You rolled it, iced it, limped around for a week or two, and moved on. That’s how most ankle sprains get treated. Then, 2 years later, it still gives out on an uneven trail, still feels loose going downhill, still tweaks doing something you used to do without thinking about it.
That’s an old sprain that never got properly rehabbed, still doing exactly what it’s been doing since day one.
The myth: it’s just a sprain, it heals on its own
Most people file a sprained ankle under “minor injury, ice it, move on.” Compared to a fracture or a torn ACL, it sounds trivial.
But “simple” sprains routinely leave the joint looser than it was before. Ligaments stretch, sometimes tear a little, and if nobody checks for that instability afterward, it just becomes your new normal. You adapt around it without ever noticing you’re compensating.
The truth: previous injury is the single biggest risk factor for the next one
It’s one of the most consistent findings in sports medicine: once you’ve sprained an ankle, your odds of spraining it again go up, and each repeat sprain tends to leave more looseness behind than the last.
Your movement mechanics shift too. How you push off, land, and change direction all adjust slightly to protect the ankle, and that shift shows up in your running, hiking, or whatever sport you play. Balance on one leg gets worse. Reaction time to an uneven step gets slower. Most people never connect these changes back to a sprain from years ago.
None of this shows up on an X-ray. A sprain that “looked fine” on imaging can still leave real, measurable looseness in the joint. The only way to catch it is to actually test the ankle for that instability, which most sprains never get.
This is fixable. It just takes more than 2 weeks of rest to get there.
What to do about it
Get the joint checked for instability, even if it’s been years since the injury. A physio can test for looseness you’ve just gotten used to living with.
Full rehab covers restoring normal range and movement mechanics, rebuilding strength and power, and retraining how you land and change direction under load. Force plates help measure that objectively instead of guessing.
Wear an ankle brace during higher-demand activity for about a year after a sprain. Not all day, every day, just for sport, hiking, or anything on uneven ground. Keep wearing it even once you feel normal and you’ve been cleared to return to activity. That window is exactly when re-injury rates are highest.
If your ankle still doesn’t feel fully trustworthy on a trail or a court, that’s worth some physio, even if the sprain happened a long time ago. We do this kind of instability check regularly at The Physio Hub in Collingwood.
Matt Sheldon, Registered Physiotherapist, The Physio Hub- Collingwood