Clinics in Bedford
Open Mon-Fri 9-5pm

Ankle Ligament Damage

In this article you will find out about the most effective treatments available to speed up the repair process of ankle ligament damage.

A sprained ankle is caused by rolling, twisting, or turning your ankle in an unusual manner. The tight bands of tissue (ligaments) that keep your ankle bones together might be stretched or torn as a result of this.

Ligaments aid in the stabilization of joints and the prevention of excessive movement. When ligaments are stretched beyond their usual range of motion, it results in ankle ligament injury. The ligaments on the outside of the ankle are injured in the majority of sprained ankles.

The anterior talofibular ligament (ATFL) is the most often damaged of the lateral ankle ligament complex. The calcaneofibular and posterior talofibular ligaments are less prone to absorb harmful stresses due to their anatomical location and the mechanism of sprain injury. Forceful inversion and eversion movements of the foot harm the powerful deltoid ligament complex on the medial side.

A sprain to the ankle is a common injury. Basketball players are prone to severe sprains. Approximately 85 percent of all ankle sprains are inversion-type lateral (1) ligament injuries. Ankle sprains are most common among sports-related populations. After a first sprain, poor recovery increases the odds of a recurrence. The ankle joint is the second most commonly injured body part in sports.

If you feel pain and swelling in your ankle and suspect a sprain, call your doctor. Self-care treatments may be sufficient, but consult your doctor to see if your ankle should be checked. You may have major ligament or bone damage in your ankle or lower leg if the signs and symptoms are severe.

How do I know that my ankle is sprained or if I have a torn ankle ligament?

If your ankle ligament is damaged, you will feel immediate pain. A small tear in the ligament is characterized by mild pain. If the ligament is completely damaged, the pain will be so severe that it will make it impossible to walk. The pain in this case will be highly localized and excruciating.

In addition, you will feel severe pain on touching the site of injury. Although, the pain you feel will be consistent, but will elevate suddenly if you touch the damaged ankle ligament.

You will feel swelling 5 to 10 minutes after ligament damage. No need to worry if this happens. This is a compensatory mechanism of your body against the damage. Swelling will increase blood flow to the damaged ligament to help heal faster.

Sometimes, you also see a bruise (skin discoloration) at the site of injury. This happens when the injury or blow ruptures the blood vessels in addition to damaging the ligament. The blood leaks from the vessels and accumulates under the skin causing skin discoloration. It causes black, blue, purple, brown, or yellow discoloration. There’s no external bleeding unless the skin breaks open.

You will feel great restriction in movement at your ankle joint. Inversion and eversion at the joint are completely restricted. This is associated with the pain in the joint. As you feel pain during movement, you will automatically reduce movement at the ankle joint to avoid more pain. Restriction of movement at the damaged ankle is necessary to heal the damage quicker (2).

Bleeding from torn ankle ligament causes swelling of the joint and it results in tenderness and discoloration of the joint. The severity of damage to the ligament is determined by the extent of bruising.

What to do immediately with ankle ligament damage?

The only thing you can do right now is to administer ‘first aid.’ R.I.C.E (3) stands for rest, ice, compression, and elevation, and it can be used to treat an ankle injury.

  • Rest. It’s critical to rest the ankle and keep weight off of it to avoid further damage.
  • Ice. Ice will help to halt or minimize swelling while also providing a numbing effect that will aid to relieve pain (4). To avoid frostbite, an ice pack should be applied within 48 hours of an accident. Never leave ice on for more than 15 to 20 minutes at a time.
  • Compression. An elastic bandage or off-the-shelf compression wrap can be used to keep the damaged ankle immobilized and supported. Make sure not to over-wrap the ankle. The wrap is too tight if your toes turn blue, become chilly, or lose sensation.
  • Elevate can reduce swelling and pain by elevating the injured ankle to at least the level of your heart.It’s crucial to avoid putting any weight on the ankle until it’s been examined by a doctor, which should happen as soon as possible. Fractures and sprains that are overlooked or improperly treated can result in long-term chronic problems with the ankle, including recurring injury, ankle weakness, and arthritis.

