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Avoiding Ankle Injury

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Ankle injuries are commonplace in the athletic population, occurring in athletes of all ages and across all sports. A recent systematic review found that the ankle was the most common site of injury in 24 of the 70 sports studied. Additionally, 22% of sports injuries that ended up in the emergency room were ankle injuries, with ankle sprains being the most common injury, followed by ankle fracture. While the incidence of ankle injury is high in athletes, ankle injury is also quite common in the general population. The incidence of ankle sprains in the general population is 600-700 per 100,000 individuals, and the incidence of ankle fracture is 107-187 per 100,000 individuals. This means that whether you’re an athlete or not, you’re at risk of suffering from a painful ankle injury.

Even though ankle sprains are common, outcomes associated with this type of injury are less than ideal. Many individuals that suffer an ankle injury are found to have high recurrence rates, prolonged symptoms, reduced quality of life, reduced lifetime physical activity, a tendency to develop chronic instability of the ankle, and an increased risk of ankle osteoarthritis.

The same holds true for ankle fracture; after an ankle fracture, individuals may suffer from pain, joint stiffness, and reduced range of motion over the long-term, which can negatively affect quality of life. Thankfully a lot of these issues can be avoided with proper care and rehabilitation after injury - particularly regarding mobility and proprioceptive retraining. However, prevention is a great way to avoid them in the first place!

If you’re an avid athlete, of if you occasionally participate in physical activity, there are some steps you can take to help minimize your risk of ankle injury, including:

  • Warm up properly before engaging in physical activity - start with taking a brisk walk or light jog - then move into sport specific dynamic movements to prepare your body for the activities ahead.
  • Be mindful when walking or running on uneven surfaces (i.e. sand, gravel).
  • Avoid running too many hills (if you do run hills, work your way up to this slowly).
  • Consider tape or a brace for your ankle if it has been recently injured to help improve your proprioception (your awareness of your body in space) as you re-introduce more dynamic activity.
  • Wear appropriate footwear that is designed for your foot and activity type.
  • Replace old, worn out footwear (about every 6 months, or sooner if you’re an avid runner).
  • Reduce the amount of time you’re in high heels.
  • Maintain your strength and flexibility.
  • Regularly perform balance training - even simply standing on one foot while brushing your teeth can help!.
  • Be cautious when participating in activities that you haven’t properly trained for.
  • Listen to your body (if you feel discomfort or pain, stop the activity until the pain subsides).

If you want to learn how to protect your ankles and enjoy physical activity fully and prevent injury, you may benefit from physiotherapy. A physiotherapist will assess your muscles, joints, and nervous system, look at how you move, and explore your work and leisure activities to determine possible causes of your pain. Individual treatment will often entail hands-on work to the body structures at fault as well as education and rehabilitative exercise to keep you pain and injury free.

Undergoing a comprehensive evaluation by physiotherapists at Excel Physical Therapy is one of the best ways to gain an understanding of how you can enhance your ankle recovery. After the assessment, our physiotherapists will create a program that is specific to your needs, and can help get you minimize your risk of ankle re-injury.


1. Lin C, Hiller C, de Bie R. Evidence-based treatment for ankle injuries: a clinical perspective. Journal of Manual & Manipulative Therapy. 2010;18(1):22-28. doi:10.1179/106698110x12595770849524.
2. Sprained ankle - Self-management. Mayo Clinic. 2017. Available at: http://www.mayoclinic.org/diseases-conditions/sprained-ankle/manage/ptc-20343734. Accessed September 15, 2017.
3. Kaminski T, Hertel J, Amendola N et al. National Athletic Trainers' Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes. Journal of Athletic Training. 2013;48(4):528-545. doi:10.4085/1062-6050-48.4.02.
4. Tips for Preventing Foot and Ankle Injuries. UCSF Medical Center. 2017. Available at: https://www.ucsfhealth.org/education/tips_for_preventing_foot_and_ankle_injuries/. Accessed September 15, 2017.

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