Ankle Ligament Injuries

A torn ligament is often painful and causes swelling in the injured foot, meaning that you can no longer walk without pain.


We’ll make your foot stable again

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. At Schoen Clinic, we employ experts specialised in sports injuries. Often, conservative treatment without surgery is sufficient for a ligament rupture. You’ll be in safe hands with our specialists, whatever your situation. Together, we can find a way to heal your injury without any after-effects.

Causes & Symptoms

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. Here 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 injured in these injuries. These 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.

How does a ligament tear of the ankle joint occur?

In 85% of cases, a ligament tear of the ankle joint happens due to the ankle rolling while walking. External forces, such as a tackle in football or rugby, can also cause ligament rupture. In general, sports that require cutting and turning such as tennis, netball or hockey carry a high risk of a low ankle sprain and ligament injury. In addition, these types of accidents can lead to bone fractures or damage to the cartilage. Tendons can also be damaged. A high ankle sprain can result from sports such as rugby and are also commonly seen in skiing injuries.

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’ll 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.


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.


We may conduct an x-ray examination to rule out bone damage. 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. MRI scans are often required to further investigate. 


Torn ankle ligament: surgery only in exceptional cases

We conduct the treatment that’s right for you, based on your diagnosis. In many cases, we are able to treat the ligament tear in the ankle joint effectively using conservative treatment. 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 is persisting symptoms despite conservative treatment or for an unstable syndesmosis in cases of a high ankle sprain.

Ankle ligament surgery 

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 Brostrom lateral ligament repair. Which 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 maybe 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.


Mr Ali Abbasian

Consultant Orthopaedic Surgeon MBBS FRCS(Tr&Orth)

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