From Ankle Sprain to Running Again

Ankle sprains are the most common acute sport injury and also one of the most undertreated. Around 40% of people who sprain an ankle develop chronic instability - not because the original injury was severe, but because rehabilitation stopped too early. Here's how to do it properly.

Stage 1: Protecting the repair (Days 1-5)

The POLICE principle applies here: Protect, Optimal Loading, Ice, Compression, Elevation. Complete rest is no longer recommended. Early gentle weight-bearing is protective and speeds recovery. Ice for 15-20 minutes every two hours in the first 48 hours, compression bandaging, and elevation above heart level when possible.

Stage 2: Restoring range and strength (Days 5-14)

Once you can walk with minimal limp, begin calf raises, single-leg standing, and ankle alphabet exercises. The peroneal muscles on the outside of the ankle are always involved in a lateral sprain and need direct attention. Towel scrunches, resistance band work, and progressive single-leg loading are the focus.

Stage 3: Neuromuscular control (Weeks 2-4)

This is the phase most people skip - and it's why re-injury rates are so high. Balance and proprioception training on an unstable surface, tandem walking, lateral step-downs, and progression toward single-leg squat control all rebuild the automatic stabilisation that protects the ankle during sport.

Stage 4: Running and sport-specific loading (Weeks 4-6+)

Before returning to running, you should be able to: walk without pain, perform 20 single-leg calf raises without compensation, and balance on the injured leg for 30 seconds with eyes closed. Running is introduced gradually - straight-line jogging before any cutting or change of direction work.

Return to sport criteria

• Pain-free single-leg hopping - 10 consecutive hops at full effort
• Agility T-test within 10% of the uninvolved side
• Figure-8 running at full speed without pain or hesitation
• Confidence and no apprehension on uneven ground