Cohen Health & Performance shares why playing through minor ankle sprains can lead to a bigger, recurring injury.
This article is shared by Dr. Zachary Cohen through DC Soccer Club's partnership with Cohen Health & Performance. Cohen Health and Performance is a sports physical therapy and performance training company that specializes in helping athletes get back in the game and excel on the field, with offices located in Bethesda and Mclean.
Ankle sprains are one of the most common injuries athletes deal with, especially during the fall sports season.
A player rolls their ankle, feels some pain, maybe notices a little swelling, and is back on the field a few days later.
Because they can walk and the pain has improved, it can be tempting to assume the injury is no big deal.
But even a mild ankle sprain can change how your ankle functions.
And if you don’t properly restore strength, stability, and your ability to control the joint, that “minor” sprain can become the first step toward a much bigger problem.
What Actually Happens When You Sprain Your Ankle?
Most ankle sprains involve the ligaments on the outside of the ankle.
These ligaments help provide stability and give your nervous system information about where your ankle is in space. When they are injured, you can lose some of that stability and your ability to accurately sense the position of the joint.
This is one reason athletes can feel better before their ankle is truly ready for the demands of their sport.
Pain may decrease relatively quickly, but that doesn’t necessarily mean you’ve restored everything you need to sprint, jump, land, cut, and react.
That’s where proper rehabilitation becomes important.
The Problem With Simply Waiting for the Pain to Go Away
One of the biggest mistakes we see after an ankle sprain is using pain as the only measure of recovery.
If the ankle doesn’t hurt anymore, an athlete may assume they are ready to return to their normal training.
But there is more to returning to sport than being pain-free.
You also need to consider:
- Ankle strength
- Balance and proprioception
- Joint stability
- Ability to absorb and produce force
- Landing mechanics
- Single-leg control
- Running and cutting ability
- Confidence in the injured ankle
- The specific demands of your sport
For example, walking around the house without pain is very different from sprinting down a soccer field, coming to a sudden stop, and changing direction on one leg.
Your ankle needs to be prepared for the environment you’re asking it to perform in.
Why Your Risk of Another Ankle Sprain Can Increase
After an ankle sprain, the injured ligaments may not provide the same level of mechanical stability they did before.
You may also experience changes in proprioception, which is your body’s ability to sense joint position and movement.
That matters because sports happen quickly.
When you’re reacting to an opponent, landing from a jump, or changing direction, you don’t have time to consciously think about where your ankle is.
Your body needs to recognize the position of the joint and respond appropriately.
If that system hasn’t been properly trained after an injury, the ankle may be more vulnerable when you return to competition.
This is one reason why athletes who have sprained their ankle before can be more likely to sprain it again.
Repeated Sprains Can Become a Bigger Problem
An athlete who repeatedly rolls the same ankle may eventually develop chronic ankle instability.
Instead of one isolated injury, they begin to experience a cycle of:
Sprain → incomplete recovery → decreased stability → another sprain
Over time, this can affect more than just the ankle.
If your ankle isn’t functioning properly, you may start changing how you move to avoid loading it.
You might shift your weight, alter your landing strategy, or compensate through the knee, hip, or other parts of the body.
The goal of rehabilitation isn’t simply to make the ankle feel better.
It’s to restore your ability to use the ankle effectively when your body is moving at higher speeds and dealing with unpredictable forces.
What Does Ankle Sprain Physical Therapy Look Like?
Effective ankle sprain physical therapy should be based on where you are in the recovery process and what you need to return to.
Early on, treatment may focus on reducing irritation and restoring comfortable movement.
As symptoms improve, the focus should shift toward rebuilding capacity.
That can include progressive strengthening, balance work, single-leg exercises, jumping, landing, running, and eventually sport-specific movements.
The progression matters.
An athlete shouldn’t go from walking without pain directly into full-speed cutting drills.
Instead, we want to gradually expose the ankle to the types of forces and movements it will experience during competition.
For a basketball player, that may mean progressing toward repeated jumping, landing, and quick changes of direction.
For a soccer player, it may involve sprinting, decelerating, cutting, and reacting to the movement of other players.
The exercises should reflect the demands of the person, not simply the diagnosis.
Sports Physical Therapy Should Prepare You for Your Sport
Returning to sport isn’t just about getting through a list of exercises.
It’s about making sure your body is prepared for the demands you’re going to face.
That’s especially important for athletes because competition is unpredictable.
You might land slightly off balance. You might have to react to another player. You might sprint, stop, and change direction multiple times in a short period.
Your rehabilitation should eventually challenge those same qualities.
This is one of the principles we emphasize with sports physical therapy at Cohen Health & Performance. We want athletes to build the strength, control, confidence, and capacity necessary to perform, not simply reach a point where everyday activities no longer hurt.
Don’t Let a Small Injury Turn Into a Recurring Problem
An ankle sprain may seem minor, but that doesn’t mean it should be ignored.
If you’ve had an ankle sprain, the goal shouldn’t simply be to wait until the pain disappears.
The goal should be to restore the qualities that allow you to trust your ankle again.
That means rebuilding strength, balance, stability, and the ability to handle the demands of your sport.
At Cohen Health & Performance, our approach to sports physical therapy is individualized to the athlete, their injury, and their goals. Whether you’re dealing with your first ankle sprain or you’ve been dealing with repeated ankle injuries, the right rehabilitation plan can help you build back the capacity you need to stay active.
If you’re looking for ankle sprain physical therapy in Bethesda or McLean, our team can help you determine what your ankle needs to safely progress back to your sport and activities.
Don’t just get back to your sport. Build the capacity to stay there.
