System Weakness: Individuals with a history of lateral ankle sprains – especially those that have been poorly rehabilitated – are at an increased risk of re-injury. Similarly, as balance is a skill, practicing this is significantly beneficial in patients who are intending on being in scenarios where the need to mitigate the risk of injury is high (e.g. a trail marathon, or hiking in the mountains).

Exercise Under Fatigue: Fatigue can lead to a decrease in proprioception (awareness of limb position) – especially so in patients whose balance skill level is low – making them more vulnerable to a lateral ankle sprain. Additionally, significant fatigue like we see in athletes competing in ultra endurance events can decrease lucidity, further increasing the injury risk. 

Environmental Factors: Weather conditions like rain or ice can make surfaces slippery, increasing the risk of injury.

Understanding how lateral ankle sprains occur is the first step in mitigating for them. At seventy9 Sports Therapy, a leading sports therapy clinic in Guildford, we have significant expertise in exercise programming that aims to improve your strength and skill level to help mitigate for this injury risk. Importantly, this does not need to be put in place after you have been injured! If you have had ankle sprains in the past, or are concerned about your ankle health prior to an event or experience that you are entering into, or if you have just had a lateral ankle sprain, our sports therapy clinic in Guildford can help! Why not contact us today or book an appointment using our online booking system?

In part 2 of this series looking at lateral ankle sprains, we will explore the initial management of a lateral ankle sprain, including first aid and when to seek professional help.

Keep an eye out for part 2!