Ankle sprains are one of the most common injuries among gymnasts, cheerleaders, and athletes who engage in high-impact movements. Whether landing a tumbling pass, dismounting from the beam, or making a quick pivot in a game, the ankle is a common weak point for injury. Understanding how to prevent and properly treat an ankle sprain can make all the difference in maintaining peak performance.
What is an Ankle Sprain?
An ankle sprain occurs when the ligaments that support the ankle stretch or tear due to excessive force. This often happens when the foot twists or rolls awkwardly upon landing or taking off.
Types of Ankle Sprains:
- Lateral Ankle Sprain: The most common type, occurring when the foot rolls inward, stretching the ligaments on the outside of the ankle. Usually from unprepared lateral landings, push offs, or uneven surfaces.
- Medial Ankle Sprain: Less common, occurring when the foot rolls outward, straining the ligaments on the inner side of the ankle. Often paired with a high ankle sprain and caused by a sudden awkward landing.
- High Ankle Sprain: Involves the ligaments above the ankle joint. This is caused by the two leg bones, the tibia and fibula, splitting apart and spraining the ligaments that hold them together. This is usually caused by “Landing short” (the ankle is in a fully flexed position on landing which jams the foot up between the ligaments above the ankle) or by rotational force of the foot.
Risk Factors for Ankle Sprains
- Awkward Landings: Poor landing mechanics increase stress on the ankle.
- Weak Ankle Muscles: Insufficient strength and stability make the joint more susceptible to injury.
- *Poor hip and knee stability or alignment*: In my opinion this is the most important. Collapsing knees or poor single leg strength means a shaky foundation for movement. The ankle is often the first joint that gives out.
- Fatigue: Tired muscles reduce coordination and reaction time.
- Previous Ankle Injuries: A history of ankle sprains increases the likelihood of re-injury. This is especially true if the original cause of an ankle sprain is never addressed during its healing process (movement patterns, strength deficits, proper skill progression).
Prevention Strategies
1. Strengthen the Ankles, knees, and hips for single leg stability
Strong hips, especially for external rotation and the ability to push through single leg activities without a collapsing knee, will lower the incidence of both knee and ankle injuries. Building strength through single leg hopping forward, backward, and side to side will improve ankle stability and reduces the risk of sprains.
2. Improve Landing Mechanics
Practicing proper landing techniques—such as bending the knees adequately to absorb force, avoid collapsing knees, and eccentric strengthening into ankle flexion —can help absorb impact and reduce stress on the ankle.
3. Use KT Tape or Athletic Tape as needed
Wearing ankle braces or taping the ankle can provide additional support to make it through training, competition, or a game before your ankle can support itself. BUT never begin taping an ankle without a rehab plan to wean off the tape. I recommend white athletic tape for firm support when an ankle is unstable and at a higher risk for reinjuring. And I like KT tape when an ankle is building back strength but not quite ready to handle all forces on its own.
4. Warm Up and Stretch
A proper warm-up, including dynamic mobility exercises like double and single leg jumping, prepares the muscles and ligaments for activity and reduces the risk of injury.
5. Progress Training Gradually
Avoid sudden increases in training intensity, as fatigue and overuse can lead to poor movement patterns and greater injury risk.
Treatment and Recovery
If an ankle sprain does occur, early intervention is key to proper healing and a safe return to sport.
Immediate Care:
- Relative Rest: Limit activities which clearly worsen symptoms. For mild to moderate sprains walking is one of the best ways to promote recovery. For moderate to severe sprains avoid weightbearing but focus on gentle active movement in mid range of motion to promote blood flow and decrease swelling
- Ice or heat: Apply ice packs for 15 minutes every few hours to reduce swelling the first day. After the first day using both heat or ice can help control pain and help with swelling.
- Compression: Gentle consistent compression with an elastic bandage, KT tape, sock, or sleeve can help control inflammation and provide support.
Rehabilitation and Return to Sport
- Range of Motion Exercises: Fully return ankle range of motion for all motions required for your sport.
- Strength Training: Strengthen the ankle as soon as tolerated for preventing future injuries.
- Progressive landing, jumping, and balance stability training: Exercises like double leg jumps and rebounds, single-leg dynamic balance, and single leg jumps improve stability and reduce re-injury risk.
- Sport-Specific Drills: Before returning to full activity, a mild return to sport with decreased intensity should be completed for a few weeks as needed.
Keep Your Ankles Strong and Resilient
Ankle sprains can sideline an athlete, but with proper prevention strategies and recovery techniques, you can reduce your risk and bounce back stronger. If you’ve suffered an ankle sprain or want to improve your ankle stability, working with a sports physical therapist can help you stay injury-free and perform at your best.
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