Ankle sprains: understanding, treating, and preventing them – by Dr. Guillaume Coovi-Sirois, chiropractor at ABC Clinique Santé Chelsea–Gatineau

Ankle sprains are one of the most common injuries, both in sports and in everyday activities. Among the different types of sprains—medial, high, or lateral—lateral sprains are the most common. They occur when the ankle suddenly twists inward, causing the external ligaments to stretch or tear.

At ABC Clinique Santé Chelsea–Gatineau, chiropractor Dr. Guillaume Coovi-Sirois assesses and treats this type of injury to promote a quick, safe, and lasting recovery.

Anatomy and role of the ankle ligaments

The ankle is stabilized by several ligaments that hold the joint in place:

Inner side (medial): deltoid ligament

Outer side (lateral):

anterior talofibular ligament (ATFL)

calcaneofibular ligament (CFL)

posterior talofibular ligament (PTFL)

When the ankle rolls inward—a movement called “inversion”—these ligaments are stretched. The first to be affected is usually the anterior talofibular ligament. If the injury is more severe, the calcaneofibular ligament and then the posterior talofibular ligament may also be affected. The extent of the injury varies from a simple sprain to a complete tear. There are three grades of sprain, from mild to severe.

Diagnosis and assessment of severity: the importance of the Ottawa Rule

Before any treatment, it is essential to rule out a fracture or more serious injury.
To do this, professionals use the Ottawa Rule, a validated protocol for determining the need for an X-ray.

This assessment is based on:

• the inability to take four steps immediately after the accident or during the consultation
• pain when palpating key areas :
  • back of the malleoli
  • base of the 5th metatarsal
  • navicular bone

If any of these signs are present, imaging is recommended to rule out a fracture.

At ABC Clinique Santé Chelsea–Gatineau, chiropractor Dr. Guillaume Coovi-Sirois performs this comprehensive assessment to make an accurate and safe diagnosis.

Treatment and rehabilitation of ankle sprains

Once a fracture has been ruled out, treatment follows proven principles of musculoskeletal rehabilitation:

1. reduce pain and inflammation
2. restore mobility
3. strengthen the joint
4. rehabilitate proprioception
5. prevent recurrence

1. Gentle mobilization as soon as possible

As soon as pain allows, light movements are introduced to maintain range of motion and stimulate circulation.
An effective example is drawing the alphabet with your foot, as if your toes were holding a pencil.

2. Dorsiflexion stretch with towel

While seated, place a towel under your foot and gently pull toward you for 30 seconds.
Discomfort should remain moderate (3–4/10).

3. Strengthening with elastic band

Work in the four main directions:

• plantar flexion
• dorsiflexion
• inversion
• eversion

These exercises restore strength, stability, and control to the muscles and ligaments.

4. Proprioceptive training

A key step in preventing recurrence.
Key exercise: stand on one foot, then touch the ground at different points around you, like the points of a star.
This training improves balance, coordination, and ankle responsiveness.

Restoring function and preventing recurrence

An improperly treated sprain can lead to:

• chronic instability
• persistent pain
• loss of mobility
• a higher risk of injury

Gradual and controlled rehabilitation is therefore essential.
The chiropractor guides the patient through the stages of returning to activity, from strengthening to neuromotor work, to ensure optimal recovery.

For any sprain, it is recommended that you consult a qualified professional. At ABC Clinique Santé, our chiropractors will offer you a personalized treatment plan tailored to the severity of your injury and your goals.

Prompt, precise, and structured care allows for better, faster recovery and reduces the risk of recurrence.

Visit the clinic nearest you:

• Chiropractic – Chelsea Gatineau (secteur Hull)
• Chiropractic – Vaudreuil-Dorion
• Chiropractic – Mirabel
• Chiropractic – Valleyfield
• Chiropractic – Québec (Duberger-Les-Saules)
• Chiropractic – Boucherville
• Chiropractic – Trois-Rivières