The ankle is stabilised by a network of ligaments — tough, fibrous bands of tissue that connect bone to bone and prevent excessive movement. When the ankle rolls or twists suddenly, one or more of these ligaments can be overstretched or torn.
Ankle ligament injuries are extremely common — they are among the most frequent musculoskeletal injuries seen in both sport and everyday life. They range in severity from mild stretching (a grade one sprain) to a partial tear (grade two) or a complete rupture (grade three).
Which ligaments are most commonly injured?
The lateral (outer) ankle ligaments are damaged in the vast majority of ankle sprains. The anterior talofibular ligament (ATFL) is the most commonly injured, followed by the calcaneofibular ligament (CFL). These are typically injured when the foot rolls inwards — the classic “going over” on an ankle.
Less commonly, the deltoid ligament on the inside of the ankle (medial side) can be damaged, usually through a high-energy injury or in combination with a fracture.
Symptoms of ankle ligament damage
- Pain on the inside or outside of the ankle, often immediate after injury
- Swelling, bruising, and tenderness over the affected ligament
- Difficulty bearing weight in more severe injuries
- A feeling of instability or “giving way” in the ankle
- Persistent aching or recurrent sprains if the injury is chronic or incompletely healed
Diagnosing ankle ligament injuries
Most ankle ligament injuries can be assessed clinically, but imaging is often used to confirm the diagnosis and assess severity. Ultrasound is an excellent tool for visualising the lateral ankle ligaments in real time, and can identify tears, thickening, and fluid around the joint.
At Alton Pain Clinic, our consultant uses diagnostic ultrasound as part of the assessment process, allowing us to give you an accurate diagnosis quickly.
Treatment Options for Ankle Ligament Injuries at Alton Pain Clinic
Ultrasound-Guided Cortisone Injections for Ankle Ligament Injuries
An ultrasound-guided cortisone injection can be an effective treatment option for a chronic ankle ligament sprain to reduce inflammation, manage pain, and promote healing when conservative treatments have not provided sufficient relief. This procedure involves injecting a corticosteroid medication directly into the affected ligament or joint, using ultrasound imaging for precise placement of the needle.
Ultrasound-Guided PRP Injection for Ankle Ligament Injuries
For patients with persistent pain or recurrent instability that has not resolved with physiotherapy, platelet-rich plasma (PRP) injection offers a non-surgical option to support ligament healing. PRP uses growth factors from your own blood to stimulate tissue repair.
PRP is particularly suited to chronic or partial ligament injuries where there is ongoing degeneration rather than acute inflammation. It is injected directly into the damaged ligament under ultrasound guidance for precise placement.
How long does an ankle ligament injury take to heal?
Grade one sprains typically recover in one to three weeks with appropriate management. Grade two injuries often take four to eight weeks. Complete ruptures may take three to six months, and some patients with chronic instability experience symptoms for longer.
If you have had an ankle sprain that is not improving as expected, or if you experience recurrent sprains, it is worth seeking assessment.
What to expect during the procedure
- A consultation to review your symptoms and confirm HA is the right treatment for you
- Ultrasound assessment to visualise the joint and identify the optimal injection site
- The injection — typically completed in five minutes or less
- Aftercare advice, including guidance on activity levels and when to expect results
Some mild swelling or discomfort around the joint is normal for 24–48 hours after the injection. Most patients are able to return to light activity the same day.
This article is intended for informational purposes only and should not replace professional medical advice. If you are experiencing persistent symptoms, please consult a qualified clinician.
Frequently Asked Questions
What is the difference between a sprained ankle and a torn ligament?
A sprain is a general term for a ligament injury that can range from mild overstretching to a complete tear. A torn ligament specifically refers to a partial or complete rupture of the ligament fibres. The treatment approach depends on the severity.
Can you walk on a torn ankle ligament?
With a grade one or mild grade two sprain, most people can bear weight. With a more significant tear, walking may be painful or difficult. If you cannot bear weight at all, it is important to have the ankle assessed and imaged to rule out a fracture.
Can injection therapy help a ligament injury?
Yes — PRP injections can support healing in partial ligament tears and chronic ligament degeneration. Cortisone is not typically used for ligament injuries as it can have a weakening effect on connective tissue.