Foot & Ankle

Ankle Sprain

Non-Operative management

About Your Injury

"Torn", "ruptured", and "sprained" ligament all describe exactly the same thing — there is no difference in severity implied by these words. A rupture of the ATFL (anterior talofibular ligament) and/or CFL (calcaneofibular ligament) — the two main ligaments on the outer side of the ankle — is what is commonly referred to as an "ankle sprain". Patients often assume a "sprain" is more minor than a "tear" or "rupture", but these terms are all medically equivalent.

Despite this, these can be disabling injuries — swelling, pain, and tightness can persist for 3–6 months post injury, although most settle much faster with appropriate rest and well-guided physiotherapy.

Non-Operative Management

The great majority of ankle sprains can be managed safely and effectively without surgery. About 90% of ankle sprains settle well with appropriate non-operative treatment and do not go on to become recurrently unstable. Careful physiotherapy focusing on strengthening the secondary stabilisers around the ankle is a key part of treatment, along with a short period of protection in a CAM boot for comfort.

Recovery Timeline

Weeks 0–2

RICE principles, CAM boot for comfort, weight-bear as tolerated.

Weeks 2–4

Gradual wean out of the boot into a supportive shoe; begin gentle range-of-motion exercises.

Weeks 4–6

Physiotherapy-led strengthening of the secondary stabilisers, along with balance and proprioceptive training.

Weeks 6–8

Progression to sport-specific training and agility work.

3 months

Return to full sport once strength and confidence in the ankle have returned.

Follow-Up Schedule

2 weeks

Clinical review to confirm progress and plan the wean out of the boot.

6 weeks

Physiotherapy-led review of strength and stability, with progression of the rehabilitation program.

Discharge

Once confident and stable, sooner if progressing well with physiotherapy.

Chronic Ankle Instability

Around 10% of people do not settle fully, with ongoing feelings of instability or continued "rolling" of the ankle despite a good course of physiotherapy — this is known as chronic ankle instability. If this persists despite dedicated physiotherapy, you may be a candidate for a lateral ligament reconstruction (a Bröström-Gould procedure), which tightens the torn ligaments to restore stability.