Ankle ligament injuries

Making your foot stable again

A ligament tear or rupture in the ankle joint is one of the most common sports injuries. It typically occurs when you twist or roll your ankle. A torn ligament is often painful and causes swelling in the injured foot, meaning that you can no longer walk without pain.

At Schoen Clinic, we employ experts specialised in sports injuries. Often, conservative treatment without surgery is sufficient for a ligament rupture. Whatever your situation, you will be in safe hands and together, we will effectively heal your injury and provide you with the best possible outcome.

The ankle joint – How is it structured?

The individual bones in your ankle joint are bound together by ligaments. They are activated by various muscles in the calf. The ligament connection between your tibia bone and fibula bone, as well as your external and internal ligaments, stabilise your foot.

Ankle sprains or ligament injuries can commonly be divided into two groups; a “high” or a “low” ankle sprain. Low ankle sprains are by far more common and occur when the ankle rolls inwards i.e. when the ligaments that attach the ankle bone to the fibula bone are torn. The three ligaments on the outer side of the ankle can get harmed in these injuries. These types of injuries are commonly managed without the need for surgery. A high ankle sprain is less common but more serious and may need surgical treatment. In a high ankle sprain, the tough ligaments that hold the two lower leg bones together are torn. This is otherwise known as a syndesmosis injury and may result in the two bones springing apart.

Symptoms: Signs of a ligament rupture of the ankle joint

After your ankle rolls, a sudden shooting pain typically occurs. Some report a crunching or cracking noise. The first signs of a ligament tear are severe swelling and bruising. In a low ankle sprain, the bruise can track into the foot and the toes. A large swelling can appear on the outer side of your ankle. You will often no longer be able to put your full weight on the foot because of the pain. Sometimes, a feeling of instability can also arise.

Initial measures for a suspected ligament tear

To prevent further injury, it is best to follow the RICE method:
  1. Rest: stop putting weight on the joint as quickly as possible.
  2. Ice: cool the affected area to combat swelling and inflammation of the joint.
  3. Compression and Elevation: apply a compression bandage and keep your leg raised. With these measures, you can slow down the swelling of your ankle joint.
In addition, you should be examined by a doctor as quickly as possible so that they can establish the type and severity of your injury. Our specialists at Schoen Clinic have years of experience in handling sports injuries and can recommend suitable treatment.

Causes: How does a ligament tear of the ankle joint occur?

In 85% of cases, a ligament rupture of the ankle joint happens due to the ankle rolling while walking. External forces can also cause ligament rupture. This is often the case in football, during a foul. In general, ball sports such as tennis, basketball and volleyball carry a high-risk of injury. In addition, these types of accidents can lead to bone fractures or joint damages. Tendons can also be damaged.

Diagnosis: How did the accident happen?

To make a reliable diagnosis, we ask you to describe the nature of the injury in detail, and we thoroughly examine your ankle joint. This helps us determine the type and extent of your injury.


In order to rule out any bone damage, we may conduct an X-ray examination. Plain X-rays are important to rule out a fracture but often appear normal in a typical ankle sprain or ligament tear. X-rays will not be able to differentiate between a high or low grade ligament injury or injuries that cause cartilage damage or subtle fractures. Magnetic Resonance Imaging (MRI) scans are often required to further investigate as they can produce detailed images of the body that X-rays cannot.

Torn ankle ligament: Surgery only in exceptional cases

Based on your diagnosis, we offer the appropriate treatment that is right for you. In many cases, we are able to treat the ligament tear in the ankle joint effectively using conservative methods. This may mean crutches, ankle splint, braces or even a walker boot. Physiotherapy is key to rehabilitate your ankle.

In a low ankle sprain or ligament injury, surgical treatment may be considered if there are persisting symptoms despite conservative treatment. For an unstable syndesmosis or in cases of a high ankle sprain surgery is often the best solution.

Torn ankle ligament: Surgery if the joint remains unstable

In up to 20% of ligament injuries in low ankle sprains, there may be persisting ankle instability despite physiotherapy. If this is the case then surgery to repair the ligaments may be an option. This is known as a Broström lateral ligament repair. This is an open operation through a small cut or incision on the outer side of your ankle and the torn ligaments are repaired. Small metal pins may be used to anchor the ligaments to the bone.

You will need a period of six weeks in a boot to allow the ligaments to fully heal. In that time you may use crutches initially. Ankle ligament surgery is very successful in restoring stability and in most cases, the ligaments heal without any problems.

In most cases, ankle joint ligament injuries heal without complications. But you need to be patient. Just use your underarm crutches carefully for support in the first few days and weeks. Intensive physiotherapy and foot training will only be beneficial after your symptoms have subsided. You should then be putting more weight on your foot in stages.

Ankle ligament injuries: Our specialists

With some of the finest specialists in foot and ankle conditions at Schoen Clinic, you are sure to find your feet in the best hands possible. Our multidisciplinary team approach combines the expertise of surgeons, physiotherapists and nurses to provide you with the optimum result, no matter what your condition may be.

Ankle ligament injuries: Our specialised hospital

Based in the heart of London, Schoen Clinic specialises in the treatment of spinal and orthopaedic conditions, providing rapid diagnosis, treatment and aftercare all in one centre of excellence.