Resuming Running After an Ankle Sprain: Time Limits

You’ve sprained your ankle and you’re wondering how soon you can get back to running without risking a recurrence?

Here’s what I think is interesting to know when you ask yourself this question!

♻️ Last update: December 10, 2024.
👩‍⚖️ Declaration of financial interests: none directly related to the subject. My complete declaration of financial interests is in the legal notice section.
Written by Nelly Darbois, physiotherapist and scientific editor

Why not go back to running straight away?

After a sprain, the ankle is less stable. The ankle needs stability to avoid twisting when running, especially when running fast or on unstable ground.

A stretched or torn ligament needs time to heal.

What’s more, the risk of a new sprain is quite high: 1 in 10 to 3 in 10 people playing contact sports such as soccer have at least one new sprain episode after having had one [D’Hooghe 2020].

📝 So it’s reasonable to think that waiting a few days, weeks or less will reduce the risk of another sprain.

How long does it take for people to resume running after a sprain?

I have listed the scientific publications that seek to answer this very question in a descriptive way: how many days, weeks or months after an ankle sprain do people return to running?

Why rely on studies rather than my experience as a physiotherapist?

✅ Because they are based on a larger sample of people.

✅ Because they’re a little better at limiting bias than someone making an estimate on their own.

I mean, what’s the point of knowing that ?

This can give you a more concrete idea of the usual turnaround times. But it will also help you to realize that recovery times vary widely from case to case.

That’s why it’s so difficult for your health professionals (physiotherapists, doctors) to give you a precise date for resuming training, even though I understand that as an athlete, you want precise answers!

Here are a few facts and figures.

➡️ High-level sportsmen and women (athletics, basketball, soccer, taekwendo) undergoing ligamentoplasty for ankle sprains.

• resumption of jogging after an average of 8.4 weeks;
• resumption of running at a higher intensity (e.g. with split training) after an average of 12.5 weeks.

[Cho 2015]

➡️ Amateur and professional footballers with external ankle ligament sprains.

• amateurs: 7 days +- 19 days [Kotofolis 2012] ;
• professionals: 15 days +-19 days [Waldén 2013].

➡️ First division university footballers with grade 1 high ankle sprain.

The average time taken to return to unrestricted gambling was 15.5 ± 9.5 days. 2 days for the earliest and 30 days for the latest returners.

[Miller 2012]

📝 What’s in it for me? Even for people who are very accustomed to sport, it can take several weeks to several months for them to resume more intensive running. Leisurely jogging is often resumed sooner.

What factors determine when to resume?

There are many academic publications discussing the relevance or otherwise of objective criteria for determining return to sport after an ankle sprain.

In particular, by carrying out clinical tests giving a score, such as theAnkle-Go for lateral ankle sprains (the most common). An application has even been developed to help physiotherapists apply this test (link at end of article).

But we can also question the relevance of criteria such as :

• is this your first sprain or a recurrence?
• Have you had a mild sprain (stage 1), or a stage 2 or 3 sprain?
• Does your ankle feel unstable, fragile or painful when you walk?
• Are you in a hurry to get back to work (even if it means risking a repeat offence) or are you more cautious, even if it means waiting a little longer?
• Has your ankle felt unstable during movement in the last few days?

Here are the conclusions of a research team on the relevance of scores and other criteria to objectivize when it’s the right time to resume in the case of chronic ankle instability:

The results showed that the single-leg balance maintenance test on firm surfaces, the modified version of the star excursion balance test, the lateral jump test and the figure-of-eight test appeared to be the most relevant functional performance tests for targeting ankle impairments in patients with chronic ankle instability.

A combination of the Foot and Ankle Ability Measure (FAAM) and the Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI) self-administered questionnaires were the most relevant questionnaires for assessing patient function.

Although these functional performance tests and questionnaires provide a solid basis for clinicians to validate their return to sport decisions, objective scientific criteria with threshold scores are still lacking.

In addition to the proposed group of tests, an analysis of the context, in particular sports-related characteristics (e.g. fatigue, cognitive constraints), to obtain more information about the patient’s risk of recurrent injury could be of great value when making decisions about returning to sport in patients with CAI.

Picot 2022

Another publication sought to establish an expert consensus on the best criteria to take into account when deciding whether to return to sport. Here’s what they came up with:

Expert opinion indicates that pain intensity, ankle impairments, sensorimotor control, athlete perception/preparation and sports and functional performance must be assessed to inform the decision to return to sport after an acute ankle injury.

Smith 2021

📝 What’s the bottom line? Even if there are very precise tests to try and objectify the return to sport or running, there’s a lot of uncertainty about their real relevance.

How do you know if it’s time to resume in YOUR case?

Are you lost when faced with all these criteria to take into account? How do you decide?

Healthcare professionals who are used to dealing with people with ankle injuries are there to advise you. They’ll be able to discuss these different criteria with you, your personal preferences and, if necessary, carry out a more detailed assessment.

And help you make a decision. And why not supervise your return to running.

Some people prefer to do things their own way.

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That’s all I wanted to say on the subject! Any questions or comments? See you in comments!

If you feel the need to learn more about the recovery period after a sprained ankle, I wrote this guide in eBook format:

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