Why Do I Keep Spraining the Same Ankle? | Physora Physio
Keep spraining the same ankle? Learn the causes, signs of chronic ankle instability, treatment options, and how physiotherapy can help prevent repeat sprains.
Paul Antony
9/14/20268 min read
Why Do I Keep Spraining the Same Ankle? Causes, Treatment & Prevention
Have you ever sprained your ankle, waited for the pain to settle, returned to your normal activities, and then somehow ended up rolling the same ankle again?
If this has happened more than once, it may be tempting to put it down to bad luck. But repeated ankle sprains can sometimes point to something more than bad luck. After an ankle injury, changes in strength, balance, movement control, and the way the ankle responds to sudden movements can remain even after the obvious pain and swelling have improved. In some people, this can develop into chronic ankle instability. (Martin et al., 2021; Gribble et al., 2016).
The good news is that recurrent ankle sprains can be assessed and treated. Understanding why your ankle keeps rolling is an important first step towards preventing the same cycle from happening again.
Why Does the Same Ankle Keep Spraining?
There isn't always one single reason. Several factors can contribute to repeated ankle sprains.
1. Your ankle may not have fully recovered from the first injury
An ankle sprain commonly affects the ligaments on the outside of the ankle. As the initial pain and swelling settle, it can feel as though the injury is completely behind you.
But recovery doesn't necessarily end when the pain disappears.
You may still have reduced ankle movement, weakness, balance problems, or difficulty controlling the ankle during more demanding movements. Clinical guidelines recommend assessing factors such as ankle range of motion, balance, previous sprain history, and functional movement when evaluating ankle sprains and chronic ankle instability. (Martin et al., 2021).
This is one reason someone can feel fine while walking on flat ground but notice their ankle becoming unstable when running, jumping, changing direction, or walking on uneven surfaces.
2. The muscles around your ankle may still be weak
Your ankle doesn't rely on its ligaments alone for stability.
The muscles around the lower leg and foot help control the position of your ankle as you move. Following an injury, these muscles may not be working at the same level as before.
This can become particularly important during activities where your foot has to react quickly — such as landing from a jump, changing direction during football or running over an uneven surface.
If the ankle doesn't have enough strength and control to respond to these demands, it may be easier for the joint to roll again.
3. Your balance and proprioception may have changed
There's another part of ankle recovery that is easy to overlook: proprioception.
In simple terms, proprioception is your body's ability to sense where a joint is positioned and how it is moving without you having to look at it.
Your ankle uses information from the muscles, joints and surrounding tissues to help your nervous system respond to changes in position. After an ankle sprain, this sensorimotor control can be affected.
That matters when your foot suddenly lands at an awkward angle.
A healthy ankle needs to recognise the change, react quickly, and help you regain control. If that response is reduced, the ankle may be more vulnerable to another sprain.
Research has found that balance and proprioceptive training can reduce ankle-sprain rates, including recurrent sprains in people with a previous injury (Schiftan et al., 2015).
4. Your ankle may have developed a pattern of “giving way”
Have you ever thought: “I don't really have pain, but I just don't trust this ankle.”
Or perhaps your ankle suddenly feels as though it is going to give way when you're walking, running, or stepping off a kerb.
That feeling is important. Repeated episodes of the ankle giving way, particularly alongside a history of previous sprains, can be a sign of ongoing ankle instability. Chronic ankle instability is recognised as a condition in which instability complaints can continue after the original ankle sprain. (Martin et al., 2021).
Could You Have Chronic Ankle Instability?
Chronic ankle instability (CAI) is a term used when ankle problems continue following an earlier sprain, particularly when someone experiences recurrent sprains or a persistent sensation of the ankle giving way.
It isn't simply another name for having had an ankle sprain.
The important distinction is that the ankle continues to have problems after the original injury, affecting confidence, movement, or activity.
There can be both mechanical and functional factors involved.
Mechanical factors
The ligaments may have been stretched or injured during the original sprain, potentially affecting the physical stability of the joint.
