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What is Ankle Sprain?
Causes
Symptoms
When to See a Doctor
Diagnosis
What to Do?
Prevention
Summary and Key Takeaways
References and Sources

What is Ankle Sprain?

A sprained ankle is one of the most common injuries that occur every single day. This type of trauma is extremely frequent among athletes, particularly at the amateur level, but also occurs in everyday life, as it is connected to risk factors that affect virtually everyone.

Despite being so common, the severity of an ankle sprain can vary considerably. Cases range from very mild injuries that can be safely managed at home to more severe conditions that require professional medical attention. Recovery times are therefore equally variable, but they generally range between 3 and 6 weeks.

In medical terminology, this condition is referred to as an ankle sprain, which is defined as a temporary loss of normal relationship between the two articular surfaces that make up the ankle joint, with possible injury to the ligaments and articular cartilage. It is a different condition from a fracture, although both can sometimes occur simultaneously and must be distinguished through proper clinical evaluation.

The prognosis for mild ankle sprains is generally very favorable, especially when the RICE protocol (Rest, Ice, Compression, Elevation) is applied promptly and correctly. Early treatment typically ensures rapid resolution of pain, swelling, and bruising. In these cases, the risk of the condition becoming chronic is very low, and sprains generally heal with complete restitutio ad integrum, meaning the tissue and function are fully restored to their pre-injury state.

On the other hand, for moderate to severe sprains, the rehabilitation pathway will inevitably be longer and more complex. These cases demand greater patience, professional monitoring, and a structured rehabilitation program to restore joint stability and function.

One crucial aspect that is often underestimated is the role of proprioception in recovery. Proprioception refers to the body’s ability to sense and recognize its own position in space without relying on vision. After an ankle sprain, this ability is often compromised because the sensory nerve endings in the ligaments and joint capsule may be damaged. Without targeted rehabilitation of proprioceptive function, the ankle remains vulnerable to future injuries.

It is now well established in the scientific literature that experiencing one ankle sprain significantly predisposes an individual to experiencing another, especially if the first sprain was associated with ligament injury. This is because there is a reduction in joint stability accompanied by an increase in ligamentous laxity. For this reason, it is strongly recommended to use a brace or support during the initial stages of returning to activities, in order to protect the joint and prevent dangerous movements that could cause re-injury.

Causes

An ankle sprain occurs when the foot is suddenly forced into a position that stretches or tears the ligaments, the strong fibrous bands that connect bones to one another and stabilize the joint. The ankle can sprain through two primary mechanisms:

Eversion: The foot rotates inward (toward the midline of the body), placing excessive stress on the ligaments on the outer side of the ankle. This mechanism is less common.
Inversion: The foot rotates outward (away from the midline of the body), placing excessive stress on the ligaments on the inner side of the ankle. This is by far the more frequent mechanism and accounts for the vast majority of ankle sprains.

An important anatomical note is that the ligaments of the ankle are extra-articular, meaning they lie outside the joint capsule. This is actually a significant advantage because extra-articular ligament injuries generally heal through the process of scar tissue formation, typically without major long-term consequences if properly treated.

Another important distinction is the type of activity associated with the injury. Sprains typically occur during low-speed activities such as walking or, at most, running. In contrast, faster movement or activities that place significant load on the foot are more likely to result in a bone fracture rather than ligament injury. This is why it is essential to rule out a fracture whenever an ankle injury occurs, especially if the force of impact was substantial.

Ankle sprains can be classified according to their severity:

Grade I (Mild): Mild stretching of the ligament with microscopic tears. Mild pain, swelling, and stiffness with no joint instability.
Grade II (Moderate): Partial tearing of the ligament. Moderate pain, swelling, and bruising with some joint instability.
Grade III (Severe): Complete rupture of the ligament. Significant pain, swelling, and bruising with marked joint instability and difficulty bearing weight.

Understanding the grade of the sprain is essential for planning appropriate treatment and setting realistic expectations for recovery.

