Injuries
Ankle sprain
The most under-treated injury in sport. Most people stop when they can walk, which is why about a third of first sprains become a chronically unstable ankle.
How long
2 to 6 weeks
The rehab almost everyone skips
Reinjury
—
Roughly a third of first-time sprains recur, and almost all of that is untreated balance and proprioception.
The phases
The phases
A grade II sprain. Uncomplicated, and still six weeks if you want it to be the last one.
A grade II sprain. Uncomplicated, and still six weeks if you want it to be the last one.
Limb symmetry
Limb symmetry
Limb symmetry at week 5. Balance is the number that predicts the next sprain, and it is the one nobody tests.
Limb symmetry at week 5. Balance is the number that predicts the next sprain, and it is the one nobody tests.
Return to play
Return-to-play criteria
Decided on measured criteria, not on whether it still hurts. Published here so you can hold me to it — and so your club can.
| Test | Threshold | Measured by |
|---|---|---|
| Balance, eyes closed | ≥ 90% of the other side | Star excursion test |
| Calf raise endurance | ≥ 90% repetitions | To failure |
| Hop battery | ≥ 90% | Single and side hop |
| Cutting | No apprehension at speed | Filmed |
Questions
Questions
Do I need a scan?
Usually not. The Ottawa rules tell us who needs an X-ray and most sprains do not meet them. If you do, I will say so and write to your doctor rather than sending you for one myself.
Should I wear a brace afterwards?
For the first season back after a significant sprain, the evidence supports it. It is not a substitute for the balance work, which is what actually reduces the recurrence.