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Ankle sprains are of the most common biomechanical injuries that we can sustain in our sporting lives. An ankle sprain occurs when the ligaments that uphold the structural integrity of the ankle joint are stretched beyond their normal barrier causing the fibres to undergo microscopic tears.


There are two main groups of ligamentous structures that hold the ankle joint together. These are the medial and lateral ligament complexes (inside and outside of the foot respectively). In the majority of sporting scenarios that result in an ankle injury, the ankle will roll outwards, resulting in an ‘eversion sprain’ and damaging the lateral complex. This occurs more commonly than an ‘inversion sprain’ (rolling inwards) due to the strength of the medial complex.

Within the lateral complex is the anterior talofibular ligament (ATFL), which is found to be the weakest and most commonly injured ligament.

Signs and Symptoms

Following an injury to the ATFL ligament, we can expect:

  •  Pain to occur immediately at the time of injury depending on the severity of the damage. This pain can present in local tenderness in the area or more vast throughout the entire foot. Our body creates pain as a way of restricting our movement in order to maximise healing potential.
  •  Swelling of the ankle joint over the site of injury as the body begins the inflammatory healing process.
  •  Inability to weight-bare threw the joint whilst standing, walking, running or jumping, depending on the severity of the sprain. 
Osteopathic Treatment 
Following the occurrence of an ankle sprain, best practice suggests resting the ankle for the first 48-72 hours and applying the PRICE protocol (protection, rest, ice, compression and elevation). 
From this point, an Osteopath will begin by assessing the severity of the injury through a thorough examination of the ankle and all anatomical structures which may have been affected in the injury. 
If indicated, the Osteopath may refer the patient for imaging to rule out potential fractures amongst other more sinister injuries.

Treatment of the ankle will include techniques including soft tissue, myofascial release, joint articulation and manipulation with an aim to restore the ankle to it’s normal function. Lymphatic drainage techniques may also be used to reduce the swelling within the ankle.

Following treatment, your Melbourne osteopathy will prescribe management exercises for the patient to perform in their own time to progress their rehabilitation.


Author: Dr. Kristian Ciciulla (Osteopath)

City Osteopathy



Eisenhart, A. W. (2003) Osteopathic Manipulative Treatment in the Emergency Department for Patients with Acute Ankle Injuries. The Journal of the Osteopathic Association.

McGovern, R. P., & Martin, R. L. (2016). Managing ankle ligament sprains and tears: current opinion. Open access journal of sports medicine, 7, 33–42. doi:10.2147/OAJSM.S72334

Melanson, S. W., Shuman V. L. (2019) Acute Ankle Sprain. Treasure Island (FL): StatPearls Publishing. Available from:

Polzer, H., Kanz, K. G., Prall, W. C., Haasters, F., Ockert, B., Mutschler, W., & Grote, S. (2012). Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm. Orthopedic reviews, 4(1), e5. doi:10.4081/or.2012.e5