Ankle sprains are one of the most common injuries in football, and probably one of the most commonly underestimated.
A player rolls their ankle, the swelling settles over a few days, walking becomes comfortable, and suddenly the question becomes:
“Can I just strap it and play?”
Sometimes the answer is yes. But not always.
What actually happens when you roll your ankle?
Most ankle sprains in football occur when the foot rolls inwards, irritating or tearing the ligaments on the outside of the ankle.
A mild sprain might settle quickly, while a more significant injury can cause substantial swelling, bruising, weakness and difficulty weight-bearing.
This is why I don’t like giving athletes a blanket timeframe for returning to play. I need to see that the ankle is stable enough to sustain competitive play.
Feeling better doesn’t mean everything is back to normal
Pain often improves before everything else does.
An athlete might be walking, jogging and even kicking a ball comfortably, but still have problems with:
- Ankle movement
- Calf and ankle strength
- Balance and control
- Hopping and landing
- Confidence when changing direction
These deficits can be difficult to notice during day-to-day activity, but become much more obvious when football becomes fast and unpredictable.
A player might feel completely fine running forward, then notice the ankle feels unstable when planting their foot to change direction, making an early return-to-sport problematic.
Can you just strap it?
Taping or bracing can absolutely have a role when returning from an ankle sprain.
They can provide additional support and are often useful when an athlete first returns to training and competition.
But they aren’t a replacement for rehabilitation.
The ankle still needs to regain strength, balance and control so that it can tolerate the demands of football.
What do I look for before match play?
For an athlete to return to competitive football, I want to see them perform high-force movements including sprinting, stopping, changing direction, jumping, and landing with confidence off the injured ankle, without swelling or discomfort later that day or the next day.
That response often tells us just as much as the session itself.
Don’t underestimate a “minor” injury
Most ankle sprains recover well, but problems tend to arise when rehabilitation stops as soon as the pain settles.
If strength, balance and confidence haven’t returned, the athlete may still be vulnerable when football becomes fast and reactive again.
A little extra rehabilitation early on can make the difference between a straightforward return and an ankle that keeps rolling throughout the season.
What about chronic ankle injuries?
Occasionally, ankle problems may persist, even if managed well in the early phases of rehabilitation.
Oftentimes, these are the athletes for whom an arbitrary amount of time has passed, before being told to strap up before all their training and matches, with nothing else said or done about the ankle.
Hope is not lost for this athlete.
I have seen players make tremendous progress with strengthening, balance, and mobility exercises that are targeted to the athlete and their injury.
Usually this occurs alongside some time away from the pitch, to allow for maximising recoverability.
Reducing the aggravating activities, and gradually building higher-intensity sport back in creates an environment that can sustain the requirements of elite football.