Healing of an ankle sprain or torn ankle ligaments

When it comes to the healing of the ankle ligaments, they do so on their own. However, it is best to seek out medical attention to ensure that the affected area heals correctly without a lot of excessive scarring. The tear of the ligament takes much more time to heal than the ligament sprain.

The recovery is based on:

  • Your musculoskeletal fitness level
  • Your nutrition
  • Your age
  • How bad is your ankle injured
  • How much time passed before seeking treatment

Blood supply is essential for the healing process to take place. When the ligament is completely torn, the blood supply to the tissue is interrupted, and therefore complete tears rarely heal naturally. If you take massage or physiotherapy (5) regularly, it improves the blood supply of your torn ligament and this will reduce your recovery time.

Massage can help relieve pain and increase blood flow to the injured area. You need physical therapy and a trained physical therapist should be consulted if the injury is especially severe or painful. A person may try a light massage at home for less serious injuries. Some people get relief by rubbing the bottom of their foot or heel. Others prefer to massage slightly above or around the ankle. If rubbing the area causes pain or worsens symptoms, it should be stopped.

An ankle injury can cause damage to adjacent muscles and other structures. This is especially true if the tissues have weakened due to lack of use. Stretching keeps muscles firm and strong. It also improves blood circulation in the area, which may aid with ankle healing. At least three times a day, gently extend the ankle by moving it in all directions. Experiment with flexing your foot forward, then backward, or rolling your foot clockwise, then counterclockwise.

Treatment for ankle ligament damage

Your doctor will do a physical examination and possibly prescribe a few tests to determine the degree and severity of the damage. X-rays, an MRI scan, and ultrasound are all possible tests. As a result, the doctor will develop a treatment plan for you and provide some advice that you should strictly follow.


Ankle ligaments have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that help to heal these structures.

Prolotherapy involves the injection of regenerative solution  into these structures to provide a direct supply of what is required to heal and repair.

As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.

If you feel a weakening of your lower leg muscle strength, consult a physiotherapist to carry out strengthening exercises. People with sports injuries are referred to the sports medicine department. In the acute stages they give them first aid by applying a splint and taping.

Once you’ve made some progress, you’ll need to focus on rebuilding your ankle’s flexibility and strength in the second phase of healing. In the next phase, you will gradually return to your regular activities, beginning with those that do not place strain on your ankles and then progressing to more rigorous activities.

Diagram of different torn ligament ankle

Grading of ankle sprains

Sprains can range from minor to severe. Your doctor likely will put your sprain at one of three “grades” based on the amount of damage:

Grade 1

Your ankle will probably feel sore and may be slightly swollen. In this grade, the ligament is overstretched but not torn. You may be feeling mild pain on touching the ankle joint. If there is swelling and stiffness and you can still walk with minimal pain, you are highly likely suffering from a grade 1 ankle sprain. No need to worry, this type of mild sprain usually heals itself within a couple of days.

Grade 2

If you feel your symptoms are relatively more intense than the grade 1 ankle sprain, chances are that you have a grade 2 ankle sprain. You will experience moderate pain due to the incomplete tear of the joint ligament.

Although it feels stable and you can still walk on your own, the damaged areas are tender to the touch and walking is painful. If you feel like these signs are present, you should categorize your injury as a grade 2 ankle sprain.

Grade 3

This is a full tear of the ankle ligament. You may have heard a popping sound when it happened. This level of sprain causes severe pain, swelling, and bruising. Because the ligament is no longer able to do its job, your ankle will feel unstable and will be unable to support any of your weight.


How long does it take for a Torn Ligament in the ankle to heal?

Generally, it takes a few weeks to several months for an ankle sprain to heal, depending upon the severity and the amount of physiotherapy you are doing.

Specifically, the time it takes to recover from a sprain depends on the degree of injury. For minor tears with microscopic damage, it may take up to 6 weeks for a full recovery. Obviously, the more severe the tear, the longer it will take to recover, especially if soft tissue surgery is required.

Is it OK to walk on torn ankle ligaments?

You can walk on torn ligaments due to the other intact ligaments and supporting structures. However, it is not advised to do so. After all, walking with a torn ankle ligament aggravates the condition and decreases the tendency to heal itself.

