Establishing a timeframe for safe return to play after an ankle sprain is highly individualized. Sometimes a person with what looks like a significant injury is able to “walk it off” and get right back into the game. And sometimes pain and swelling from what one would think is a “minor sprain” lingers for a long time. Therefore it is best to base return to sports on one’s ability to perform sport simulation movements without pain or movement compensation.
First, can you run straight ahead at near 100% without a limp? Listen to your foot strike pattern for an even rhythm or have someone video you from the front and side to be able to study the running pattern. Next can you balance on both feet equally; barefoot, with eyes open, eyes closed, standing on an unstable surface, and while reacting to outside forces like catching and throwing a ball? This gives you an idea of the ability of your nervous and muscle systems to work together to stabilize the ankle joint that was over stretched. Now test side to side stability with a side shuffle type movement. Change direction at progressively increasing speeds to ensure that the outside of the ankle is able to withstand the stress. Be careful to progress gradually and stop if pain occurs as this is an advanced test of the sprain’s recovery. Finally, some sort of single leg hopping task (like a square or star pattern or the old hopscotch course!) should be timed to be sure that both ankles are working comparably. If you can make it through these type activities without compensating and pain free, it is reasonable to return to your sport.
Keep in mind that ankle sprains are notorious for reoccurring, but at least you know that you have done your best to make a reasonable decision. Consulting with a sports medicine professional may be your best bet because of the tendency to reinjure the ankles. For instance, he or she will be able to utilize their knowledge of research into the relationship of ankle sprains to hip weakness to optimize your ankle sprain rehabilitation to minimize the chance of re-injury.
More Answers from David Hogarth - NASM Elite Trainer, NASM Elite Trainer