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Returning To Sport After Ankle Injury

Ankle sprains. We’ve all had them, and statistically, many of us will re-injure the same ankle in the future. Simple ankle sprains can continue to inhibit activities years after the injury.  

Research suggests that lateral ankle sprains have a relatively high rate of recurrence. It is estimated that approximately 40-70% of people who have experienced an initial lateral ankle sprain may go on to experience another sprain at some point in the future. Recurrence rates tend to be highest within the first year after the initial injury.

Several factors contribute to the increased risk of recurrence, including:

  1. Inadequate Rehabilitation: Failure to properly rehabilitate the ankle after the initial sprain can lead to residual weakness, instability, and altered movement patterns, increasing the risk of subsequent sprains.

  2. Anatomical Factors: Certain anatomical factors, such as a naturally unstable ankle joint or a history of previous ankle injuries, can predispose individuals to recurrent sprains.

  3. Poor Proprioception and Balance: Impaired proprioception (the body's awareness of its position in space) and balance deficits can contribute to recurrent ankle sprains. Proprioceptive training and balance exercises are often prescribed as part of ankle sprain rehabilitation.

  4. Insufficient or Inappropriate Footwear: Wearing inappropriate footwear or footwear without adequate support can increase the risk of ankle sprains and subsequent recurrences.

  5. Return to Activity Too Soon: Returning to physical activity or sports too quickly without allowing sufficient time for complete healing and rehabilitation increases the chances of re-injury.

We spoke to sports podiatrist Ryan Quintano, of Sutherland Sports Podiatry about why some individuals struggle when getting back to running after an ankle sprain.  Ryan explains, "Once a fracture has been ruled out,  a common issue I see when with individuals trying to return to running is not at the torn ligament itself, but rather other surrounding structures at the ankle such as the peroneal tendon which helps stabilise and move the ankle joint.  The tendon can be damaged in the initial injury, or can simply be affected by the local swelling which results in increased stress on the tendon.  Returning to running and jumping can then result in tendon pain which slows the return to sport".

In physiotherapy there are some key tests that indicate if you are ready to return to sport safely. These tests are broken up into strength/endurance, mobility, and stability.

  • Calf endurance

A comparative single leg heel raise between the injured side and the non-injured limb is used to help assess strength and endurance deficits. We like our runners to achieve 30-50reps on each leg and have less than 20% deficit before returning to running activities.

  • Knee to wall test

This test is to assess the limitation of ankle mobility into dorsiflexion. Ideally, the injured leg should be within 2cm of the unaffected side and we hope to achieve a score between 8cm – 12cm of movement.


  • Star Excursion Balance Test

This balance test is to assess balance and proprioception (your ability to know where your body is in space). Poorer scores correlate to increased chance of re-injury


  • Lateral Hop test.

The lateral Hop test is used to assess power, balance and stability. We compare the time it takes to complete 10 hops (one hop = over and back) over a 30cm distance.


Although an individual’s return to sport is dependent on many factors, we work to ensure all our ankle sprain patients complete these tests successfully before returning to sport. This reduces the risk or re-injury and ankle problems in the future.

At Eastside Physio + Co, we are committed to delivering the best care to the locals of Surrey Hills and its neighbouring areas. Our skilled and experienced surrey hills physios​ are dedicated to supporting the well-being of our clients, who come from a variety of nearby suburbs, including AshwoodAshburtonAuburnBalwynBlackburnBox HillBurwoodCamberwellCanterburyDoncaster and Hawthorn

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