Risk Factors

Several situations can make a person more susceptible to developing an ankle sprain. The most well-documented risk factors include:

Sports involving rapid movements or direct contact with opponents: Basketball, soccer, tennis, volleyball, and other court sports are particularly associated with high rates of ankle sprains due to the frequent changes in direction, jumping, and landing involved.
High ankle mobility and ligamentous laxity: Some individuals have naturally hypermobile joints, which while sometimes considered an advantage in certain sports, also makes the ankle more prone to spraining.
Accidents: Falls from motorcycles or bicycles, and motor vehicle accidents can all produce the rapid, unexpected foot positioning that causes ligament injury.
Use of inappropriate footwear on uneven terrain: High heels, worn-out athletic shoes, or footwear without adequate ankle support significantly increase the risk, especially when walking on cobblestones, slopes, or other irregular surfaces.
Previous ankle sprain: This is one of the strongest individual risk factors. A history of prior ankle sprain is associated with a 3.5-fold increased risk of re-injury, largely due to residual proprioceptive deficits and ligamentous laxity that may persist after inadequate rehabilitation.
Fatigue: Physical fatigue impairs neuromuscular control, reducing the body’s ability to protect the ankle joint during dynamic activities.
Environmental conditions: Wet or slippery surfaces, poor lighting, and unfamiliar terrain all increase the likelihood of an unexpected misstep.

Symptoms

Recognizing the symptoms of an ankle sprain is important for initiating appropriate treatment quickly. The classic signs and symptoms of an ankle sprain include:

Edema (swelling): Unlike localized swelling, the swelling associated with an ankle sprain is typically diffuse and extends throughout the entire ankle region. It develops rapidly in the hours following the injury and may be impressive in appearance even for relatively mild sprains.
Ankle pain: The pain can range from mild discomfort to severe, disabling pain. Importantly, the intensity of pain does not always correlate with the severity of the sprain. Some complete ligament tears may initially feel less painful than minor sprains, as the nerve fibers in the torn ligament can be completely disrupted.
Ankle stiffness: The combination of pain, swelling, and reflex muscle guarding limits range of motion in the ankle, making it difficult to move the foot freely.
Hematoma (bruising): Discoloration of the skin from blood leaking into the surrounding tissues is common and may take 24–72 hours to become visible. The bruising can sometimes be quite extensive and spread well beyond the immediate area of injury.
Sense of instability: Due to the loss of proprioceptive function in the injured joint, people often describe feeling as though the ankle is “giving way” or is unreliable. This sensation is particularly pronounced on uneven surfaces or during activities that challenge balance.

The area most commonly involved in ankle sprain injury is the anterior talofibular ligament (also known as the peroneal-astragalic ligament), which is the weakest and most frequently damaged ligament in the ankle complex. Pain tends to increase when the ankle is placed at 90 degrees, meaning the foot is brought to a horizontal position relative to the leg, or when weight is placed on the affected foot. This type of pain typically makes it difficult to walk without limping, and in more severe cases, weight-bearing may be entirely impossible.

It is worth noting that in some cases, the patient may hear or feel a “pop” at the moment of injury. While this sensation can be alarming, it does not necessarily indicate a complete ligament rupture or fracture; however, it does warrant careful evaluation.

When to See a Doctor

Many mild ankle sprains can be initially managed at home with the RICE protocol and over-the-counter anti-inflammatory medications. However, there are important situations that require prompt medical evaluation. It is advisable to consult your physician whenever:

Pain does not improve despite consistent application of the RICE protocol and the use of topical or systemic NSAIDs (non-steroidal anti-inflammatory drugs) multiple times per day for several days.
A significant hematoma is present that does not gradually reabsorb over the expected timeframe, or that continues to expand.
Associated symptoms are present, such as fever, general malaise, numbness or tingling in the foot or toes, or signs of circulatory compromise.
The dynamics of the accident were particularly significant: high-energy trauma, falls from height, vehicle accidents, or a twisting injury accompanied by a loud “pop” or immediate inability to bear weight.
The ankle feels grossly unstable or the foot appears deformed, which may suggest a complete ligament rupture or an associated fracture.
Symptoms persist or worsen beyond the expected recovery period without clear improvement.

Delaying medical evaluation in these circumstances can lead to missed fractures, undertreated ligament injuries, and ultimately, a prolonged or complicated recovery.

Diagnosis

Because the symptoms of an ankle sprain can be somewhat non-specific and variable, it is always a good practice to seek evaluation from an orthopedic physician who, through a thorough clinical examination, can formulate a reliable diagnosis and provide tailored advice for rapid recovery. In the absence of a correct diagnosis and adequate treatment, the symptoms of an ankle sprain, particularly pain and the sense of instability, can persist and become chronic. This situation is far more difficult to treat effectively.

