Medial Sprains: Causes & Treatments

medial ankle sprain

Medial Ankle Sprains: A Pain in the Ankle

Ankle sprains are one of the most common orthopedic injuries. In fact, more than 20,000 ankle sprains occur each day in the United States.

While most people think of sprains on the outer side of the ankle, medial ankle sprains—affecting the inner side—are less common but can be tricky.

In this article, we’ll discuss: 

  1. What are medial ankle sprains?
  2. How medial ankle sprains differ from other ankle sprains
  3. What causes medial ankle sprains
  4. Treatments for medial ankle sprains
  5. Physical therapy for medial ankle sprains

What Are Medial Ankle Sprains?

Medial ankle sprains happen when the ligaments on the inner side of the ankle—specifically the deltoid ligament—are stretched or torn, usually due to a forceful twisting motion.

These sprains are less common than the typical lateral ankle sprain, making up only about 5% of all ankle sprains. Despite being less frequent, they can be quite painful and challenging to recover from.

How Medial Ankle Sprains Differ

Medial ankle sprains differ from the more common lateral ankle sprains in both the mechanics of the injury and the ligaments involved.

– Injury Mechanics

While lateral ankle sprains typically occur when the foot rolls inward (inversion), medial ankle sprains happen when the foot twists outward (eversion), causing the heel to face away from the other foot.

This movement stretches or tears the deltoid ligament, which is located on the inner (medial) side of the ankle.

– Deltoid Ligament Involvement

The deltoid ligament is thicker and stronger than the ligaments on the outer side of the ankle, which makes medial sprains less common but often more severe.

This ligament plays a critical role in stabilizing the ankle during movement, so an injury here can result in prolonged recovery and greater instability compared to lateral sprains.

 

Causes of Medial Ankle Sprains

The simplest reason is that the majority of medial ankle injuries occur as a result of physical sports such as football, basketball, and soccer that involve a lot of jarring landings.

Other causes include:

  • Sudden changes in direction during sports like football, basketball, or soccer
  • Collisions with other players that force the foot outward
  • Tripping on uneven ground or missing a step
  • Slipping on wet or unstable surfaces
  • Having poor ankle stability or a history of ankle injuries
Men are more likely to experience medial ankle sprains.

Interestingly, men are about three times more likely to experience medial ankle sprains than women, often due to higher participation in sports that involve sudden direction changes or awkward landings.

 

Treatment and Recovery

If the sprain occurs in conjunction with an ankle fracture, it does not need to be surgically repaired.

If the sprain is severe and there is no fracture, you will be advised to:

  • Avoid putting weight on the ankle for some time
  • Wear a boot or a cast
  • Keep the weight off the injured ligament

Such protective measures should allow the ankle to heal on its own.

You may have to wear the boot for five or six weeks and will only be allowed to put weight on the ankle as symptoms allow.

Surgery is generally not required.

Physical Therapy Rehabilitation

A well-structured rehabilitation program is key to recovering from a medial ankle sprain.

Physical therapy plays a crucial role in helping to restore strength, flexibility, and stability to the injured ankle.

– Early-Stage Physical Therapy

During the initial phase of rehabilitation, the focus is on:

  • Reducing Swelling and Pain: Therapists may use ice, compression, and elevation techniques to control inflammation, along with gentle range-of-motion exercises to keep the ankle mobile.
  • Improving Range of Motion: Gentle stretches and mobility exercises are introduced to prevent stiffness and ensure the ankle maintains its normal range of motion as healing begins.
  • Strengthening and Stability Training: As the ankle heals, the rehabilitation program moves into a more active phase:
    • Strengthening Exercises: Targeted exercises focus on strengthening the muscles around the ankle, particularly the calves and supporting ligaments, to improve joint stability.
    • Balance and Proprioception Training: Exercises designed to improve balance and proprioception (your body’s sense of position) help retrain the ankle to respond to uneven surfaces and sudden movements, reducing the risk of future sprains.
– Return to Activity

In the final stage of rehabilitation:

  • Gradual Return to Sports and Daily Activities: Your physical therapist will create a progressive plan that carefully increases activity intensity, ensuring you can safely return to your usual routines or sports without risking re-injury.

With consistent effort and guidance, you can expect a full recovery and a stronger, more resilient ankle.

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Schedule your appointment today with The Jackson Clinics at one of our 18 convenient locations throughout Northern Virginia.