Ankle Sprains: Why They Are Underestimated and How They Can Hinder Your Return to Sport
Ankle sprains are one of the most common injuries among athletes and active individuals, but often, they are significantly underestimated. While the initial pain and swelling may subside with rest and basic treatment, the long-term effects of an ankle sprain—if not properly managed—can hinder your ability to return to sport and even lead to chronic issues. Many individuals overlook the importance of rehabilitation and mistakenly assume that once the pain is gone, they can resume their normal activities. However, failing to fully address an ankle sprain can have lasting consequences, including recurring injuries and long-term instability.
What is an Ankle Sprain?
An ankle sprain occurs when the ligaments surrounding the ankle joint are stretched or torn, typically as a result of an unnatural twist or force applied to the ankle. The most common type of ankle sprain is an inversion sprain, where the foot turns inward, injuring the ligaments on the outside of the ankle. Ankle sprains can vary in severity, from mild strains to complete ligament tears.
While many ankle sprains are considered “minor” injuries, they can lead to more significant complications if not properly managed. Unfortunately, the perception that an ankle sprain is a relatively “harmless” injury often leads to inadequate care and delayed rehabilitation.
Why Are Ankle Sprains Often Underestimated?
Ankle sprains are often viewed as a routine, short-term injury with no long-term consequences. The reality, however, is that they can have lasting effects on both the ankle joint and the surrounding tissues. Here are some reasons why ankle sprains are frequently underestimated:
Initial Symptoms May Be Mild: After an ankle sprain, many people experience immediate pain, swelling, and bruising, but these symptoms often improve relatively quickly with basic treatment such as rest, ice, and elevation. When the acute symptoms subside, it can be tempting to think the injury is “healed,” leading to premature activity resumption.
Lack of Awareness About Long-Term Risks: Many athletes and active individuals focus on the short-term recovery process and fail to recognize that a poorly rehabilitated ankle sprain can lead to chronic issues like instability, weakness, and an increased risk of reinjury.
Rehabilitation is Overlooked: A significant factor contributing to underestimating ankle sprains is the lack of proper rehabilitation. While resting the injured ankle and applying ice can manage the initial symptoms, rehabilitation exercises to restore strength, flexibility, and proprioception (the ability to sense the position of the body in space) are often neglected or skipped. These exercises are vital for restoring function and preventing future problems.
How Ankle Sprains Can Hinder Your Return to Sport
While ankle sprains may seem like a minor setback, improperly managed injuries can lead to long-term issues that affect athletic performance and increase the likelihood of re-injury. Here’s how an ankle sprain can hinder your return to sport in the long run:
1. Chronic Ankle Instability
One of the most common long-term complications of ankle sprains is chronic ankle instability. This occurs when the ligaments in the ankle become weakened or overstretched after an injury, causing the ankle to feel unstable or "give way" during physical activities. This can lead to repeated sprains, and the constant instability can disrupt your ability to perform well in sports.
Chronic instability can also affect your confidence in your ankle's ability to handle certain movements, leading to compensations that may cause other injuries in the body. Proper rehabilitation and strengthening are essential to prevent chronic instability.
2. Reduced Strength and Endurance
After an ankle sprain, the muscles and ligaments around the joint may become weak and deconditioned, making it more difficult to return to full athletic performance. If the ankle hasn’t fully regained its strength, agility, and stability, you may find that your speed, jumping ability, and overall performance are compromised.
It’s important to strengthen the muscles surrounding the ankle to provide support during physical activities. Weakness in the ankle can also place increased strain on other joints, such as the knees or hips, potentially leading to new injuries.
3. Proprioception Deficits
Proprioception refers to your body’s ability to sense the position and movement of your joints, and it is essential for balance and coordination. After an ankle sprain, proprioception is often impaired, leading to difficulties with tasks that require agility, such as changing direction quickly or maintaining balance during dynamic movements.
If proprioception is not fully restored, athletes may have a higher risk of re-injury and may find it difficult to perform sport-specific movements effectively. Balance and proprioception exercises, often integrated into physiotherapy rehabilitation programs, are key to restoring full function to the ankle.
4. Fear of Re-injury
For many athletes, the fear of reinjuring the same ankle can be a psychological barrier to returning to sport. The body may subconsciously limit movement to avoid the pain associated with re-injury. This fear often leads to compensatory movement patterns that not only affect performance but also place undue stress on other joints.
Psychological readiness plays a crucial role in returning to sport after an ankle sprain. It’s important for athletes to rebuild confidence in their ankle’s ability to perform, which is often facilitated through gradual reloading, sport-specific drills, and guidance from a physiotherapist.
5. Increased Risk of Future Injuries
An ankle sprain that is not fully rehabilitated increases the likelihood of future injuries—not only to the ankle but also to other areas of the body. The body may compensate for an unstable or weak ankle by altering movement patterns, which can increase stress on the knees, hips, or lower back. Over time, this compensation can lead to new injuries and further complications.
The Importance of Proper Rehabilitation
Returning to sport after an ankle sprain requires more than just resting and icing the injured joint. Proper rehabilitation is essential for a safe and effective return to physical activity. The key elements of rehabilitation include:
Range of Motion and Flexibility: Restoring flexibility and range of motion in the ankle is crucial to avoid stiffness and ensure that the joint can handle the demands of sport.
Strengthening Exercises: Strengthening the muscles surrounding the ankle, including the calves, peroneals, and tibialis muscles, is essential to provide stability and support during movement.
Balance and Proprioception: Working on balance through exercises like standing on one leg, using a balance board, or performing agility drills can help restore proprioception and prevent future sprains.
Gradual Return to Sport: A phased approach to returning to sport is essential to prevent re-injury. This includes progressing from low-impact activities like cycling or swimming to more intense sport-specific drills before fully returning to competition.
When to Seek Professional Help
If you’ve suffered an ankle sprain, it’s important to seek professional help to ensure that you fully recover and reduce the risk of long-term complications. A physiotherapist can design a rehabilitation plan that addresses the specific needs of your injury and sport. They can also guide you through the process of gradually returning to sport, ensuring you’re both physically and psychologically ready.
If you experience any of the following signs, it may be time to consult a healthcare provider:
Persistent pain, swelling, or instability after the initial recovery period.
Difficulty with balance or proprioception.
Recurrent sprains or injuries to the same ankle.
Conclusion: Don’t Underestimate the Impact of Ankle Sprains
Ankle sprains, though common, should never be underestimated. Even seemingly minor sprains can lead to long-term consequences that affect athletic performance and increase the risk of further injuries. A proper rehabilitation program is essential not just for recovery, but also for preventing chronic instability and ensuring a safe return to sport.
If you’ve experienced an ankle sprain, don’t rush back into activity too soon. Seek professional help from a physiotherapist, who can guide you through a tailored rehabilitation program and help you return to sport stronger, more stable, and better equipped to avoid future injuries.
Reference: CNA, Ankle Sprains
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