Understanding Ankle Sprains Part 2: Why do I keep rolling my ankle?

Clare Lawson • December 4, 2024

Chronic Ankle Instability: Why do I keep rolling my ankle?

Unfortunately, it is very common for people to still experience pain months after they have injured their ankle, or to keep re-injuring it. Even when your pain has gone, the ankle still might not be completely healed, or you could have ongoing instability, poor strength, balance or proprioception that you are not aware of.
If you continue to roll your ankle, this is called chronic ankle instability and almost 1 out of every 2 ankle sprains will develop this.


What are the causes?
1. Ligaments - When the ligaments have been compromised (either stretched or torn) then you are most likely to re-injure your ankle as it is structurally not as stable.
2. Muscle Weakness – after an ankle injury you can get changes to your calf and peroneal muscles which stabilise the ankle joint. If these are not rehabilitated correctly then you will be more likely to roll your ankle again.
3. Poor Balance/Proprioception – Can you stand on one leg without falling over? Or walk over uneven ground without feeling unsteady? Regaining these elements of balance are often neglected after an ankle sprain.

4. Power & Agility – Being able to run, jump and hop, even if these are things you don’t do very often are important for the ankle to be able to function normally. If you can’t do these with your injured ankle then you are more likely to roll your ankle again.


Will I need surgery?
In 89-90% of cases, physiotherapy will fix ankle sprains but in some cases, surgery is necessary to tighten the ligaments to restore full stability to the ankle joint.


Preventing Ankle Sprains
There are a number of things you can do to reduce the chance of injuring your ankle again.

1.    Good Footwear: Supportive shoes are important both in sports and for daily wear to reduce the chance of an ankle sprain.

2.    Ankle braces and taping; Your physiotherapist can show you the best way to strap your ankle or a suitable brace for your level of activity.

3.    Targeted Exercises – Full range of movement, strength, balance and power are needed for ankle stability.

4.    Good Warm-up and Cool-down: Completing these routines around your sport or exercise will reduce the chance of you re-injuring your ankle.


If you keep rolling your ankle, or are still experiencing pain or swelling, then it is important that you book in for physiotherapy so we can identify what the issue is. Refined Physiotherapy can help you now: Book here.


Ardakani, M. K., Wikstrom, E. A., Minoonejad, H., Rajabi, R., & Sharifnezhad, A. (2019). Hop-stabilization training and landing biomechanics in athletes with chronic ankle instability: a randomized controlled trial. Journal of athletic training, 54(12), 1296-1303.

Biz, C., Nicoletti, P., Tomasin, M., Bragazzi, N. L., Di Rubbo, G., & Ruggieri, P. (2022). Is kinesio taping effective for sport performance and ankle function of athletes with chronic ankle instability (CAI)? A systematic review and meta-analysis. Medicina, 58(5), 620.

Cain, M. S., Ban, R. J., Chen, Y. P., Geil, M. D., Goerger, B. M., & Linens, S. W. (2020). Four-week ankle-rehabilitation programs in adolescent athletes with chronic ankle instability. Journal of athletic training, 55(8), 801-810.

Chang, S. H., Morris, B. L., Saengsin, J., Tourné, Y., Guillo, S., Guss, D., & DiGiovanni, C. W. (2021). Diagnosis and treatment of chronic lateral ankle instability: review of our biomechanical evidence. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 29(1), 3-16.

Dhillon, M. S., Patel, S., & Baburaj, V. (2023). Ankle sprain and chronic lateral ankle instability: Optimizing conservative treatment. Foot and Ankle Clinics, 28(2), 297-307.

Rowe, P. L., Bryant, A. L., Egerton, T., & Paterson, K. L. (2023). External Ankle Support and Ankle Biomechanics in Chronic Ankle Instability: Systematic Review and Meta-Analysis. Journal of Athletic Training, 58(7-8), 635-647.

