Ankle Sprain and Chronic Ankle Instability
One of the most common sports injuries, and one of the most likely to come back.
We grade the injury properly, image the ligaments with on-site MSK ultrasound, and use objective tests to decide when you are ready to return to sport.
Why a "simple" sprain deserves proper care
A lateral ankle sprain happens when the foot rolls inwards and the ligaments on the outside of the ankle are stretched or torn. The anterior talofibular ligament (ATFL) is usually injured first, and in more forceful injuries the calcaneofibular ligament (CFL) is involved too. It is a daily event in GAA, rugby, soccer, basketball and trail running.
Sprains are graded by severity. A grade I sprain is a stretch with minimal loss of function. A grade II sprain is a partial tear with more swelling and some instability. A grade III sprain is a complete tear, often with significant swelling and difficulty weight-bearing.
The bigger problem is what happens next. A large share of people who sprain an ankle go on to have repeated sprains, ongoing pain or a feeling that the ankle gives way. This is known as chronic ankle instability. It is usually linked to deficits in balance, reaction time and strength that were never fully rehabilitated after the first injury, which is why we treat the rehab phase as seriously as the injury itself.
Not every "sprain" is a ligament injury alone. Ongoing pain can also come from a high ankle (syndesmosis) sprain, a peroneal tendon injury, a bone bruise, a fracture of the fifth metatarsal base, or a stress fracture. A sprain that is not settling as expected needs a proper look.
Could it be broken?
If you could not take four steps immediately after the injury, or you have tenderness over the bony edges of the ankle or the outer midfoot, a fracture needs to be ruled out with an X-ray first. Go to your nearest injury unit or emergency department before booking with us.
Common symptoms
Grade it, image it, then load it
Your assessment is with Darren Costello, a CORU-registered podiatrist with an MSc in Sports and Exercise Medicine and a CASE-accredited postgraduate certificate in MSK ultrasound.
We examine ligament integrity with clinical tests such as the anterior drawer and talar tilt, then use MSK ultrasound to look at the ATFL, CFL, peroneal tendons and the high ankle ligament. Ultrasound is dynamic, so we can watch the ligament under gentle stress rather than rely on a still image.
For recurrent sprains we also measure balance reach and single-leg strength against your other side, and ask about giving-way episodes using a validated questionnaire. That tells us whether the main problem is mechanical laxity, functional control, or both.
Diagnostic Injury Assessment
The right starting point for a new or recurring ankle sprain. 45 minutes, €160, includes MSK ultrasound and a staged rehab plan.
How we manage ankle sprains
Current evidence favours early, protected movement over prolonged rest. Rehab progresses in stages, and each stage has criteria to meet before moving on.
Protection and Early Loading
Compression and a semi-rigid brace in the first days, with early weight-bearing as pain allows. A walking boot is kept for severe injuries and only for a short period.
Learn moreStrength and Balance Rehab
A prescribed home programme to restore ankle range, calf and peroneal strength, then single-leg balance and reactive control. This is the stage most often skipped, and the one that matters most for preventing re-injury.
Learn moreCustom 3D-Printed Orthotics
For recurrent sprains where foot posture tips the ankle towards inversion, custom orthotics with lateral wedging can reduce that tendency. Always supplied as a pair.
Learn moreOnward Referral When Needed
If hands-on physiotherapy would help, we can refer you to the physiotherapy team at Body Med in the same building. Where the ligament is very lax despite good rehab, we advise on surgical opinion.
Learn moreCriteria, not calendar dates
Going back too early is one of the main reasons sprains recur. Before full clearance for training and matches we look for:
A brace or tape is often advised for sport for several months after return. If the pain is at the back of the ankle rather than the outside, see our page on Achilles tendinopathy.
Frequently asked questions
Should I rest my sprained ankle completely?
No. For most grade I and II sprains, early protected weight-bearing and gentle movement lead to a better recovery than immobilisation. A short spell in a walking boot is usually reserved for severe (grade III) sprains, followed by a move to a brace and structured rehab.
Do I need an X-ray?
Not always. The Ottawa Ankle Rules help decide whether a fracture needs to be ruled out. If you could not take four steps straight after the injury, or you have bony tenderness at specific points around the ankle or midfoot, go to an injury unit or emergency department for an X-ray first.
When can I go back to training and matches?
When you pass objective tests, not on a fixed date. We compare hop tests, balance reach and heel-raise strength between your two legs, and check you can complete a full training session without pain or apprehension. Time frames vary with the grade of injury and the demands of your sport.
My ankle keeps giving way months after the sprain. Is that normal?
It is common but it is not something to live with. Repeated giving way after a sprain is the hallmark of chronic ankle instability. It usually reflects a gap in balance, reaction time and strength, and it often responds to targeted rehab. Where the ligament itself is very lax, we can advise on onward referral.
Can I claim on my health insurance?
Many VHI, Laya healthcare and Irish Life Health plans include a day-to-day benefit for podiatry visits. You pay on the day, we give you an itemised receipt, and you claim it back through your insurer. See our insurance page for what plans typically pay.
More on claiming: health insurance for podiatry in Dublin.