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Foot and Ankle

Sprained Ankle


Acute ankle sprain is the most common injury in sports. It occurs when the foot twists or rotates beyond its normal range of motion causing the ligaments to stretch or tear.  The two ligaments on the lateral side of the ankle which are injured are the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL).

Ankle sprains can affect just about anyone including athletes and non-athletes, men, women, children, and adults.  This can happen with sport participation, stepping on uneven surfaces, or tripping while walking.  In most cases, a sprained ankle will heal itself over 3-6 weeks with conservative measures.  If a sprain does to heal as anticipated, this may indicate there was damage to structures other that the lateral ankle ligaments.


The symptoms associated with a sprained ankle are typically determined by the degree of injury.  Our physicians describe and ankle sprain on a grade of 1 to 3, one being stretch of a single ligament and 3 being complete tearing of both ligaments.  Symptoms will usually include pain, tenderness and swelling.

Diagnostic Testing

Our physicians will perform a complete history and examination of the ankle including x-rays.  X-rays are needed to rule out fracture of the ankle and evaluate any boney avulsions around the ankle.  Based on the degree of injury (pain level, overall range of motion and mobility), treatment options will be discussed.  In some cases we may order an MRI or CT to evaluate the damage to the ligaments and assess if any other structures were injured.


Non-Surgical Treatment for an Ankle Sprain

Many patients require a boot in order to walk with a sprained ankle comfortably, while some require only an ankle brace. Other treatment recommendations include RICE (rest, ice, compression, elevation), anti-inflammatory medications, or in some cases complete immobilization with casting.  After a short course of rest, we typically recommend a functional rehabilitation program to work on strengthening and proprioception.      

Surgical Treatment for a Sprained Ankle

For ankles that do not heal in an appropriate timeframe or for those with complex ligament tears, our physicians may recommend a surgery to repair or reconstruct the damaged ligaments.  These decisions are made on a case by case basis after through evaluation of the patient.  Our physicians take into account many factor including prior sprains, activity level, and imaging results.

Post-Operative Measure

Following lateral ankle ligament repair most patients require a short course of non-weight bearing.  After sutures are removed and the soft tissue has begun to heal, patients will begin weight bearing on the ankle and start physical therapy.  Our physicians are very particular about the therapy exercises after lateral ankle ligament surgery and will prescribe you an individualized plan for your physical therapist.  Most patients are able to resume normal activities and partake in sports once the healing process has concluded in 6-8 weeks.

At a Glance

Dr. Brian Waterman, MD

  • Chief & Fellowship Director, Sports Medicine, Wake Forest
  • Team Physician, Wake Forest University, Chicago White Sox
  • Military affiliation/Decorated military officer and surgeon
  • Learn more

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