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Although sprains of the lateral collateral ligaments of the ankle are extremely common, controversy still exists over the proper treatment. Some authors recommend early mobilization of the ankle, others recommended cast immobilization for 1–6 weeks, and others insist that sprains should be treated with primary surgical repair. A critical appraisal of the literature supports the concepts of early mobilization with a proper rehabilitation program. The review of treatment is followed by a discussion of the potential causes of persistent pain and functional instability.