Clinical Evaluation

Immediately after the trauma, intense inflammation, edema, swelling, and pain make an accurate clinical evaluation difficult. Even the most sensitive imaging techniques, such as MRI (Magnetic Resonance Imaging), may not provide reliable information about soft tissue injuries during this acute phase. For this reason, after an initial assessment at the time of injury, it is appropriate to schedule a follow-up evaluation approximately 4–5 days later, once the acute manifestations have partially subsided and a more accurate examination can be performed.

During the physical examination, the doctor will typically assess:

The precise location and severity of pain on palpation
The range of motion of the ankle
Joint stability through specific stress tests (such as the anterior drawer test and the talar tilt test)
The ability to bear weight
Neurovascular status of the foot

Imaging Studies

X-ray (Radiograph): An X-ray should be obtained promptly whenever a fracture is suspected. The Ottawa Ankle Rules, a validated clinical decision tool, help clinicians determine when radiography is necessary. According to these rules, an X-ray is indicated when the patient:

Is unable to bear weight for 4 steps (immediately after injury or in the emergency department)
Has pain on palpation of the posterior edge or tip of either malleolus, the base of the fifth metatarsal, or the navicular bone

These criteria have a sensitivity of approximately 96–99% for clinically significant fractures, making them a reliable tool for avoiding unnecessary radiation exposure while not missing important injuries.

MRI (Magnetic Resonance Imaging): MRI provides the most detailed assessment of soft tissue structures including ligaments, tendons, and cartilage. However, it is an expensive examination that requires specialized personnel and equipment. For this reason, MRI of the ankle should be reserved for selected cases, particularly when surgical intervention is being considered, and should generally be performed no sooner than two weeks after the acute injury.

CT Scan (Computed Tomography): A CT scan may be used as a second-line investigation when an X-ray is inconclusive but clinical signs strongly suggest the presence of a fracture that was not identified on plain films. CT is particularly useful for detecting subtle fractures of small bones or identifying the precise extent and pattern of complex fractures.

Ultrasound: Diagnostic ultrasound can be a useful, quick, and low-cost tool for evaluating ligament integrity and the extent of soft tissue swelling, and can be performed bedside. However, it is highly operator-dependent and may not provide the level of detail offered by MRI for complex injuries.

Differential Diagnosis

It is important to distinguish an ankle sprain from other conditions that may present similarly, including:

Fractures: Of the fibula, tibia, fifth metatarsal (Jones fracture or dancer’s fracture), or navicular bone
Tendon injuries: Peroneal tendon tears or Achilles tendon injuries
Osteochondral lesions: Cartilage damage to the talar dome
Syndesmotic injuries: High ankle sprains involving the ligaments connecting the tibia and fibula (more serious and requiring longer recovery)

What to Do?

Following the injury, it is essential to implement measures immediately that aim to reduce inflammation and place the joint in the most favorable conditions for rapid recovery. These recommendations are summarized in the RICE protocol, an English acronym that stands for:

Rest: Place the ankle at rest. This does not necessarily mean complete immobilization, but rather avoiding activities that cause pain or could worsen the injury. Relative rest with limited weight-bearing, assisted by crutches if necessary, is typically recommended in the early days after injury.
Ice (Cryotherapy): Apply ice or a cold pack to the injured area. Ice must never be placed directly against the skin due to the risk of cold burns; always wrap it in a cloth or towel before applying. Apply for 15–20 minutes every 2–3 hours during the first 48–72 hours after injury. The action of cold helps reduce pain and, by causing vasoconstriction, limits the extent of edema and hematoma formation.
Compression: Use a bandage or supportive brace. Compression bandaging must be applied carefully; it should exert a compressive action but must not obstruct circulation. Signs of excessive compression include increased pain, numbness, tingling, or discoloration of the toes. Figure-of-eight bandaging techniques are commonly used for ankle compression.
Elevation: Passively keep the leg and foot elevated above the level of the heart to facilitate the reabsorption of edema and hematoma. This should be done as much as possible during the first 48–72 hours, especially when sitting or lying down.

Some clinicians and researchers have proposed updating the classic RICE protocol to PRICE (adding Protection) or even POLICE (Protection, Optimal Loading, Ice, Compression, Elevation), the latter emphasizing that controlled, progressive loading of the injured tissue during recovery may actually enhance healing more effectively than pure rest. More recently, the acronym PEACE & LOVE has been proposed in the sports medicine literature:

PEACE: Protect, Elevate, Avoid anti-inflammatory modalities (in very early stages), Compress, Educate
LOVE: Load, Optimism, Vascularization, Exercise

While these frameworks reflect evolving evidence, the core principles of early protection, swelling control, and progressive rehabilitation remain universally accepted.

