With the arrival of summer, opportunities to stay active increase: beach volleyball, padel, tennis, five-a-side football, running, hiking, water sports, or simply long walks in less supportive footwear. During this time of year, one of the most common injuries is an ankle sprain, which is often dismissed as a minor issue: “I just twisted my ankle,” “A little ice and it’ll be fine,” or “I can still walk on it.”
An ankle sprain can lead to significant long-term consequences if it is not properly assessed and treated.
Dr. Davide Bertinetto
Even when the pain seems to improve within a few days, an ankle sprain can have significant long-term consequences if it is not properly evaluated and treated. The ankle is a complex joint that must provide mobility, stability, balance, and the ability to adapt quickly to different surfaces. When these functions are compromised, recovery may only be apparent, leaving the ankle weaker, less responsive, and more prone to future sprains.
An ankle sprain is not always “just a twisted ankle.”
The most common type of ankle sprain is an inversion sprain, which occurs when the foot rolls inward, placing excessive stress on the lateral ligaments of the ankle. This can happen during a sudden change of direction, a jump, an awkward landing on uneven sand, hiking downhill, or an unexpected movement while playing recreational sports.
The problem is that the initial pain does not always reflect the true severity of the injury. Some ankle sprains are mild and heal quickly, while others may be associated with more significant ligament damage, bone marrow edema, joint injury, or tendon damage.
For this reason, it is important to watch for certain warning signs, including significant swelling, bruising, difficulty bearing weight, well-localized bone pain, a feeling of instability, joint locking, or symptoms that persist beyond the first few days. In these cases, a thorough clinical evaluation is recommended to determine whether further imaging is needed and to avoid following an overly generic recovery plan.
The Real Risk: Recurrence and Chronic Ankle Instability
The main reason an ankle sprain should never be underestimated is the risk of recurrence. After the initial injury, the ankle may remain less stable and less precise in controlling movement. This is not simply a matter of “looser ligaments”; the problem often also involves proprioception—the body’s ability to sense the position of the joint in space and respond quickly to changes in movement.
When this system is not fully restored, patients may return to walking or running even though the ankle is not truly ready. As a result, they may experience another sprain, a feeling of the ankle “giving way,” pain during sports, or recurrent swelling after physical activity. Over time, this can lead to chronic ankle instability, a condition that limits athletic performance, reduces confidence and stability during weight-bearing activities, and may even affect the knee, hip, and overall dynamic posture.
Healing, therefore, does not simply mean being pain-free. It means restoring an ankle that is strong, mobile, stable, and responsive.
Every ankle sprain is different. That is why an early specialist evaluation is essential to develop the most appropriate, individualized rehabilitation program.
Dr. Davide Bertinetto
Accurate Diagnosis and Targeted Rehabilitation
The first step is an accurate clinical assessment. During the examination, the specialist evaluates the mechanism of injury, the location of the pain, swelling, joint mobility, ligament stability, muscle strength, balance, and the quality of weight-bearing. Depending on the clinical findings, imaging studies such as X-rays, ultrasound, or MRI may be recommended, particularly if the pain is severe, persistent, or if associated injuries are suspected.
Treatment should follow a progressive rehabilitation plan. During the initial phase, the goals are to control pain and swelling, protect the ankle, and gradually restore range of motion. As recovery progresses, rehabilitation focuses on muscle strength, neuromuscular control, balance, dynamic stability, and gait quality. In the later stages—especially for athletes—it is essential to reintroduce jumping, cutting and directional changes, running, sport-specific movements, and functional testing before returning safely to full activity.
Every ankle sprain is different. That is why an early specialist evaluation is essential to develop a personalized rehabilitation program, promote optimal recovery, ensure a safe return to sport, and reduce the risk of future sprains.
Specialist in Physical Medicine and Rehabilitation | Isokinetic Turin
