Three Types of Ankle Sprains

By Isabel Alvarado MS, LAT, ATCAthletic Trainer at Dell Children's

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A sprain is a term used to describe when ligaments are stretched or torn. Ligaments are a type of connective tissue in the body that connect bones to bones. There are three types of ankle sprains: medial, lateral, and high.

A medial ankle sprain refers to injury to the inside (medial) of the ankle where the deltoid ligaments are located. Medial ankle sprains occur when the ankle rolls outward, also called eversion.

Lateral ankle sprains occur when the ankle rolls inward (also called inversion) and injures the ATFL (anterior talofibular ligament), and/or CFL (calcaneofibular ligament), and/or PTFL (posterior talofibular ligament).

High ankle sprains occur when the foot and lower leg are forcefully rotated and the syndesmosis ligaments in the ankle are injured. Syndesmosis is a type of joint where two bones (in this case the tibia and fibula) are held together by strong connective tissue and ligaments. Because of the location, this type of sprain usually takes longer to heal than a medial or lateral ankle sprain.

Red Flags To Look Out For: Using the Ottawa Ankle Rules (OAR) can help determine whether or not you need to get an x-ray. If these 3 rules apply to you, go to the ER or see a doctor:

● Pain and/or point tenderness when touching the back edge of the outside ankle bone (fibula)

● Pain and/or point tenderness when touching the back edge of the inside ankle bone (tibia)

● Inability to walk 4 steps immediately after the injury

References

Bachmann LM, Kolb E, Koller MT et-al. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003;326 (7386): 417.

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