Pharmacological Treatment

For more significant injuries in which the RICE protocol alone does not achieve adequate pain control, non-steroidal anti-inflammatory drugs (NSAIDs) may be used. In addition to reducing pain, NSAIDs contribute to:

Reducing inflammation at the site of injury
Reducing edema and hematoma
Facilitating early mobilization of the ankle, which is always beneficial for the restoration of its function

Both topical and systemic NSAIDs can be used for this purpose. Topical preparations (creams, gels, ointments) have the advantage of acting exclusively on the area being treated. This bypasses the systemic side effects associated with oral intake, most notably gastrointestinal toxicity (such as stomach irritation and ulcers) and cardiovascular effects. For this reason, topical NSAIDs are generally preferred for ankle sprains when pain is moderate.

For more severe pain, systemic NSAIDs such as ibuprofen, naproxen, or diclofenac may be prescribed, typically for a short course of 5–7 days. In patients with contraindications to NSAIDs (such as kidney disease, peptic ulcer, or certain cardiovascular conditions), paracetamol (acetaminophen) may be used for pain control instead.

In specific cases of severe swelling or refractory inflammation, a short course of oral corticosteroids may be considered by the treating physician, though this is not standard practice for routine ankle sprains.

Physical Therapy

Physical therapy plays a central role in the recovery from ankle sprains, particularly for Grade II and Grade III injuries. A comprehensive rehabilitation program typically progresses through several phases:

Acute phase (Days 1–3): Focus on pain and swelling control using RICE and medications.
Subacute phase (Days 4–14): Progressive restoration of range of motion and early proprioceptive training.
Rehabilitation phase (Weeks 2–6): Strengthening exercises, advanced proprioceptive training, and sport-specific activities.
Return to sport phase: Gradual reintroduction to full athletic activities with functional testing to confirm readiness.

An orthopedic physician or physiotherapist will be able to identify the most appropriate therapeutic approach for each individual clinical situation. Among the most commonly used physical therapy modalities:

Tecar Therapy

Tecar therapy, also known as capacitive and resistive electric transfer (CRET), works through the principle of the electrical capacitor. By generating an endogenous electrical field within the tissues, it aims to accelerate cell regeneration by restoring the electrical charge of damaged cells, promoting increased blood flow and lymphatic drainage, and stimulating the body’s natural healing processes. It is frequently used to reduce pain and swelling and to accelerate tissue repair in musculoskeletal injuries.

TENS (Transcutaneous Electrical Nerve Stimulation)

TENS is an acronym that stands for Transcutaneous Electrical Nerve Stimulation. It is primarily used to relieve pain. This is achieved by delivering electrical impulses to the skin through electroconductive pads. These impulses block the nervous pain signals traveling to the brain (according to the gate control theory of pain) and stimulate the production of endorphins, the body’s natural pain-relieving molecules. TENS is safe, non-invasive, and can be applied in a clinical setting or, with appropriate guidance, at home using portable TENS devices.

Therapeutic Ultrasound

Therapeutic ultrasound uses high-frequency acoustic waves directed at the injured tissue. The primary goals are to produce an anti-inflammatory effect, stimulate the reabsorption of edema, and increase the permeability of cell membranes. This is believed to facilitate the entry of nutrients and removal of waste products, promoting faster healing. Therapeutic ultrasound can also produce a gentle warming effect in deeper tissues, promoting increased circulation and tissue flexibility.

Laser Therapy (Low-Level Laser Therapy / LLLT)

In laser therapy, electromagnetic rays are directed precisely onto the affected area. This focused beam of photons reaches cell membranes and mitochondria, increasing their metabolic activity. Through mechanisms including vasodilation and improved lymphatic drainage, laser therapy helps reduce pain and inflammation and has been shown in multiple studies to accelerate soft tissue healing. It is particularly useful in the subacute phase of recovery.

Electrostimulation (Neuromuscular Electrical Stimulation / NMES)

Electrostimulation is used to strengthen the muscles of the ankle, particularly the lateral peroneal muscles, which play a crucial role in dynamic ankle stabilization. By stimulating muscle contractions artificially, NMES can help maintain or rebuild muscle mass and strength during periods when voluntary exercise is limited by pain. Strengthening the peroneal muscles is essential for preventing future ankle sprains and is therefore particularly valuable in the rehabilitation phase following an acute injury.

