A lateral ankle sprain may be graded based on the degree of damage to the ligaments. This can help separate athletes with minor injuries from those with more significant ones.


Presentation: Edema and bruising over the lateral aspect of the affected ankle.


Usual cause: Landing with the body weight on the foot, with the foot plantar flexed and internally rotated. Stretching of the ankle ligaments occurs as the foot rolls inward. This injury may occur if a play steps or lands on another player's foot or an uneven surface.


Ligaments potentially involved:

(1) anterior talofibular (ATFL): most commonly injured

(2) calcanofibular (CFL): next most injured

(3) posterior talofibular (PTFL)

Extent of Injury to the Anterior Talofibular Ligament

Extent of Injury to the Calcanofibular Ligament

Extent of Injury to the Posterior Talofibular Ligament


stretched with some fibers torn

may be stretched

may be stretched


significant disruption

partial tear

may be stretched


complete tear

complete tear

possible disruption




Test Finding


positive anterior drawer

ATFL disrupted

positive talar tilt

CFL disrupted


To read more or access our algorithms and calculators, please log in or register.