An ankle sprain happens when the ligaments around the ankle are stretched or torn. Many people picture a sprain as a sports injury, but it can just as easily happen on a walk, a hike, or a misstep off a curb. Knowing what raises the chance of a sprain can help you spot habits and conditions worth addressing.
Several ankle sprain risk factors tend to come up again and again: a previous ankle sprain, weak ankle muscles and poor balance, jumping and cutting sports, unsuitable footwear, uneven or slippery surfaces, returning to activity too soon, and limited ankle mobility. None of these guarantees an injury. They simply make an awkward landing or a sudden roll harder for the ankle to handle.
This guide explains each of the seven factors, offers a practical prevention tip for each, and covers when to seek medical advice. If you already have an injured ankle, our guide to ankle sprain treatment options explains how sprains are managed. This article is general information, not a substitute for individualized medical advice.
What Is an Ankle Sprain?
Ligaments are tough bands of tissue that connect bones and help keep a joint stable. An ankle sprain is a stretch or tear of those ligaments. According to the American Academy of Family Physicians (AAFP), most sprains involve the ligaments on the outer side of the ankle and happen when the foot rolls inward, often after an awkward landing or step.
Typical symptoms include pain, swelling, bruising, and difficulty bearing weight. Mayo Clinic provides a helpful overview of sprained ankle symptoms and causes.
A sprain can look much like a fracture or another ankle injury, and symptoms alone cannot always tell them apart. A clinician can examine the ankle and decide whether imaging is needed.
7 Risk Factors That Increase Your Chance of an Ankle Sprain
Researchers study risk factors for a first-time sprain and for repeat sprains separately, and the evidence is stronger for some factors than others. Treat the list below as general patterns, not predictions for any one person.
1. Previous Ankle Sprains
A previous sprain is widely described as one of the most important risk factors for another. The AAFP notes that a history of ankle sprain is a common risk factor for later sprains. This seems most likely when the ankle has not fully recovered.
Common reasons include:
- Lingering weakness or reduced range of motion
- Reduced balance and awareness of ankle position
- Returning to activity too quickly
Prevention tip: Complete rehabilitation, and regain strength, balance, and confidence before returning to demanding activities.
2. Weak Ankle Muscles and Poor Balance
The muscles around the ankle and lower leg help the joint react when the foot lands unevenly. If those muscles are weak, or if balance and coordination are limited, it may be harder to correct a sudden ankle roll in time.
Factors that may play a role include:
- Limited ankle and lower-leg strength
- Poor single-leg balance
- Inadequate neuromuscular control (how well the nervous system coordinates muscle responses)
Mayo Clinic lists poor physical conditioning among its ankle sprain risk factors.
Prevention tip: Progressively build strength and balance with appropriate exercises. Our guide to strength training can help you build strength safely, and a clinician or physical therapist can tailor a plan if you have had an injury.
3. Sports Involving Jumping, Cutting, or Rapid Direction Changes
Basketball, soccer, volleyball, tennis, and similar sports expose the ankle to sudden twisting forces. Mayo Clinic notes that sports that involve jumping, cutting, or rolling of the foot carry a higher risk.
Common situations include:
- Landing on another player’s foot
- Pivoting or changing direction quickly
- Fatigue-related lapses in control
Not every sport or athlete carries the same level of risk, and individual factors matter.
Prevention tip: Warm up, practice controlled landing and change-of-direction skills, and increase training demands gradually.
4. Unsuitable Footwear
Shoes that fit poorly or do not suit the activity may affect comfort, traction, and stability. Mayo Clinic also lists wearing shoes that do not fit properly or are not appropriate for an activity as a risk factor.
Examples include:
- Worn-out shoes
- Poor fit or inadequate support for the intended activity
- Footwear that does not suit the playing surface
Footwear alone does not decide whether a sprain happens, and no shoe style can completely prevent one.
Prevention tip: Choose well-fitting shoes appropriate for the activity, and replace heavily worn pairs.
5. Uneven or Slippery Surfaces
The environment can cause the foot to land awkwardly, even when you are doing something as ordinary as walking. Mayo Clinic includes walking or exercising on an uneven surface among the risk factors.
Examples include:
- Uneven trails or pavements
- Wet or slippery floors
- Potholes, loose gravel, and poorly maintained playing areas
Prevention tip: Pay attention to your footing, wear suitable footwear, and adjust your speed to surface conditions. For everyday activity, see our guide to walking for health for general tips on getting started safely.
6. Returning to Exercise Too Soon or Increasing Activity Too Quickly
A sudden jump in training load can leave the body less prepared for physical demands. So can returning before an injury has fully recovered. The ankle may look and feel fine at rest yet still lack the strength and control to handle sport or hard training.
Examples include:
- Increasing running distance or intensity too quickly
- Resuming jumping sports while pain, weakness, or instability remains
- Skipping rehabilitation after an injury
Prevention tip: Progress gradually, and use functional recovery, not just the number of days since the injury, to guide your return. Learning how to recover properly after exercise can help, and so can allowing enough time for recovery between harder sessions.
