Ankle sprain: returning to sport step by step

Why it happens

Poorly placed landing, uneven ground, previous sprains, returning too early.

Coming back in four stages

1. 1

   Walking without limping on flat ground, 20 to 30 minutes.

2. 2

   Balance and strengthening exercises prescribed or approved by your physiotherapist.

3. 3

   Slow running in a straight line on flat ground, then slightly uneven ground.

4. 4

   Changes of direction and ball sports (tennis, football) last, in small touches.

Move on to the next stage after 2 sessions in a row with discomfort of 2 out of 10 or less and no pain the next day. Each stage usually lasts 1 to 2 weeks, depending on your healthcare professional’s advice. For an ankle sprain, add a simple test: hold 30 seconds balancing on the injured foot without discomfort before moving on.

Movements to postpone

• changements de direction et pivots from stage 4
• sauts from stage 4
• côtes et descentes from stage 3

Strengthening exercises

• Single-leg balance

  from stage 1 of the plan

  Stand 30 seconds on one foot, knee slightly bent. Then with eyes closed, then on a cushion or unstable surface.

  To start: 3 holds of 30 seconds per leg, every day.

  Variations, mistakes and progression

  Easier

  One hand on a chair, or the tip of the free foot on the floor.

  Harder

  Eyes closed, then on a cushion, then throwing a ball against a wall.

  Common mistakes

  • Knee straight and locked.
  • Looking at your feet instead of a point ahead.

  Moving on

  When you can hold 30 seconds without putting the other foot down, as on the healthy side.

• Toe raises

  from stage 1 of the plan

  Back to a wall, heels a few centimetres from it, lift your toes then lower slowly.

  To start: 3 sets of 15, slowly, once a day.

  Variations, mistakes and progression

  Easier

  Seated, lift the toes of both feet.

  Harder

  One foot at a time, or a band pulling forward over the top of the foot.

  Common mistakes

  • Pushing the hips back to help.
  • Letting the foot drop.

  Moving on

  When 3 × 20 causes no discomfort along the shin.

• Ankle eversion with band

  from stage 2 of the plan

  Seated, band around the forefoot, turn the foot outwards slowly then return over 3 seconds.

  To start: 3 sets of 15, slowly, once a day.

  Variations, mistakes and progression

  Easier

  No band, or a very light band.

  Harder

  Stronger band, then standing side steps with a band around the ankles.

  Common mistakes

  • Turning the leg instead of the ankle.
  • Letting the band snap back.

  Moving on

  When 3 × 20 is easy with the strongest band.

• Heel raises

  from stage 2 of the plan

  Standing, rise on both feet and lower slowly over 3 seconds. Keep the knee straight, then bent to work the other part of the calf.

  To start: 3 sets of 12, 3 seconds down, every other day.

  Variations, mistakes and progression

  Easier

  Seated on a chair, a light weight on your knees.

  Harder

  Heels over the edge of a step, to go lower.

  Common mistakes

  • Bouncing at the bottom instead of controlling the way down.
  • Rising higher on one side than the other.

  Moving on

  When 3 × 15 is easy with no discomfort the next day: move on to single-leg raises.

The doses are starting points. Stay at 2 out of 10 discomfort at most, during and the next day; otherwise switch to the easier version or go back to the previous exercise.

Rehab’s advice

Start on flat, stable ground. Avoid uneven trails and sudden changes of direction (tennis, football) at first.

What the Rehab plan does for this injury

The plan starts at 40% of your previous training volume and builds up to 90%, with a consolidation week every three weeks. If your discomfort reaches 5 out of 10, it stops and refers you to your doctor or physiotherapist.

In which sport?

• Trail runningResume on the flat first, then on smooth trail, before roots and rocks; keep single-leg balance in the programme.
• HikingStart on flat, even trails before rocks and roots; add support if your professional advises it.
• Inline skatingStart by rolling in a straight line, then add turns and braking.
• SkateboardingBegin with straight-line rolling, then add turns; avoid jumps before the last stage.
• TennisResume lateral movement slowly before fast rallies.
• PadelChanges of footing on sandy courts slip: resume slowly and choose a suitable sole.
• SquashResume lateral movement slowly before fast rallies.
• PickleballQuick changes of footing come last; start by staying near the net.
• Football (soccer)Resume footwork slowly on dry ground before duels and tackles.
• FutsalBegin without duels; quick footwork comes last.
• BasketballResume single-leg landings after simple footwork; add duels last.
• VolleyballWatch your landing under the net, where an opponent’s foot may be.
• HandballResume footwork before duels and jumps.
• HIITChoose stable floor exercises and add jumps last.
• KarateResume footwork slowly, barefoot on tatami, before jumping kicks.
• TaekwondoResume footwork slowly before jumping kicks and contact.
• SnowboardingChoose well-supported boots and avoid hard or icy terrain at first.
• SkatingChoose well-supported skates and start in a straight line, no jumps.