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Ankle Injuries

What’s the difference between tendons and ligaments?

Tendons attach muscles to bone, whereas ligaments attach bones to other bones.


What’s the difference between a Sprain and a Strain?

A sprain occurs when ligaments become damaged from over-stretching. A strain happens when muscle or tendon fibres are damaged from over-stretching.

Ankle sprain while jogging, anteriortalofibular ligament sprain.

One of the most frequently injured ligaments in the body is in the ankle – the anterior-talo-fibular ligament or ATFL for short. If we break this word down, Talo and Fibular relate to the bones that this ligament connects to. Anterior means at the front. So this ligament is the front one of two ligaments which connects the Talus to the Fibula.


The lateral or outside part of the ankle contains three ligaments: the anteriortalofibular ligament, posteriortalofibular ligament and calcaneofibular ligament. Any one or all three of these ligaments can be damaged with a lateral ankle sprain, but most commonly it is the anteriortalofibular and calcaneofibular ligaments.

The most common mechanism of injury is twisting the ankle inwards or “rolling the ankle” when stepping on an uneven surface. However it can also happen in contact sports such as football as a consequence of a mis-timed tackle.


The amount of force and weight combined with the amount of twisting frequently determines the extent of injury. It is possible to fracture the bones of the ankle and leg, damage muscles and tendons with this sort of injury, however most frequently it is just the anteriortalofibular ligament that sustains some damage.

X-ray image of right ankle joint sprain, mortisn

If the ankle gets twisted outwards, it is more likely that the deltoid ligament on the inner (meidal) side of the ankle will get damaged. Depending on the severity and the mechanism of injury, the both sides of the ankle can be injured.


It is possible to reduce the likelihood of anteriortalofibular ligament sprains by wearing appropriate footwear, avoiding uneven surfaces where possible, strapping the ankle and doing proprioception exercises. Proprioception is the body’s awareness of position. By improving proprioception, the body is less likely to fall and therefore damage the ankle when suddenly off-balance.

To improve proprioception, try standing on one leg with something to hold onto nearby. If you close your eyes, you might notice that its increasingly difficult to remain balanced. By practicing this on a regular basis, the body learns to remain balanced as it is not relying so much on visual cues as to its position.


Most minor ankle sprains do not require medical intervention, however in severe cases an x-ray may be necessary. The application of ice for 5 minutes, then remove the ice for 5 minutes and repeat 3 times can help to reduce swelling surrounding the ankle.


Osteopathic treatment can help with ankle injuries. This involves soft tissue work on the area around the ankle, the peroneal muscles and assessment of the knee, hip other nearby joints. Fill in the form below to book an appointment. 

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