7. Limited Ankle Mobility or Certain Foot and Movement Characteristics
Some people have restricted ankle movement or movement patterns that may make landing, balancing, or changing direction harder. Possibilities include:
- Limited ankle dorsiflexion (the ability to bring the shin forward over the foot)
- Movement-control differences
- Individual foot structure, where clinically relevant
These characteristics do not mean a person will inevitably sprain an ankle, and their importance varies from one individual to another. The evidence is also less consistent than for a previous sprain.
Prevention tip: If you have a persistent mobility or movement limitation, discuss it with a qualified physical therapist or healthcare professional. General routines can help you improve flexibility and ankle mobility, but they are not a replacement for individual assessment.
How to Reduce Your Risk of an Ankle Sprain
You cannot prevent every sprain, but several steps may lower your risk:
- Warm up before sports and vigorous exercise.
- Build ankle and lower-leg strength gradually.
- Include balance and coordination training, especially after a previous sprain.
- Wear suitable, well-fitting footwear.
- Be cautious on uneven or slippery surfaces.
- Complete rehabilitation before returning to high-demand activities.
- Consider an ankle brace or taping for higher-risk sports, particularly after a previous sprain, after discussing options with a healthcare professional.
Clinical guidelines support balance training and external ankle support for reducing the risk of repeat sprains, especially in athletes. The British Journal of Sports Medicine guideline update and the Journal of Orthopaedic and Sports Physical Therapy clinical practice guideline both address these approaches. The AAFP also notes that braces, lace-up supports, and taping can reduce the risk of ankle sprains during sports.
When Should You Seek Medical Advice?
Seek prompt medical assessment if an ankle injury causes any of the following:
- Severe pain or swelling
- Marked tenderness over a bone
- Deformity
- Numbness
- Inability to bear weight or walk
These symptoms can point to a more serious injury, including a fracture. You cannot reliably diagnose a sprain or rule out a fracture at home.
Also ask a clinician about repeated sprains, an ankle that keeps giving way, or symptoms that are not improving. Mayo Clinic explains when to see a doctor for a sprained ankle.
Frequently Asked Questions About Ankle Sprain Risk Factors
What is the biggest risk factor for an ankle sprain?
A previous ankle sprain is an important risk factor for another. Incomplete recovery, ongoing instability, and inadequate rehabilitation may all contribute to a repeat injury. Mayo Clinic lists a history of ankle sprains among its risk factors.
Can weak ankles increase the risk of a sprain?
They may. Reduced strength, balance, or coordination can make the ankle less able to respond to a sudden roll or awkward landing. Progressive strengthening and balance work may help, though the right approach varies by person and injury history.
Do certain sports increase ankle sprain risk?
Yes. Sports that involve jumping, pivoting, rapid direction changes, or contact can expose the ankle to twisting forces, according to Mayo Clinic. Risk still depends on conditioning, technique, and previous injuries.
Can footwear cause an ankle sprain?
Poorly fitting or activity-inappropriate footwear may contribute to risk, but footwear alone does not decide whether a sprain happens. Fit, wear, traction, and the surface all matter. Choose shoes suited to your activity and replace worn pairs.
Can balance exercises prevent ankle sprains?
Balance training can help reduce repeat sprains, particularly in people with a previous sprain, according to clinical practice guidelines. The evidence for preventing a first-time sprain is less certain.
Does a previous ankle sprain ever fully heal?
Many sprains recover well, but some people have ongoing weakness or instability. Appropriate rehabilitation can help restore function and may lower the risk of another injury. If your ankle feels unreliable months later, ask a clinician to evaluate it.
How can I tell if my ankle is at risk of another sprain?
Previous sprains, repeated episodes of the ankle giving way, persistent weakness, and balance difficulties are reasons to consider a professional assessment. A clinician or physical therapist can check strength, balance, and movement and suggest next steps.
Conclusion
Not every ankle sprain can be prevented. Still, addressing previous injuries, strength and balance gaps, unsafe surfaces, and a premature return to activity can help you make more informed decisions about protecting your ankles. Focus on the factors you can change, and seek help for persistent ankle instability.
Sources
- Mayo Clinic. Sprained ankle: Symptoms and causes
- Mayo Clinic. Sprained ankle: Diagnosis and treatment
- American Academy of Family Physicians. Update on Acute Ankle Sprains
- American Academy of Family Physicians. Acute ankle injury article (American Family Physician, November 2006)
- British Journal of Sports Medicine. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline
- Journal of Orthopaedic and Sports Physical Therapy. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021
Medical Disclaimer: This article is for general information and education only. It is not medical advice and does not diagnose, treat, or replace care from a qualified healthcare professional. Ankle injuries and risk factors vary from person to person, and only a healthcare professional can tell whether you have a sprain, a fracture, or another problem. Seek medical care if you cannot walk, have severe pain or deformity, or notice numbness in your foot.
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