The Most Common Reason: Incomplete Rehabilitation
The single biggest reason ankle sprains recur is that the first injury was never fully rehabilitated. Rest removes pain, but it does not restore the joint to its pre-injury state. After a sprain, three key deficits typically develop:- Ligament laxity, where the stretched tissue is less able to resist force
- Muscle weakness around the ankle and lower leg
- Impaired proprioception, the joint’s ability to sense position and react quickly
What Is Chronic Ankle Instability
When the ankle repeatedly gives way or is frequently re-injured, the condition is referred to as chronic ankle instability. It develops when structural damage from one or more sprains is compounded by ongoing weakness, poor neuromuscular control, and sometimes permanent ligament laxity. People with chronic ankle instability often describe a feeling of the ankle being unreliable, particularly on uneven ground, during sport, or when changing direction quickly. You can read more about the range of conditions that contribute to ongoing ankle problems on our ankle pain page.The Role of Proprioception
Proprioception is the body’s sense of joint position and movement. The ankle ligaments contain a high density of sensory nerve endings that feed real-time information to the nervous system. When the foot starts to roll, these sensors detect the change and trigger a protective muscular response. After a sprain, this system is disrupted. The nerve endings in the damaged ligament are less responsive, meaning the ankle is slower to detect and react to instability. The muscles do not contract quickly enough to prevent the joint from rolling. Proprioception can recover with targeted training, but it does not recover from rest alone. This is why balance and neuromuscular exercises are a non-negotiable part of proper ankle rehabilitation.How Foot Mechanics Increase Recurrence Risk
Some people have foot structures or movement patterns that make them inherently more susceptible to ankle sprains. A foot that supinates, meaning it rolls outward, places the ankle in a position that is closer to its tipping point with every step. High arches reduce the foot’s natural shock absorption and create a narrower base of support, both of which increase instability. Overpronation, while more commonly associated with inner ankle and arch problems, can also affect overall ankle mechanics and lead to compensatory patterns. Addressing these biomechanical contributors is essential for people with repeated sprains. Custom orthotics can help correct underlying foot posture and reduce the mechanical load on the ankle ligaments. Find out more on our orthotics page.The Contribution of Ankle Stiffness
After a sprain, the ankle joint often becomes stiffer than before. This reduced mobility changes how the foot contacts the ground and how forces are distributed through the lower limb. A stiff ankle forces other joints, including the subtalar joint and midfoot, to compensate. This compensation can alter gait patterns in ways that increase the likelihood of rolling the ankle, particularly on uneven surfaces. Restoring full ankle range of motion is an important but often overlooked part of sprain rehabilitation. Foot mobilisation and manipulation can help restore joint movement after a sprain. Read more about this on our foot mobilisation page.Returning to Activity Too Soon
One of the most common contributing factors to re-injury is returning to sport or high-demand activity before the ankle is ready. Pain is not a reliable guide. An ankle can feel fine during easy walking but still lack the strength and neuromuscular control needed for running, jumping, or changing direction. Return to activity should be progressive and based on objective measures, not just symptom resolution.How to Break the Cycle
Preventing recurrent ankle sprains requires addressing the root causes rather than just managing the symptoms of each new injury. A structured approach includes:- A thorough assessment to identify any residual instability or movement deficits
- Targeted strengthening of the ankle, lower leg and hip stabilisers
- Progressive proprioception and balance training
- Correction of contributing biomechanical factors through orthotics or footwear changes
- A graduated return to activity guided by clinical criteria
Want to Start Race Day Confident?
If you’ve got a niggle, persistent soreness, or you’re unsure about footwear and blister prevention, an assessment can help you calm symptoms and make smart last-week decisions.
Visit a clinic
Up and Running Podiatry has clinics across Melbourne’s inner west and bayside suburbs. Our podiatrists are experienced in assessing and treating ankle injuries at every stage of recovery.Frequently Asked Questions
It is common but not inevitable. Repeated sprains of the same ankle usually indicate that the original injury was not fully rehabilitated and underlying deficits in strength and proprioception have not been addressed.
Chronic ankle instability is a condition where the ankle repeatedly gives way or feels unreliable, particularly during activity or on uneven ground. It develops as a result of unresolved ligament laxity, muscle weakness, and impaired proprioception following one or more sprains.
For people with contributing biomechanical factors such as high arches or supinated foot posture, custom orthotics can help reduce the load on the ankle ligaments and improve overall stability.
Most cases of chronic ankle instability respond well to conservative care, including rehabilitation, orthotics, and bracing. Surgery is considered when conservative management has been thorough and unsuccessful, or when there is significant structural damage that cannot be addressed otherwise.
With a structured rehabilitation program, most people see meaningful improvement within eight to twelve weeks. Full resolution can take longer depending on the severity of instability and how consistently the program is followed.
