History

• Pain on weight bearing and moving their ankle
• Swelling and tenderness anterior to lateral malleolus
• Effusion of blood (haematoma) with bruising and skin discolouration around and distal to the injury
• Ankle sprain may be accompanied by an audible snap, crack or tear, which, although often of great concern to the athlete and onlookers, has no particular diagnostic significance

Examination

• Assess the degree of instability present and the grade of ligamentous instability
• Palpate for bony tenderness
• Investigations
• X-ray
• CT, MRI or bone scan if persistent pain and disability despite appropriate treatment for four-six weeks.

Management

• Restricted weight bearing
• RICER regimen initially