Magnetotherapy

Magnetotherapy uses two solenoids placed directly on the ankle to exploit the beneficial effects of magnetic fields on biological tissues. The most effective form is pulsed electromagnetic field therapy (PEMF) at both high and low frequencies; static magnetic fields have not been shown to produce documented beneficial effects. Pulsed magnetotherapy is believed to reduce inflammation, stimulate cell proliferation, and promote bone and soft tissue healing, with some studies suggesting it can reduce healing time by up to 50%.

Kinesio Taping

Kinesio taping involves the application of elastic adhesive bandages directly to the skin over and around the ankle. The therapeutic effect is based on the mechanical traction exerted by these tapes on the skin and underlying tissues. Some kinesio tapes also incorporate slow-release pharmacological solutions for additional local effect. Kinesio taping serves multiple functions simultaneously: it provides a gentle compressive and draining effect to reduce swelling, offers pain relief by reducing pressure on pain receptors, produces an anti-inflammatory effect, and provides a degree of external joint support (acting as a functional brace).

Manual Therapy and Exercise

Manual therapy techniques performed by a trained physiotherapist, including joint mobilization, soft tissue massage, and stretching, can be highly effective in restoring range of motion and reducing pain in the subacute and rehabilitation phases. Progressive therapeutic exercises, including balance training on unstable surfaces (wobble boards, foam pads), are essential for restoring proprioception and preventing re-injury.

Surgery

Arthroscopy represents the last resort approach for managing an ankle sprain, reserved exclusively for the most severe cases in which conservative therapy has not produced the desired results. When pain and instability do not diminish despite all other therapeutic measures, it becomes necessary to investigate whether the ankle conceals an unexpected or unrecognized lesion that has not been visible on standard imaging.

The procedure involves inserting a small camera (arthroscope) into the ankle joint through a minimal incision, allowing the surgeon to directly visualize the internal structures of the joint and repair damaged parts with precision. Arthroscopic procedures for ankle sprains may include:

Debridement: Removal of scar tissue, bone spurs, or other debris that may be causing impingement or pain
Osteochondral lesion repair: Treatment of cartilage damage on the talar dome
Ligament reconstruction: Surgical repair or reconstruction of completely torn ligaments (such as the Broström procedure for lateral ligament repair)
Synovectomy: Removal of inflamed synovial tissue

Arthroscopic surgery is minimally invasive compared to open surgery, offering several advantages including smaller incisions, reduced risk of infection, faster recovery, and less postoperative pain. However, it still requires general or regional anesthesia and carries the inherent risks of any surgical procedure. Rehabilitation following ankle surgery is intensive and typically extends over several months.

Prevention

Preventing ankle sprains, or at least reducing the risk of a first episode or recurrence, is achievable through several practical strategies. The following evidence-based recommendations are particularly important:

Maintain a Healthy Body Weight

Achieving and maintaining an appropriate body weight is strongly recommended. Obesity is significantly associated with an increased risk of ankle sprains, as excess body weight places greater mechanical stress on the ankle joint and its supporting structures, reduces mobility, and impairs neuromuscular control. Even a modest reduction in body weight can meaningfully lower the mechanical load on the ankle during daily activities and exercise.

Warm Up Before Physical Activity

A proper warm-up before sports or exercise is essential. The warm-up serves to gradually prepare the neuromuscular system for the demands of the activity, increasing blood flow to muscles and tendons, improving flexibility, and providing the nervous system with the sensory information needed to adapt to terrain conditions and athletic movements. A warm-up should include at least 5–10 minutes of light aerobic activity followed by dynamic stretching and sport-specific movements.

Progress Exercise Intensity Gradually

When starting a new sport or returning to physical activity after a period of inactivity or injury, it is crucial to increase the intensity and volume of exercise progressively. Sudden increases in training load do not give the musculoskeletal system, including the ligaments and tendons of the ankle, sufficient time to adapt, significantly increasing the risk of injury. This principle applies equally to weekend warriors and elite athletes.

Strengthen the Ankle and Surrounding Muscles

Regular strengthening exercises targeting the muscles that support the ankle, particularly the peroneals (lateral) and the tibialis anterior and posterior (medial), provide active dynamic stabilization. This complements the passive stability offered by ligaments. Balance and proprioception training, using tools such as balance boards or single-leg stance exercises, are particularly effective in reducing recurrence risk and should be included in any ankle injury prevention program.

