Physiotherapy Q&A: returning to running after a sprained ankle

By Matthew Carr, Chartered Physiotherapist

I badly sprained my ankle nearly a year ago and at the time just managed it with rest and ice. I have recently taken up running and am now finding that the ankle feels unsteady while I am running and is often quite painful after a run. I would have thought after a year the ankle would be fine. Why am I having these problems this long after the injury?

A bad ankle sprain often causes damage to the structures that provide the ankle with its strength and stability, namely the muscles and the ligaments, though other structures can also be damaged. A period of rest and ice will allow the swelling caused by the damage to settle and then a gradual return to walking will allow most of the pain to settle as the muscles strengthen to support your walking. However, your ankle is now struggling to cope with the increased demand you are now placing on it by taking up running. The ligaments and muscles you will have damaged with the sprain contain small receptors that send messages to your brain to help keep you balanced and stable. These will not be performing their job well with the sudden increased demand on them, hence why your ankle feels unstable and often painful after running. Make sure you warm up well before running and stretch your muscles well after.

Also, do ensure you gradually build up the time that you are running for and don’t suddenly start with too long a distance. If you continue to have problems it would be worth you seeing a physiotherapist or fitness instructor to give you a personal rehabilitation program to ensure your muscles and joints are strengthened to cope with the demands you are now placing on them.

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