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Easy Steps to Avoid Ankle Sprains

The injury may seem minor, but it may cause serious problems down the road

Close up of unrecognizable athletic woman feeling pain in her ankle at the park
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Acute ankle sprains are the most common lower-limb injury in sports, but you don’t have to be a pro athlete to get one — an awkward step off a curb or changing direction too abruptly during a casual game of pickleball can result in a searing jolt of pain in your lower leg.

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That twist to your ankle can put too much stress on a ligament, resulting in a sprain, according to sports medicine expert Jamil Neme, M.D., an assistant professor at the Saint Louis University School of Medicine. “When you turn your ankle in, there’s so much force that it tears one of the ligaments on the outside,” Neme says.

It’s easy to think of a sprained ankle as a minor inconvenience. But health care practitioners who treat this type of injury say that a sprained ankle can put someone at greater likelihood of reinjuring the ankle and that this could lead to chronic instability that makes daily activities difficult or makes the individual shy away from enjoyable pastimes.  

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While you can’t totally protect yourself from an ankle sprain, experts say that a good exercise regimen that builds strength, flexibility and balance, coupled with commonsense moderation in activities, can reduce the risk of injury.

What causes a sprain?

Sedentary adults are at risk of ankle injuries from tripping over a carpet or some other obstruction at home. Also vulnerable are people who overdo it as they try to increase their fitness. Because they’re not quite ready for what they’re trying to do, they are prone to injuries, Neme says.

Ankle sprains vary in severity, from mild stretching and microscopic tearing of ligaments to complete ruptures, which cause moderate to severe joint instability. As a 2021 article from the National Library of Medicine details, about 40 percent of ankle sprains lead to chronic pain and other symptoms that can persist for a year or more. Worse yet, among people who suffer acute sprains, 1 in 5 develop chronic ankle instability.

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Older adults sometimes have a history of sprains going back to childhood, so their ankles have become unstable, says Lance Silverman, M.D., an orthopedic surgeon based in the Minneapolis area who has 20 years of experience in treating ankle and foot problems. Repeat injuries can lead to ankle fusion or replacement surgery. Seventy-five percent of those who get such operations “either had chronic ankle sprains or an ankle sprain that just wouldn’t get better,” Silverman says. “And that’s what turns into their arthritis.”

More often, though, adults with chronic ankle problems simply stop doing physical activities that they enjoy. “You say, you know, I really love playing basketball with my grandson or my granddaughter,” Silverman says. “I want to go play with them. But I can’t because it hurts.”

How you can protect your ankles

Health care experts offer these tips to keep your ankles healthy.

  • Work on your balance. One reason people get ankle injuries is that they don’t adapt to uneven surfaces as they walk or run. Reduce that risk by improving proprioception, the body’s ability to sense movement, action and location. You can do that with exercises in which you balance on one foot, as well as activities such as tai chi and yoga. Silverman recommends going barefoot or wearing only socks when you exercise, if possible, so that feedback from the ground isn’t blocked by the soles of your shoes.
  • Build strength in your lower body and core. Instead of focusing on your ankles in your strength workouts, build up strength in your legs and hips to improve your stability. “Squats, bridges, lunges, sidestepping with a band at the knees or ankles, and heel and toe raises are some good exercises to perform,” says Jill Henderzahs-Mason, a wellness physical therapist at the Mayo Clinic in Rochester, Minnesota. And don’t neglect strength exercises for your core, which Silverman says can improve your posture and gait and reduce pain in your ankles.
  • Work on flexibility. “Heel mobility is an important feature to avoiding foot and ankle injury,” Henderzahs-Mason says. “One great activity to achieve this is to stand at the edge of a step, coming to the tiptoes, and then slowly lowering heels to below the step, performing this for about 10 repetitions. You can maintain a stretch at the end of this with the heels dipped below the step for a count of 30 seconds or more, being sure to keep the feet pointed forward. To isolate the heel itself, perform with the knees slightly bent.”
  • Avoid overuse. As much as you want to push yourself, be careful not to increase the duration of your workouts beyond what your ankles can handle, Henderzahs-Mason cautions.
  • Pick the right footwear.  You might think that high-top shoes will give you protection, but Silverman says they don’t stop sprains and may make you weaker by restricting your motion. Having a well-fitting shoe with arch support is more important, Neme says.
  • Do a morning warm-up. After being inactive overnight, Silverman says, warm up your ankles by moving them gently in a circular motion. Early-morning squats with just your body weight as resistance also help.

For more tips on keeping your lower extremities healthy, the American Academy of Orthopedic Surgeons offers this foot and ankle conditioning program. You may also want to check out Silverman’s blog posts on foot and ankle injuries. 

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