What does a damaged ankle ligament feel like?

You may have felt the popping sound at the time of injury. This is the sound of a damaging ankle ligament. You may feel a lot of pain and a sensation of weakness and joint instability as you try to walk.

If you have only one of your ankle ligaments torn, you can walk with the support of the other ligaments and other foot. If multiple ligaments are torn along with ankle dislocation, it will put you in great difficulty to walk.

What helps ligaments heal faster?

Resting the ankle and wearing an ankle brace to stabilize the affected area are both important for healing. Heat also improves blood flow to an injury, allowing it to recover faster. Strengthening exercise (8) faster the healing process and also prevent chronic ankle instability.

How do I know if my ankle sprain is serious?

If you have swelling, pain, or decreased range of motion and you can walk on your own, then your ankle sprain is mild. You don’t need to worry about this.

If you felt intense ankle pain at the time of injury and the site of injury shows discoloration, your ankle sprain is a moderate one. This is a bit of a serious condition as this can lead to chronic ankle instability if not treated on time.

If you feel intense pain and the weight-bearing ankle joint is bent at an unnatural angle, you need to know that this is serious. It is highly likely that one of your ankle bones, like the talus, is fractured. If you feel like this, seek medical advice immediately.

What is a Grade 3 ankle sprain?

This is a complete tear of the ankle ligament. This also includes a high ankle sprain when the tibia or the fibula detaches from your ankle ligament. Maybe you tripped on something while sprinting or jumping on uneven surfaces.

How do I know what grade my ankle sprain is?

If you feel mild pain with no ankle instability, you are having a grade 1 ankle sprain. If your pain is mild to moderate with some difficulty walking, your ankle sprain is of grade 2. If your pain is excruciating one with complete joint instability, you are having a grade 3 ankle sprain.References

  1. Dubin, J. C., Comeau, D., McClelland, R. I., Dubin, R. A., & Ferrel, E. (2011). Lateral and syndesmotic ankle sprain injuries: a narrative literature review. Journal of Chiropractic Medicine, 10(3), 204–219. https://doi.org/10.1016/j.jcm.2011.02.001
  2. Schneck, C. D., Mesgarzadeh, M., & Bonakdarpour, A. (1992). MR imaging of the most commonly injured ankle ligaments. Part II. Ligament injuries. Radiology, 184(2), 507–512. https://doi.org/10.1148/radiology.184.2.1620856
  3. van den Bekerom, M. P. J., Struijs, P. A. A., Blankevoort, L., Welling, L., van Dijk, C. N., & Kerkhoffs, G. M. M. J. (2012). What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults? Journal of Athletic Training, 47(4), 435–443.
  4. Soyuncu, S., Yigit, O., & Eken, C. (2009). Frostbite Injury Related to Chlorethane Application. Wilderness & Environmental Medicine, 20(1), 103–104. https://doi.org/10.1580/08-weme-le-211.1
  5. Brison, R. J., Day, A. G., Pelland, L., Pickett, W., Johnson, A. P., Aiken, A., Pichora, D. R., & Brouwer, B. (2016). Effect of early supervised physiotherapy on recovery from acute ankle sprain: randomised controlled trial. BMJ, 355, i5650.
  6. van den Bekerom, M. P. J., Sjer, A., Somford, M. P., Bulstra, G. H., Struijs, P. A. A., & Kerkhoffs, G. M. M. J. (2015). Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 23(8), 2390–2399.
  7. Vega, J., Allmendinger, J., Malagelada, F., Guelfi, M., & Dalmau-Pastor, M. (2017). Combined arthroscopic all-inside repair of lateral and medial ankle ligaments is an effective treatment for rotational ankle instability. Knee Surgery, Sports Traumatology, Arthroscopy, 28(1), 132–140. https://doi.org/10.1007/s00167-017-4736-y
  8. Calatayud, J., Borreani, S., Colado, J. C., Flandez, J., Page, P., & Andersen, L. L. (2014). Exercise and Ankle Sprain Injuries: A Comprehensive Review. The Physician and Sportsmedicine, 42(1), 88–93.

Read more: