This is by Xandah Hicks
If your ankle feels fine walking but keeps rolling when you run, jump or change direction, there is a good chance it has not fully recovered yet. Being pain-free is a positive step, but it does not necessarily mean your ankle is ready for sport.
After an ankle sprain, you can be left with reduced strength, balance, coordination or confidence around the ankle. These changes may not bother you during everyday activities, but can become obvious when you put the ankle under the higher demands of sport.
That is where rehabilitation comes in.
“But it doesn’t hurt anymore?”
We hear this a lot when people are deciding whether they are ready to return to sport.
Pain is only one part of the picture.
You might be able to walk, jog or even complete some training without pain, while still having:
- Reduced ankle strength
- Poorer single-leg balance and control
- Difficulty controlling the ankle during quick movements
- Less confidence when landing or changing direction
- Reduced ability to control the ankle when tired
- Difficulty handling repeated jumping or running loads
The demands of sport are very different from walking around the house or going to work.
A footballer might need to sprint, stop suddenly, change direction and land on one leg within a few seconds. A netballer may repeatedly jump, land and pivot. A rugby player might have their foot planted while the rest of their body is moving in another direction.
Your ankle needs to be ready for those demands.
Why does my ankle keep rolling?
An ankle sprain can affect the ligaments on the outside of the ankle. Depending on the injury, this can temporarily change how the ankle moves and how confidently you load it.
The muscles around your ankle also have a big job to do.
If your foot lands awkwardly or your ankle starts moving into a vulnerable position, those muscles need to react quickly. Your brain and nervous system also rely on information from your foot and ankle to help you control your position.
After an ankle sprain, these systems may not be working as well as they were before the injury.
You might notice that your ankle feels weak, wobbly or unreliable, particularly during sport.
This is one reason why simply resting until the pain settles may not be enough.
Rest can settle the ankle, but rehab rebuilds its capacity
A common pattern is:
Sprain the ankle → rest until it feels better → return to sport → ankle struggles with a high-demand movement → roll it again.
If your rehabilitation stops once you can walk without pain, you may not have progressed far enough.
The aim is not just to get your ankle feeling better. You need to gradually rebuild its ability to cope with the movements and loads you are going to put through it.
That means your rehab should get harder as you get better.
Your exercises need to progress
Early rehabilitation may involve fairly simple exercises. These are useful, but they should not necessarily be the exercises you are still doing several weeks later.
For some people, we might start with basic strength and control exercises such as:
- Double-leg calf raises
- Single-leg calf raises
- Resistance-band ankle movements
- Single-leg balance
- Controlled step-ups
Once these become easier, the challenge can increase.
This might include exercises such as:
- Single-leg calf raises from a step
- Split squats
- Single-leg Romanian deadlifts
- Step-downs
- Lateral step-downs
- Single-leg balance with reaching
These exercises ask more from the ankle while also involving the rest of the lower limb.
From there, you can start introducing faster and more dynamic movements. This is where rehabilitation starts to look more like the activities you need to perform in sport.
- Examples include:
Lateral lunges - Lateral step-ups
- Single-leg squats
- Skater squats
- Controlled lateral hops
- Single-leg landing drills
The exercise itself is only part of the picture. What matters more is whether the exercise is challenging you at the right stage of your rehabilitation.
What about jumping?
Jumping and landing are a big part of many sports, so they need to be introduced progressively as your ankle recovers. This is where plyometric exercises can be useful.
Plyometrics involve jumping, landing and producing force quickly. They allow you to gradually expose the ankle to the faster and higher loads it will experience during sport.
You might progress through exercises such as:
Double-leg pogo jumps → forward pogo jumps → lateral pogo jumps → line hops → single-leg hops → repeated single-leg jumps.
Landing drills can also be used, such as a jump-and-stick landing where you focus on controlling the landing before progressing to faster or repeated movements.
You do not need to jump straight into difficult single-leg exercises.
Start with movements you can control, then gradually increase the speed, height, distance or number of repetitions.
The aim is to give your ankle a chance to adapt rather than going from basic rehabilitation straight back into a full game.
Your rehab should eventually look like your sport
This is something we consider when progressing rehabilitation.
If your sport involves jumping, your rehab eventually needs to involve jumping.
If you need to sprint and change direction, those movements need to be progressively reintroduced.
For a field or court sport, this might eventually include:
- Running
- Accelerating
- Decelerating
- Cutting
- Lateral movement
- Jumping and landing
- Single-leg loading
- Repeated efforts when fatigued
You don’t need to jump straight from rehabilitation exercises into a full training session.
Instead, the demands can be built up gradually. For example, you may first work on controlled hopping before progressing towards repeated hops, running, change-of-direction drills and eventually sport-specific movements.
Does ankle strapping stop you from rolling it?
Ankle strapping can provide useful external support, particularly when returning to sport after an ankle injury.
But strapping should not replace rehabilitation.
Tape can provide support around the ankle, but it does not build the strength, balance and control you need to manage sporting movements yourself.
Think of strapping as an extra layer of support rather than the whole solution.
Your rehabilitation should still focus on building the capacity of the ankle and lower limb.
A physiotherapist can also help determine whether strapping or bracing is appropriate for you and how it fits into your return to sport.
Don’t forget the rest of the leg
When people think about an ankle sprain, they often focus only on the ankle.
Your calf, foot, knee and hip all contribute to how you control your body when you are running, landing and changing direction.
The calf muscles, for example, help produce force when you push off and control the ankle as your body moves over your foot.
That is why ankle rehabilitation can include exercises such as calf raises, split squats, single-leg deadlifts and lateral movements alongside more ankle-specific exercises.
The goal is to build a lower limb that can handle the demands you are asking of it.
Is balance training enough?
Balance exercises are useful, but standing on one leg is only one part of ankle rehabilitation.
There is a big difference between standing still on one leg and landing from a jump or changing direction at speed.
A simple progression might look like:
Single-leg balance → reaching → dynamic balance → hopping → landing → changing direction.
As your rehabilitation progresses, the exercises should become more similar to what you actually need to do in your sport.
How do I know if my ankle is ready for sport?
Being pain-free is a good sign, but it should not be the only thing you use to decide whether you are ready.
Your ankle also needs to demonstrate appropriate strength, control and tolerance for the activities your sport requires.
Depending on your injury and sport, your physiotherapist may look at things such as:
- Single-leg calf raise capacity
- Single-leg balance and control
- Hop testing
- Repeated hopping
- Landing control
- Lateral movement
- Running and acceleration
- Deceleration and change-of-direction drills
- Sport-specific drills
Another useful consideration is how your ankle responds afterwards.
You want to be able to gradually tolerate more training without a significant increase in symptoms.
Returning to sport is better viewed as a progression rather than a single “yes or no” test.
When should I see a physiotherapist?
It is worth having your ankle assessed if you:
- Keep rolling the same ankle
- Feel like your ankle is unstable or gives way
- Are unsure how to progress your rehabilitation
- Have returned to sport but don’t trust your ankle
- Have symptoms when jumping or changing direction
Still have swelling or pain
Are struggling to get back to your previous level of sport
A physiotherapy assessment can help identify what is still limiting your ankle and where your rehabilitation needs to progress.
At PhyxYou Physiotherapy in Port Macquarie, rehabilitation can progress from basic strength and balance work through to jumping, running and sport-specific loading.
The main takeaway
If you keep rolling your ankle, simply waiting for it to stop hurting or relying on strapping may not be enough. Your ankle may need more rehabilitation.
No pain does not automatically mean your ankle is ready for sport.
The later stages of rehabilitation should challenge your ankle with progressively greater strength, speed, jumping, landing and change-of-direction demands.
Start with the basics, build your strength and control, introduce plyometrics, then gradually work towards the movements your sport requires.
If you’re in Port Macquarie and your ankle keeps giving way, or you’re unsure whether it is ready to return to sport, book an assessment with PhyxYou Physiotherapy. We can assess your current capacity and help you work through the appropriate stages of rehabilitation.
