As you may very well know, you don’t have to be an elite athlete to experience a sprained ankle. You can pretty easily sprain your ankle stepping in a hole, stepping off a curb wrong, or just putting weight down on your foot at an awkward angle.

“An ankle sprain is basically damage to the ligaments that surround the ankle,” explains Caitlin Shaw, PT, DPT, a physical therapist at Hinge Health. It can be as minor as a slight stretch or as major as a full tear, but most ankle sprains are easily treatable with conservative measures, like over-the-counter pain medications, home exercises, and, occasionally, a course of physical therapy. 

Unfortunately, you can’t really prevent ankle sprains completely, but there's a lot you can do to lower your risk of experiencing one. Here’s what physical therapists recommend to take good care of your ankle strength, balance, and more.

Ankle Sprains: Common Causes

There can be many causes of ankle sprains, which is when your foot rolls onto its side and damages a ligament, which is a tough, fibrous connective tissue that connects the bones in your ankle, explains Dr. Shaw. Some of the most common causes include: 

• Losing your balance when walking or exercising on an uneven surface.

• Falling or tripping. “Sometimes you just take an awkward step, or trip going up stairs,” says Dr. Shaw.

• Playing a sport that requires cutting or jumping actions (think: trail running, basketball, tennis, football, or soccer).

Whatever the cause of an ankle sprain, there’s one commonality: If you’ve had one, you may be more likely to have another in the future. “Recurrent ankle sprains are common, mainly due to changes in your proprioception, or sense of balance,” explains Dr. Shaw. This may sound alarming, but it doesn’t have to be. In fact, if you’ve experienced an ankle sprain, you may be more likely to work on your ankle strength and balance to try and minimize your risk of experiencing one in the future. 

PT Recommended Tips to Help Avoid Ankle Sprains

Many people wonder how to prevent ankle sprains. While you can’t always prevent them, there’s a lot you can do to keep your ankles strong and healthy, says Dr. Shaw. Here are some tips. 

Warm up before exercise. “You want to prepare your muscles and ligaments for whatever activity is coming,” explains Dr. Shaw. A warmup that includes light aerobic activity along with a dynamic stretch or two will increase blood flow to your ankle area and increase your ankle’s range of motion. “Just like you mentally have to prepare for a test, you want to prepare your ankle for what’s to come. For example, if you’re going on a hike with uneven terrain, you’ll want to do balance exercises like standing on one leg to activate your ankle,” she says.

Watch your step. If you’re walking or running, it helps to watch where you’re going so you don’t step into a pothole or get side-swiped by uneven terrain. That said, you can’t really go around staring straight down at your feet, either. 

Wear shoes that fit you well. If you play any sports that involve cutting maneuvers — think soccer, football, basketball, or lacrosse — consider a high-top sneaker or cleat during those workouts, says Dr. Shaw. A 2020 review published in the Journal of Orthopedics, Trauma and Rehabilitation found that these shoes offer some protection against ankle sprains.

It’s also important to pick shoes with the right support for you. Everyone is different and you should always choose shoes that are comfortable for you personally, but people with low arches tend to gravitate toward shoes that provide support both in front and under the arch, says Dr. Shaw. If you have high arches, you could consider a shoe with more cushioning near the arch. Also remember — you can have the most supportive, cushioned sneakers in the world, but they won’t protect against a sprain if your shoelaces are untied. Keep those laces tied and close any Velcro to make sure your shoes are as supportive as possible.

Avoid overtraining. If you push yourself too hard, your entire body can fatigue — including your ankles. This in turn can impact your proprioception, or balance. “The message here is not to cut back on exercise, but rather to switch up your activities so you challenge your body in different ways,” Dr. Shaw explains. If you’re training for a 5K, for example, add in a cross- training session like biking or swimming to give your ankles a bit of a break while still staying active.

Above all, the number-one thing you can do to try and prevent ankle sprains is to keep your ankles strong and flexible, advises Dr. Shaw. This is supported by a 2022 review of 14 studies that found that exercise therapy for a sprained ankle was an effective way to reduce the risk of repeat sprains.

These ankle-strengthening exercises recommended by Hinge Health physical therapists are great for keeping your ankle and foot muscles strong. They also boost your balance to help prevent an ankle sprain from even occurring, notes Dr. Shaw. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

When to Treat a Sprained Ankle With Physical Therapy

Even if you have a seemingly minor ankle sprain, it’s still a good idea to do a short course of physical therapy to heal and help prevent another one. Usually, PT involves some or all of the following:

• Range-of-motion exercises to prevent stiffness 

• Strengthening exercises to strengthen the muscles and tendons in the front and back of your leg and ankle

• Balance training

• Endurance and agility exercises (once the worst of your pain has passed) 

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

PT Tip: Stand on a Pillow

Once you’ve mastered the single leg stance, you can take it up a notch by standing on a pillow. “Since it’s an unstable surface, it challenges your ankle more,” Dr. Shaw explains, which further strengthens your ankles and balance to help prevent future sprains. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Mugno, A. T., & Constant, D. (2020). Recurrent Ankle Sprain. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560619/

2. Kruckeberg, B. M., Beahrs, T., & Haddad, S. L. (2022, April). Sprained Ankle. OrthoInfo — American Academy of Orthopedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/sprained-ankle/

3. Herzog, M. M., Kerr, Z. Y., Marshall, S. W., & Wikstrom, E. A. (2019). Epidemiology of Ankle Sprains and Chronic Ankle Instability. Journal of Athletic Training, 54(6), 603–610. doi:10.4085/1062-6050-447-17

4. Wagemans, J., Bleakley, C., Taeymans, J., Schurz, A. P., Kuppens, K., Baur, H., & Vissers, D. (2022). Exercise-based rehabilitation reduces reinjury following acute lateral ankle sprain: A systematic review update with meta-analysis. PLOS ONE, 17(2), e0262023. doi:10.1371/journal.pone.0262023

5. Lai, J. H.-C., Ling, S. K., Cacho, P., Mok, S., & Yung, P. S. (2020). The effects of shoe collar height on ankle sprain mechanics in athletes: A review of literature. Journal of Orthopaedics, Trauma and Rehabilitation, 27(2), 221–230. doi:10.1177/2210491720950325

6. Trojian, T. H. (2006). Single leg balance test to identify risk of ankle sprains. British Journal of Sports Medicine, 40(7), 610–613. doi:10.1136/bjsm.2005.024356