Functional factors
The ankle may also have problems with strength, balance, coordination, or sensorimotor control.
These two aspects can overlap. That's why an assessment shouldn't focus only on whether the ligament feels loose. Looking at how the person actually moves and controls the ankle is also important. Current clinical guidelines recommend functional and sensorimotor assessment for people with chronic ankle instability. (Martin et al., 2021).
If your ankle repeatedly rolls or gives way, that doesn't automatically mean you have chronic ankle instability. A proper assessment is needed to understand what's happening in your individual case.
Why Rest Alone May Not Fix a Repeatedly Sprained Ankle
Rest has an important role after an injury.
If your ankle is painful and swollen, reducing the activities that aggravate it can allow the initial symptoms to settle.
The problem comes when rest is the entire rehabilitation plan.
You can wait until the pain disappears without necessarily rebuilding the strength, balance, and movement control needed for your usual activities.
Think about it this way: Pain settling is one milestone. It isn't necessarily the finish line.
If you want to return to running, football, hiking, or another demanding activity, your ankle needs to be prepared for those specific demands.
That is why rehabilitation after an ankle sprain often includes progressive exercise, balance work, and functional activities rather than relying on rest alone. The 2021 clinical practice guideline supports impairment-focused exercise and functional rehabilitation for ankle sprains and chronic ankle instability. (Martin et al., 2021).
How Can Physiotherapy Help With Chronic Ankle Instability?
The first step isn't simply giving you a list of ankle exercises. A good rehabilitation programme starts by understanding why your ankle keeps giving way.
At Physora Physio, an assessment can consider your previous injuries, symptoms, goals, and the activities that challenge your ankle.
Depending on what the assessment finds, rehabilitation may include:
Restoring ankle movement
Stiffness after an ankle sprain can affect how you walk, run and load the joint.
Restoring appropriate range of movement can be an important part of getting the ankle moving normally again.
Building strength
Progressive strengthening can target the muscles around the ankle and lower limb.
The aim isn't simply to make one muscle stronger. It's to improve the ankle's ability to tolerate and control the loads placed on it during everyday activities and sport.
Improving balance and control
Single-leg balance is often used as part of ankle rehabilitation, but rehabilitation can progress far beyond simply standing on one leg.
Exercises can become more challenging by introducing movement, unstable or changing conditions, reaching, jumping, landing, and other tasks relevant to the person's goals.
Clinical guidelines specifically recommend assessing single-leg balance and dynamic balance in people with ankle sprains and chronic ankle instability. (Martin et al., 2021).
Retraining the ankle for real-life movement
Your ankle doesn't only work when you're standing still.
If you're a runner, your rehabilitation needs to eventually prepare you for running.
If you play football, you may need to prepare for acceleration, deceleration, jumping and changes of direction.
If your main concern is everyday life, rehabilitation can focus on activities such as walking, stairs and uneven surfaces.
The goal is to bridge the gap between rehabilitation exercises and the activities you actually want to return to.
How Do You Stop Spraining the Same Ankle?
There isn't one exercise that guarantees you will never sprain your ankle again.
But there are several things that can help reduce the risk of another injury.
Don't stop rehabilitation just because the pain has gone
If your ankle still feels weak, unstable, or difficult to trust, don't assume that you're automatically ready for every activity.
Rebuild strength progressively
Your ankle and lower limb need to be able to handle the demands you place on them.
Train balance and movement control
Balance and proprioceptive training have evidence supporting their use in reducing recurrent ankle sprains. One systematic review and meta-analysis found that proprioceptive training reduced recurrent ankle-sprain risk in people with a previous history of ankle sprain. (Schiftan et al., 2015).
Progress towards your actual activity
Someone returning to five-a-side football may need very different preparation from someone whose goal is simply to walk confidently on uneven ground.
Your rehabilitation should reflect your goals.
Don't use pain as your only return-to-activity test
Feeling comfortable at rest is useful information, but it doesn't tell you everything about how your ankle will perform under load.
Strength, balance, and functional performance can also be assessed when deciding whether you're ready to progress. (Martin et al., 2021).
