30 Seconds Of Therapy: Lateral Ankle Sprains: Prevention and Interventions

Jul 8, 2025

5 min read

A lateral ankle sprain is a common musculoskeletal injury where the ligaments on the outer side of the ankle are stretched or torn due to excessive inward rolling of the foot (inversion). This injury often occurs during activities involving sudden changes in direction or landing awkwardly. Clinically, it presents with pain, swelling, and bruising on the outer ankle, difficulty bearing weight, and possibly limited range of motion. — A ***lateral ankle sprain*** is a common musculoskeletal injury where the ligaments on the outer side of the ankle are stretched or torn due to excessive inward rolling of the foot (inversion). This injury often occurs during activities involving sudden changes in direction or landing awkwardly. Clinically, it presents with pain, swelling, and bruising on the outer ankle, difficulty bearing weight, and possibly limited range of motion.

START:

Apply a prevention model to all LAS cases
1. Primary prevention – Target everyone, regardless of risk; modify rules of the game, playing surfaces, and issue standard protective equipment.
2. Secondary prevention – Target people at risk (e.g., athletes in cutting sports); implement dynamic warm-ups and neuromuscular exercise programs.
3. Tertiary prevention – Target patients with a history of LAS; use bracing and exercise to prevent recurrence and reduce disability.
Combine Manual Therapy with exercise for optimal outcomes.
1. Acute phase: Use lymphatic drainage, anterior-to-posterior talar mobilization (Promote Dorsiflexion), and soft tissue mobilization within pain-free range.
2. Subacute and chronic phases: Apply mobilization with movement,and strain-counterstrain.
Match exercise to the phase of recovery.
1. Acute phase: Encourage early weight-bearing with support, ideally using a semi-rigid brace (like a lace-up or stirrup brace) to stabilize the ankle while allowing movement. Taping can be used but is less reliable and more costly over time. Avoid full immobilization unless absolutely necessary, and limit it to no more than 10 days.
2. Subacute: Begin balance retraining, ankle/lower quarter strengthening, and neuromuscular training.
3. Chronic: Include agility drills like double-limb hop, shuffle step, Carioca, and high-knee skip.

STOP

Using external support as a stand-alone treatment in Chronic Ankle Instability.
1. Combine bracing with proprioceptive and balance-focused therapeutic exercise to minimize reinjury.
Depending on passive modalities for long-term recovery.
1. Only using cryotherapy (C grade), diathermy (C), low-level laser (C), and ultrasound (A – should not be used) for symptom reduction in the acute phase doesn't offer long term functional improvement.
Delaying rehabilitation and weight-bearing.
1. Start weight-bearing with support as early as tolerated.
2. Immobilization, if needed, should be used no longer than 10 days.
3. Delayed loading can result in slower ROM recovery and persistent instability.

WHY

Why prevention-first care is essential.
1. Treating an ankle sprain shouldn’t mean waiting for the next one. A prevention-focused approach keeps you ahead of the injury curve—reducing recurrence, preserving function, and helping your patients stay strong, stable, and off your schedule for the same issue twice.
Why manual therapy + exercise + external support is the gold standard.
1. Manual therapy can effectively increase ankle dorsiflexion through Gastroc and Soleus Stretching, as well as AP TaloCrual mobilization, thus addressing the potential source of ankle sprain. When combined with therapeutic exercise muscle fibers contract faster, react faster to uneven surfaces and optimize blood flow for muscular and tendon healing, pain reduction, and swelling reduction. Lastly when external support in the form of bracing, taping, proper shoe wear is implemented, skin receptors give additional stimuli and increase reaction time thus limiting additional injury and reducing strain.

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