A lateral ankle sprain is sometimes dismissed as a minor injury that will simply settle. Months later, the ankle may still give way, feel unreliable on uneven ground or be sprained again. This pattern can fit chronic ankle instability, but a fresh examination is needed to identify what remains limited.
It is more than a “loose ligament”
Ligament laxity can contribute, but strength, dynamic balance, neuromuscular control, rapid reactions and confidence may also be reduced. Two people with similar imaging can function very differently. The ankle-sprain clinical practice guideline recommends an individual assessment and progressive rehabilitation.
The ankle should be tested in tasks relevant to the person: walking, running, landing and changing direction. A feeling of giving way does not establish by itself which tissue is at fault.
Balance is useful, and it is only one part of recovery
A 2024 meta-analysis reported improvements in patient-reported function and several balance-test directions after balance training. A second synthesis also supports combined strength and balance work. These findings do not mean every session has to take place on a wobble cushion.
- Rebuild calf and whole-leg strength.
- Practise absorbing landings, hopping and repeated jumps.
- Progress running speed, braking and changes of direction.
- Train quick responses to unexpected movements and surfaces.
For a trail runner this may mean fast foot placement on uneven terrain. For a team-sport player, landing under pressure. For a BMX rider, stable foot contact with the pedal and control on landing. Exercises should progressively reflect the sport.
When should another injury be considered?
Persistent pain or unusual swelling, locking or a course that does not fit an ordinary sprain deserves reassessment. Depending on the findings, a clinician may consider cartilage damage, a syndesmosis injury, tendon problems, impingement or a missed fracture. MRI is not needed automatically after every recurrent sprain; it is useful when the examination suggests associated injury or the result may change management.
The relevant question is whether the ankle can handle the load the person wants to place on it. Sports physiotherapy in Basel can assess function and guide a return to sport. Book an appointment.
Frequently asked questions
Why does my ankle give way months after a sprain?
Ligament laxity, balance and strength deficits, impaired neuromuscular control and loss of confidence can combine. Persistent symptoms deserve reassessment.
Are wobble-board exercises enough for an unstable ankle?
They can help balance, but sport also calls for strength, speed, landings, reactions and changes of direction.
Do recurrent ankle sprains always require MRI?
No. Imaging may be appropriate with persistent pain, unusual swelling, locking, suspected associated injury or an atypical recovery.
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