How soon can I play sports after an ankle sprain?

Andrew S. Levy, MD
Sports Medicine
It depends on the sport, the position within the sport and how severe the sprain. Prior to being cleared to play, an athlete should be able to hop on the ball of the foot 10 times. This can be done with the ankle braced or taped. On average return is 2-6 weeks, with high ankle sprains 6-10 weeks.
For minor ankle sprains that you are able to walk on without any difficulty, they usually resolve in several days to weeks. Generally, the swelling should be down, and your range of motion should be identical to the opposite side before you resume sports activities. Also, you should be able to run without any pain or discomfort. You should also ice your ankle after your first few times back on the field. If healing takes longer than you would like, you could always get into some physical therapy to help accelerate the process.
David Hogarth
Physical Therapy

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.

Vincent Burke
Physical Medicine & Rehabilitation

TRAAS (trace) Tissue Ready Athletes Action Scale...Is the tissue ready to play?

Over the years this scale has been a nice guide for parents, coaches and trainers alike to use. It is not about using a pain scale or happy faces because that is too subjective. This scale puts function/action and pain together. The question we ask the athlete is do you have pain and loss of function/performance when you play or during any task that mimic playing.

  1. The patient has no pain before playing, during or after. This is a safe play. They can play without any limits however one may consider joint protection brace.
  2. The patient has no pain before but has pain during play. The is NOT safe play or needs some type of modification such as a position change like a baseball player NOT fielding but can DH bat or NO PITCHING but playing first base is OK. When it is a 2, one would also need to have treatment from a professional clinician.
  3. The athlete has pain before the game or practice even starts this means one needs to be sidelined with aggressive intervention.

There are varying degrees of ankle sprains depending on how much of the ligament was stretched. Depending on how severe the injury is and how well it has been managed will determine when you are able to safely return to your sport. 

It is very important to manage the symptoms of an ankle sprain with rest, ice, compression and elevation so that proper healing can occur. If these symptoms have been managed then gradually work back into regular activity. If you are looking to return to regular sports, look for the aid of a certified athletic trainer or physical therapist to get you back in the game as quickly and safely as the injury allows. They will be able to determine when you have regained full range of motion, strength and are ready to start cutting (use quick change of direction). You want to make sure you are ready so that you don't reinjure or create a new injury. 

Nadia F. Levy, DPM
Podiatric Medicine

Overall, anywhere from 6 weeks to 3 months.  Sometimes more or less.  It is not a clear cut question to answer.

The answer to this question depends on many things.  The extent of the sprain, the amount of pain you have and your own personal speed of healing. It also depends what sport.  This is a very complicated but crucial question.  A podiatrist can evaluate your ankle in terms of pain, balance and strength and help give an individual prediction.  Also, at times it is advisable to use a brace for a period of time when returning to your sport, again depending on the sport.

My advice: 1) Do appropriate physical therapy.  2) Do not rush back when you still have not fully healed because then an injury that could easily have healed can become a chronic problem. 3) Listen to your body when you feel pain and pull back.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.