Ankle Ligaments

What are ankle ligaments?

Your ankle ligaments are firm bands of fibrous tissue that connect your foot bones (talus and calcaneus) with your lower leg bones (tibia and fibula). The ligaments of the ankle help keep your bones in the proper position and help stabilize your ankle joint. They also prevent your ankle from twisting or collapsing.

Without ankle ligaments, you wouldn’t be able to stand, walk or run. Located on both sides of your ankle, they help absorb the shock of any movements you make. If you develop any pain in your ankle ligaments, it’s important to see a healthcare provider for prompt diagnosis and treatment.

How many ligaments are in the ankle?

There are three main sets of ligaments in your ankle. They all surround and support the different parts of your ankle to keep your body moving properly.

Medial ligaments

Also known as the deltoid ligaments, these are located at the inner side of your ankle. They start at the medial malleolus (the end of the tibia), which forms the bump on the inside of your ankle. Then, they fan out to connect to your talus, calcaneus and navicular bones. The four main medial ligaments are:

• Anterior tibiotalar ligament (ATTL)
• Posterior tibiotalar ligament (PTTL)
• Tibiocalcaneal ligament (TCL)
• Tibionavicular ligament (TNL)

Lateral ligaments

The lateral ligaments are located at the outer side of your ankle. They start at the lateral malleolus (the end of the fibula), which forms the bump on the outside of the ankle. Then, they connect to your talus and calcaneus bones. The three main lateral ligaments are:

• Anterior talofibular ligament (ATFL)
• Calcaneofibular ligament (CFL)
• Posterior talofibular ligament (PTFL)

Syndesmotic ligaments

The syndesmotic ligaments connect your tibia and fibula bones. The five main syndesmotic ligaments are:

• Anterior inferior tibiofibular ligament (AITFL)
• Posterior inferior tibiofibular ligament (PITFL)
• Inferior transverse ligament (ITL)
• Transverse tibiofibular ligament (TTFL)
• Interosseous ligament (IOL)

What is the purpose of the ankle ligaments?

While you probably don’t think about them much, your ankle ligaments have several important jobs. They:

• Absorb shock when your foot strikes a surface
• Connect the bones of your foot with the bones in your lower leg
• Keep your bones in the proper position
• Prevent your ankle from twisting, folding or collapsing
• Stabilize your ankle joint (formed by your lower leg bones and your talus)
• Stop your ankle from moving in any unsafe or unnatural directions

What are ankle ligaments made of?

Ankle ligaments are made of strong, cord-like connective tissue that contains:

• Collagen, a protein that binds tissues
• Slightly stretchy elastic fibers

Where are the ankle ligaments located?

You have ankle ligaments throughout your foot, ankle and lower leg. They connect certain bones:

• Calcaneus (heel bone)
• Fibula (calf bone)
• Navicular (a bone on the top of your foot)
• Talus (ankle bone)
• Tibia (shin bone)

Can I injure an ankle ligament?

You can injure an ankle ligament when it moves in the wrong direction, stretches too far or tears. A ligament injury is called a sprain.

A sprained ankle is a very common injury. It happens to people of all ages and levels of health. An ankle sprain usually occurs when someone twists their ankle. For example:

• Falling or almost falling
• Having someone step on your foot, forcing it into an unnatural position
• Playing sports that require rolling your foot or cutting back and forth in different directions quickly (like basketball, soccer and tennis)
• Walking or running on uneven surfaces (like a trail)

How can a healthcare provider tell if I’ve injured an ankle ligament?

If you think you have a sprained ankle, a healthcare provider may:

• Ask you about your symptoms and when they started
• Conduct a physical exam by looking at your injured ankle, assessing how it moves and comparing it to your other ankle
• Take X-rays to rule out a broken bone or other problems
• Order other imaging tests, like an MRI, if your pain isn’t improving

How can I prevent ankle ligament injuries?

You can’t prevent all ankle injuries, but you can take steps to keep your ankle ligaments safer, especially during physical activity. Steps you can take include:

• Avoid uneven surfaces, which can cause you to roll or twist your ankle.
• Improve your flexibility and balance. Doing so helps train your body to react to missteps or stumbles without putting pressure on your ankles.
• Stretch often for better flexibility, and practice standing on one foot for balance.
• Strengthen your ankles with physical motions like standing heel raises, squats, squat jumps and lunges.
• Strengthen your core to help your body react and change direction safely when it needs to.
• Maintain a healthy weight for you to put less pressure on your ankles.
• Mix up your physical activity routine, combining weight training and aerobic activities (cardio).
• Warm up before you participate in any physical activity, increase intensity gradually and then stretch afterward.
• Wear shoes that fit well.