Medial Ankle Sprain

What is a medial ankle sprain?

A medial ankle sprain is a specific kind of ankle sprain that occurs when rolling your ankle outwards, straining the ligaments on the inside of the ankle. While they occur far less commonly than inversion ankle sprains (in which you roll your ankle inwards), eversion ankle sprains can often be much more painful

The primary structure responsible for stabilising the inside of your ankle (and therefore the one that is most commonly injured during an eversion ankle sprain) is the deltoid ligament. Medial ankle sprains are further categorised into 3 grades dependent upon severity. Take a look at our sporting series: sprained ankle for more information on determining the severity of an ankle sprain.

What is the deltoid ligament?

The deltoid ligament is a strong ligamentous structure that is made of 4 separate bands that form a triangle on the medial (inside) aspect of the ankle of each foot. The deltoid ligament connects the tibia, talus, navicular, and calcaneal bones of the foot and is responsible for supporting the inside of the ankle or preventing excessive eversion of the ankle. A deltoid ligament sprain can occur during a trip or fall in which the ankle turns outwards excessively. Typically, pain will be experienced over the inside of the ankle and substantial swelling may be present.

How do we manage inversion ankle sprains?

and second-degree sprains are typically managed conservatively. Over the first 24-48 hours treatment consists of rest to allow the healing process to begin, ice to aid in pain relief, and compression and elevation to reduce swelling. Third degree sprains will likely require surgical intervention depending upon the extent tissue injury. When pain and inflammation are controlled, we can start with therapeutic exercises to increase the range of motion, stability, strength, proprioception, and function.

Initial exercises for range of motion include ABC’s:

As swelling and pain is controlled, light strength training exercises can be initiated. Exercises that may be prescribed include:

• resisted plantar flexion

• resisted ankle eversion

• resisted ankle dorsiflexion

• resisted ankle inversion.

From about the 3-4 week mark, proprioceptive training can be initiated. Often, following an ankle sprain, sensation in the affected ankle can be altered. Proprioceptive training is designed to improve/restore your sense of ankle and foot position, and in this way, reduce the risk of re-injury. Exercises to train ankle proprioception may include balance board training, single-leg stand variations or balance training on a variety of unstable surfaces.

The number of repetitions and intensity of exercises will be based on your Physiotherapist's recommendations. However, as a general rule, strength exercises will be prescribed in a range of 8-12 repetitions performed 3 times throughout the day. Balance exercises will typically be for 2-3 mins for each exercise.

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Blog and videos by UQ Physiotherapy student undertaking clinical placement, supervised by principal physiotherapist, Winnie Lu.