Do You Need an Ankle Brace?
An ankle brace or taping may sometimes be useful, particularly during higher-risk activities or while someone is returning to sport.
But a brace shouldn't automatically be viewed as the complete solution. External support can be one part of an overall management plan, while rehabilitation focuses on improving the ankle's own strength, control and function. The best approach depends on the individual, their injury history and their activity demands.
If you're unsure whether a brace would be useful for you, a physiotherapy assessment can help determine what support is appropriate.
Frequently Asked Questions
Is it normal to sprain the same ankle multiple times?
It is relatively common for people to experience recurrent ankle sprains, but repeated sprains shouldn't simply be dismissed as something you have to live with. Recurrence can be associated with ongoing ankle instability and may warrant a more detailed assessment and rehabilitation plan. (Gribble et al., 2016).
Why does my ankle keep rolling when I walk?
Repeated ankle rolling can have several causes, including reduced strength, balance difficulties, altered movement control or ongoing instability following a previous sprain. If it is happening repeatedly, an assessment can help identify which factors may be contributing.
How do you fix chronic ankle instability?
Treatment depends on the individual, but rehabilitation commonly focuses on improving ankle and lower-limb strength, balance, sensorimotor control, movement and functional performance. Clinical practice guidelines support exercise-based rehabilitation and functional assessment for chronic ankle instability. (Martin et al., 2021).
Can physiotherapy fix a weak ankle?
Physiotherapy can help improve strength, balance and movement control following an ankle injury. The exact programme depends on what is causing the weakness or instability and what activities you want to return to.
What exercises can help stop ankle rolling?
Exercises may include progressive strengthening, single-leg balance, dynamic balance and sport- or activity-specific drills. The right exercises depend on your current ability and the stage of recovery, so simply copying an advanced exercise from the internet isn't always appropriate.
Don't Keep Starting the Same Recovery Again
If you've sprained your ankle several times, it can be easy to think:
“That's just my bad ankle.”
But repeated injury can be a sign that something in the ankle's strength, balance, movement or stability still needs attention.
You don't necessarily need to stop everything or avoid the activities you enjoy.
The first step is understanding what is actually contributing to the repeated sprains.
At Physora Physio in Neath, an assessment can look at how your ankle moves and functions, what activities cause it to give way, and what you need to get back to whether that's running, sport, hiking or simply feeling confident on your feet.
If your ankle keeps rolling, don't just keep waiting for the next sprain. Find out why.
References
Martin, R. L., Davenport, T. E., Fraser, J. J., Sawdon-Bea, J., Carcia, C. R., Carroll, L. A., Kivlan, B. R., & Carreira, D. (2021). Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. Journal of Orthopaedic & Sports Physical Therapy, 51(4), CPG1–CPG80.
Gribble, P. A., Bleakley, C. M., Caulfield, B. M., Docherty, C. L., Fourchet, F., Fong, D. T. P., Hertel, J., Hiller, C. E., Kaminski, T. W., McKeon, P. O., Refshauge, K. M., Verhagen, E. A., Vicenzino, B. T., Wikstrom, E. A., & Delahunt, E. (2016). 2016 consensus statement of the International Ankle Consortium: Prevalence, impact and long-term consequences of lateral ankle sprains. British Journal of Sports Medicine, 50(24), 1493–1495.
Schiftan, G. S., Ross, L. A., & Hahne, A. J. (2015). The effectiveness of proprioceptive training in preventing ankle sprains in sporting populations: A systematic review and meta-analysis. Journal of Science and Medicine in Sport, 18(3), 238–244.
Postle, K., Pak, D., & Smith, T. O. (2012). Effectiveness of proprioceptive exercises for ankle ligament injury in adults: A systematic literature and meta-analysis. Manual Therapy, 17(4), 285–291.
van der Wees, P. J., Lenssen, A. F., Hendriks, E. J. M., & Stomp, D. J. (2006). Effectiveness of proprioceptive training for ankle sprains: A systematic review. Clinical Rehabilitation, 20(10), 846–854.
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