Wear Appropriate Footwear

The choice of footwear can significantly affect ankle stability. Shoes should provide adequate support for the specific activity being performed, fit properly, and have appropriate tread for the surface. High-heeled shoes are associated with a significantly higher risk of ankle sprains, particularly on uneven surfaces. For athletes with a history of ankle sprains, semi-rigid ankle braces or prophylactic taping may provide additional external support during high-risk activities.

Use Protective Braces During High-Risk Activities

For individuals who have previously suffered an ankle sprain, especially a moderate to severe one, wearing a functional ankle brace during sports or other high-risk activities provides additional protection during the period when proprioception and ligamentous stability are not yet fully restored. Current evidence suggests that external ankle support is effective in reducing the rate of re-injury in people with a history of ankle sprains.

Consider Proprioceptive Training Programs

Structured neuromuscular and proprioceptive training programs, such as the HARP (High Ankle Risk Prevention) program or similar evidence-based protocols, have been shown to reduce the incidence of ankle sprains by 30–50% in athletes when consistently implemented. These programs include a combination of balance exercises, strength training, and plyometric movements specifically designed to improve the ankle’s ability to respond to unexpected perturbations.

Pay Attention to Environmental Conditions

Being mindful of the surfaces you walk or run on and adapting your pace and footwear accordingly can meaningfully reduce the risk of an unexpected misstep. Wet, uneven, or unfamiliar surfaces should be approached with increased caution. Adequate lighting when walking in low-visibility conditions is also an important and often overlooked preventive measure.

Summary and Key Takeaways

Ankle sprains are among the most common musculoskeletal injuries worldwide, affecting people of all ages and activity levels. While most sprains are mild and resolve completely with appropriate home management using the RICE protocol, a significant proportion require professional medical evaluation and structured rehabilitation to achieve full recovery and prevent recurrence.

Key points to remember:

Act quickly: Apply the RICE protocol as soon as possible after the injury to limit swelling and pain.
Seek medical evaluation if pain is severe, if weight-bearing is impossible, if bruising is extensive, or if symptoms do not improve within a few days.
Don’t skip rehabilitation: Even after symptoms resolve, proprioceptive rehabilitation is essential to restore normal joint function and reduce the risk of future sprains.
Prevent recurrence: Strengthening exercises, balance training, appropriate footwear, and bracing during high-risk activities can significantly reduce the likelihood of another sprain.
Know when surgery is needed: Arthroscopic surgery is reserved for severe or refractory cases and can achieve excellent outcomes when conservative treatment has failed.

With timely, appropriate management and a commitment to rehabilitation, the vast majority of ankle sprain patients can expect to return to their full pre-injury level of activity.

References and Sources

Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med. 2014;44(1):123-140.
Van den Bekerom MP, Kerkhoffs GM, McCollum GA, Calder JD, van Dijk CN. Management of acute lateral ankle ligament injury in the athlete. Knee Surg Sports Traumatol Arthrosc. 2013;21(6):1390-1395.
Bleakley CM, Glasgow P, MacAuley DC. PRICE needs updating, should we call the POLICE? Br J Sports Med. 2012;46(4):220-221.
Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE. Br J Sports Med. 2020;54(2):72-73.
Kerkhoffs GM, van den Bekerom M, Elders LA, et al. Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline. Br J Sports Med. 2012;46(12):854-860.
Stiell IG, Greenberg GH, McKnight RD, et al. A study to develop clinical decision rules for the use of radiography in acute ankle injuries. Ann Emerg Med. 1992;21(4):384-390. (Ottawa Ankle Rules)
Vuurberg G, Hoorntje A, Wink LM, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018;52(15):956.
Hupperets MD, Verhagen EA, van Mechelen W. Effect of unsupervised home based proprioceptive training on recurrences of ankle sprain: randomised controlled trial. BMJ. 2009;339:b2684.
Doherty C, Bleakley C, Delahunt E, Holden S. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. Br J Sports Med. 2017;51(2):113-125.
American Academy of Orthopaedic Surgeons (AAOS). Clinical Practice Guideline on the Diagnosis and Treatment of Acute Achilles Tendon Rupture. Rosemont, IL: AAOS; 2010.
National Institute for Health and Care Excellence (NICE). Sprains and strains. Clinical Knowledge Summaries. Available at: https://cks.nice.org.uk/topics/sprains-and-strains/

Ankle Sprain: What to Do, Remedies, and Recovery Time