How to Keep a Sprained Ankle From Becoming Chronic Instability

You’ve already experienced the pain of a sprained ankle, so you don’t want to go through the same experience over and over. But that’s what you’ll face if you develop chronic ankle instability. At Pennsylvania Orthopedic Associates, we have years of experience helping our patients prevent chronic instability with customized rehabilitation. Here are the steps you can take to ensure complete recovery from an ankle sprain.

How chronic ankle instability develops

When you sprain your ankle, one of the ligaments is stretched beyond its normal ability. Ankle sprains range in severity from a minor stretch, to a stretch with small tears, and in severe cases, a complete ligament rupture.

Ligaments are strong bands of tissue that connect bones. Their job is to hold bones in their correct position and to stabilize the joint. A mild sprain temporarily weakens the joint, while a moderate-to-severe sprain can lead to ongoing ligament weakness. When your ligament doesn’t heal properly, you develop chronic ankle instability.

Once the ankle joint loses stability as a result of a weak ligament, you have a higher risk of injuring it again, leading to a cycle of repeated ankle sprains. Over time, chronic instability damages bones and cartilage in the joint, leading to long-term problems such as arthritis and ankle pain.

The most important way to prevent chronic instability is to give your ligament time to heal. Here are some tips to follow:

Immediately start the RICE protocol.

Mild, moderate, and severe sprains can all benefit from the RICE protocol to minimize swelling. These steps should be taken as soon as possible after the injury:


Protect your ligament, and let it start healing by taking a break from activities.  


To reduce pain and swelling, apply an ice pack immediately. Keep the ice pack on for 10-20 minutes, three times daily for the first two to three days after spraining your ankle.


Wrapping an elastic bandage around the ankle helps keep swelling down and provides some stabilization.


Keep the injured ankle elevated when you apply ice and any time you can sit down. Try to keep your foot at or above the level of your heart to reduce swelling.

Seek medical evaluation.

If it hurts to put weight on the ankle and you can’t walk, schedule an immediate appointment for medical care. You should also see us if the swelling lasts longer than a few days. Don’t hesitate to call if you have any questions about needing treatment.

Don’t keep using a sprained ankle.

Unless your sprain is mild, the worst thing you can do — and a sure way to develop ongoing instability — is to continue using your ankle and engaging in your normal activities.

Whether you love sports or you have a job that requires physical activity, we understand that it’s hard to stop using your ankle. But when we recommend an initial period of immobilization, you can be sure it’s needed to make a full recovery and restore optimal ligament strength.

In most cases, you’ll only need to keep weight off your ankle for 7-10 days. If your sprain is moderate or severe, chances are we’ll ensure your ankle is protected and immobilized with a walking boot or cast.

Rehabilitate your ankle gradually.

Recovering full ligament strength depends on a gradual rehabilitation. Putting stress on the ligament too soon only puts you at risk for ongoing instability. In most cases, it takes at least six weeks for a ligament to heal.

We start rehabilitation as soon as it’s safe, beginning with exercises to improve the ankle’s range of motion. Once the swelling and pain go down, your rehabilitation progresses to include exercises to strengthen the ankle.

If you participate in regular or competitive sports, your rehabilitation includes exercises that are specific to your athletic activities. We may ask you to wear a functional brace to stabilize your ankle and prevent it from twisting again as you return to normal activities. During your rehabilitation, we also focus on rebuilding strength in your leg and foot muscles, so they can properly support your ankle.

Evaluate your foot biomechanics.

Most patients sprain their ankle by twisting it on uneven ground or when they participate in sports requiring sudden stops and turns. However, problems in your foot can also contribute to a sprained ankle. During your recovery, we’ll assess your foot biomechanics and structure and recommend treatment if needed to prevent future ankle sprains.

To receive individualized rehabilitation for an ankle sprain, call Pennsylvania Orthopedic Associates, or schedule an appointment online.

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