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Ankle Sprains: What You Need to Know.
- Yannick Sarton
- Oct 10, 2024
- 3 min read
Updated: Nov 28
Why ankle sprains are so common — and so misunderstood
Ankle sprains are among the most frequent musculoskeletal injuries worldwide. They happen during sports, daily activities, or even simple missteps. Despite being common, they are also one of the most misunderstood injuries: many people believe they “heal on their own,” that rest is enough, or that a sprain is less serious than a fracture.
Scientifically, a sprain is a ligament injury. Ligaments heal slowly, and the absence of proper rehabilitation increases the risk of recurrent sprains, chronic instability, and long-term movement limitations.
What actually happens during an ankle sprain?
Most sprains involve the lateral ligaments, particularly the anterior talofibular ligament (ATFL). When the ankle rolls inward, these ligaments stretch beyond their natural range.
Depending on the severity, fibres may stretch, partially tear, or rupture. Even a mild sprain triggers pain, swelling, and a temporary loss of control.
The crucial point:
Ligament healing does not depend on rest — it depends on progressive loading.
Why rest alone doesn’t work
Total rest feels instinctive after an injury, but it works against recovery. Research shows that:
• immobilisation delays ligament healing
• muscle activation decreases
• balance and proprioception worsen
• swelling takes longer to resolve
• reinjury risk increases dramatically
The body heals best through controlled, progressive movement — not through inactivity.
What physiotherapy does — the science-based plan
Modern physiotherapy uses a structured, evidence-based progression:
Early load and mobility
Gentle mobility within pain limits improves circulation and supports tissue recovery. Light loading stimulates ligament repair and reduces long-term stiffness.
Strength and tendon loading
Strengthening the peroneal muscles is essential. They stabilise the ankle and prevent reinjury. Research shows this phase is what predicts long-term success.
Balance and proprioception
After a sprain, the brain temporarily “forgets” how to stabilise the ankle in space. Proprioceptive training restores these pathways and reduces instability.
Sport-specific reconditioning
Jumping, cutting, landing, and sprinting require controlled and progressive reintroduction — too early = reinjury risk, too late = loss of performance.
When should you worry?
A sprain needs professional assessment when:
• weight-bearing is impossible for more than 24–48 hours
• swelling is severe or spreading
• a sharp “crack” sound occurred
• bruising appears rapidly
• recurrent sprains or instability are present
• pain persists after 10–14 days
These signs may indicate a higher-grade sprain or associated injury.
The long-term message
Most ankle sprains recover well — but only with proper rehab. Without structured physiotherapy, up to 40% of people develop chronic instability.
A sprain is not a simple injury. It is a ligament trauma that requires progressive loading, structured exercises, and objective milestones before return to sport or full activity.
Whether you are in Phnom Penh or abroad, you can book your next in-clinic or online physiotherapy session today.I’m available worldwide for online consultations — simple, fast, and evidence-based.
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References:
Wikstrom, E. A., et al. “Joint position sense and muscle activation in patients with chronic ankle instability and copers,” 2019.
Delahunt, E., et al. “Consensus statement of the International Ankle Consortium: prevalence, impact, and long-term consequences of lateral ankle sprains,” 2018.
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