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How to Best Manage Your Acute Injury

By Clare Lawson • October 30, 2024
For decades we have been told to ‘RICE’ after we get an injury, but it’s time to let go and make room for some ‘PEACE & LOVE’. This new acronym has replaced the old ‘RICE’ acronym and it has some significant changes, including avoiding ice and anti-inflammatories after an injury as these have been found to disrupt the natural healing process that we want to occur. It also gives us more guidance on what to do after the initial injury phase, a crucial step that was missing from the old ‘RICE’ acronym. For the first few days after an injury, give them some ‘PEACE’ P: Protect We want to protect the injury by de-loading and reducing movement for the first 2-3 days to prevent further damage and allow the healing process to occur. Prolonged rest can in fact lead to longer recovery times. E: Elevate Try to keep the injured limb elevated higher than the level of your heart; this will help to reduce swelling out of the area. A: Avoid anti-inflammatory modalities It is now recommended to avoid taking anti-inflammatories, such as ibuprofen and aspirin in the first few days after your injury as these can interfere with the inflammatory process and slow down tissue healing. Applying ice to an injury may also disrupt this process; it can be still be used to assist with pain relief. After the first few days heat can also be used for pain management. C: Compress Compression of the injured area using bandages or tape is recommended to help reduce swelling and bleeding. E: Educate Education plays a huge part in any injury management. Your physiotherapist will provide education specific to your injury and situation to help you understand your recovery times and what you need to do to get better fast. After the first few days have passed, injuries need ‘LOVE’ L: Load Try to resume normal activities if your pain and symptoms allow; this will promote repair, remodelling and improve tissue tolerance. Your body will tell you when it is okay to increase the load, or if it is not ready. O: Optimism Be optimistic about your recovery! People who are optimistic have better outcomes as the brain plays an important role. Fear and avoidance surrounding your injury can be barriers to recovery. Working with your physiotherapist can help to improve your confidence with getting moving again after your injury. V: Vascularisation Starting some cardiovascular exercise, such as a walking, swimming or a stationary bike will help to increase blood flow to the injured area. This, combined with rehabilitation exercises can help with pain relief and getting your back to your usual activities faster. E: Exercise Your physiotherapist will give you the specific exercises required to rehabilitate your injury and restore factors like mobility, strength and proprioception, as well as helping you to prevent the same injury from occurring again! To find out the best way to manage your injury, book in for an appointment where you will get your own comprehensive and individualised rehabilitation plan.

Heat or Ice – Which is best for my injury?

By Clare Lawson • October 30, 2024
One of the most common questions I get asked is should I use heat or ice for my injury? There’s no correct answer, it ultimately depends on the type of your injury and which stage of the healing process it is at. When should I ice an injury? Ice has traditionally been used straight after an acute injury or surgery. For up to 72 hours after an injury, there is an inflammatory response occurring in the body. Signs of inflammation include localised skin redness, swelling, and heat, as well as pain. Cold therapy helps to reduce the blood flow to the area, thus helping to reduce the inflammation as well as giving pain relief. However, new research is showing that ice has little effect on skin temperature and reducing swelling. While it may numb the area and provide temporary pain relief, it’s ability to accelerate healing beyond the initial stage of an injury appears to be not as effective as we thought it was.  What about ice baths? – see our other blog on them here

What is an APA Sports Physiotherapist?

By Clare Lawson • October 30, 2024
What is a Sports Physiotherapist? They are a highly qualified physiotherapist with expert knowledge and skills in the prevention, diagnosis and treatment of sports injuries. The Title awarded by the Australian Physiotherapy Association, serves as a professional mark of distinction in the field of Sports Physiotherapy, which not all physiotherapists have.  They have undergone intensive training and a rigorous selection process by demonstrating expertise and achieving an outstanding level of contribution to the field of sports physiotherapy. Clare completed this process, obtaining her titling as a Sports Physiotherapist in 2018, after completing a Masters of Sports Physiotherapy degree. Clare has also earnt membership into the Australian College of Physiotherapists; a distinguished group of leaders in physiotherapy clinical practice. Sports Physiotherapists are skilled in fixing all sports injuries and work with people across the physical activity continuum; those returning to exercise, weekend athletes, fitness fanatics and elite athletes. At Refined, you can be reassured that you are receiving the best care with Clare, as she has demonstrated the highest standard of clinical experience and knowledge to accurately identify, prevent and treat injuries.