Key Takeaways
- Repeat ankle sprains usually happen because the ligaments (tough bands of tissue that connect bones) healed stretched out after an earlier sprain. The muscles and balance around the ankle may not have been fully retrained either.
- Weak ankle muscles, a high-arched foot, and a tight Achilles tendon (the thick cord at the back of your ankle) can also add to the problem.
- An ankle that keeps rolling or 'giving out' may have chronic ankle instability, which means it is often unstable. Get it checked.
- Physical therapy, balance training, and bracing help many people feel steadier. Surgery is considered when the ankle stays unstable despite treatment.
- Repeated sprains can lead to ongoing pain and, over time, arthritis (painful, stiff joints) in the ankle.
- Orthopedic + Fracture Specialists provides foot and ankle care for patients in Portland, Oregon. Request an appointment online or call (503) 214-5200 to find out why your ankle keeps rolling.
Why Does My Ankle Keep Rolling?
A sprain happens when you roll, twist, or turn your ankle in an awkward way. That stretches or tears the ligaments that hold your ankle bones together. Mayo Clinic's sprained ankle overview explains that most sprains involve the three ligaments on the outer side of the ankle.
The trouble starts after the first sprain. FootCareMD's ankle instability guide comes from the patient education site of the American Orthopaedic Foot & Ankle Society (AOFAS). It says repeated sprains can cause the ligaments to heal stretched out. Stretched ligaments lose some of their ability to keep the ankle stable. That makes the next roll easier, and each one can weaken the ankle more.
This is called chronic ankle instability. 'Chronic' means ongoing or repeated. The ankle has too much motion and easily gives out.
Signs Your Ankle May Be Unstable
FootCareMD lists these common signs of ankle instability:
- Your ankle twists easily, especially on uneven ground.
- It rolls when you turn or change direction fast, such as in basketball.
- It feels wobbly or like it might give out.
- Each roll may hurt less over time, because it takes less force to roll a damaged ankle.
What Raises Your Risk of Spraining Your Ankle Again?
Mayo Clinic lists several risk factors for ankle sprains:
- Past ankle injuries. A past sprain makes another one more likely.
- Sports with jumping or quick turns, such as basketball, soccer, tennis, pickleball, and trail running.
- Uneven surfaces, such as trails or poor field conditions.
- Weak ankles. Poor strength or flexibility raises the risk.
- Poor footwear, such as high heels or shoes that do not fit or suit your activity.
FootCareMD adds one more: a high-arched foot (called a cavovarus foot). It can make repeated sprains more likely and puts the peroneal tendons at risk of tearing. Tendons are cords that connect muscle to bone. The peroneal tendons run along the outer ankle and help support its ligaments.
One Sprain vs. Chronic Ankle Instability
This table shows how an occasional sprain compares with chronic ankle instability.
| Feature | Occasional Ankle Sprain | Chronic Ankle Instability |
|---|---|---|
| What is going on | One roll or twist stretches or tears the ligaments. | Ligaments have healed stretched out, so the ankle easily gives out. |
| What you may notice | Pain, swelling, bruising, tenderness, and limited movement. | The ankle gives way easily and feels wobbly. Pain may continue. |
| Usual care | Rest, ice, compression, and elevation for two or three days, then strengthening and balance exercises. | Bracing for risky activities and rehab that includes strengthening, Achilles stretching, and balance training. |
| Surgery | Rare. Considered if the ankle stays unstable after long physical therapy. | May be recommended based on your symptoms and exam findings. |
Other Problems That Can Make an Ankle Give Out
Loose ligaments are not the only cause. FootCareMD points to several other possibilities:
- Weak muscles around the ankle.
- A high-arched foot or other foot shape problem that puts extra strain on the ankle.
- A tight Achilles tendon or pain. Sometimes the ankle gives out even when the ligaments are stable. This is called functional instability.
- Cartilage damage or tendon tears. Cartilage is the smooth cushion in a joint.
For more on Achilles tendon pain, read the practice's blog on why your Achilles tendon hurts and when to stop pushing through it.
Pain and swelling after a twist can also mean a torn ligament or a broken bone, Mayo Clinic notes. Get it checked.
How a Specialist Finds the Cause
A diagnosis starts with your story and a hands-on exam. FootCareMD says a foot and ankle surgeon asks about past injuries, then tests your ankle's strength, motion, and looseness.
Imaging can fill in the rest:
- X-rays can check for broken bones, according to Mayo Clinic's guide to sprained ankle diagnosis and treatment. FootCareMD adds that standing X-rays can show arthritis or bone alignment changes, and stress X-rays can show how loose the ankle is.
- Magnetic resonance imaging (MRI) shows soft tissue. It cannot show looseness, but it can help rule out cartilage damage and tendon tears.
Orthopedic + Fracture Specialists offers X-ray and MRI imaging in-house, so you can get your exam and images in one place.
Treatment Options for an Ankle That Keeps Rolling
Nonsurgical Care
Many people do not need surgery. FootCareMD says nonsurgical care may include:
- Bracing for risky activities, such as running, basketball, and volleyball.
- Rehab with a physical therapist or on your own. Rehab includes muscle strengthening, Achilles stretching, and balance training.
Mayo Clinic adds that balance exercises, such as standing on one leg, help retrain the muscles to work together.
FootCareMD explains that bracing and physical therapy do not strengthen the ligaments themselves. They can help the ankle feel more stable and may prevent sprains if the instability is moderate. Use only a brace that your provider has recommended.
The foot and ankle team at Orthopedic + Fracture Specialists treats ankle instability. Care includes:
- Physical therapy.
- Bracing.
- Manual therapy (hands-on pain relief).
- Personalized exercise programs.
- Education on preventing injuries.
When Surgery Is Considered
Some people still have an unstable ankle after nonsurgical care. FootCareMD says a surgeon may then recommend surgery, based on how unstable the ankle is and how well other treatments worked. Surgery usually does one of two things:
- Tightens the ligaments you already have.
- Rebuilds the ligaments with a graft, which is tissue taken from a nearby tendon.
With a high arch, the surgeon may also realign the foot to lower the chance that instability comes back. FootCareMD reports a high success rate for ankle ligament reconstructions. Full recovery can take up to six months, but most people return to many activities sooner.
How to Lower Your Risk of Another Sprain
Mayo Clinic offers these tips to help prevent a sprain or another ankle injury:
- Practice balance exercises to improve stability and ankle strength.
- Warm up before you exercise or play sports.
- Be careful when you walk, run, or work on uneven surfaces.
- Wear shoes that fit well and suit your activity, and limit high heels.
Mayo Clinic also suggests an ankle brace or tape if your ankle is weak or was hurt before. Ask your provider first, and use only the brace or support your provider recommends.
If you just sprained your ankle, finish healing before you go back to your sport. Mayo Clinic recommends checking with a healthcare professional first. A physical therapist may test whether your ankle is strong and stable enough.
When to See a Foot and Ankle Specialist in Portland
Book a visit if any of these sound familiar:
- Your ankle keeps rolling or giving out.
- Your ankle feels wobbly or unstable.
- Pain or swelling does not improve with self-care, or you keep having pain.
- You think you may have torn a ligament or broken a bone. Orthopedic + Fracture Specialists provides trauma and fracture care.
Ankle sprains are one of the most common injuries the foot and ankle specialists at Orthopedic + Fracture Specialists see. A foot specialist in Portland can find the cause and build a plan for your ankle.
Get Your Ankle Checked in Portland Before the Next Roll
A sprain that keeps coming back is a sign that something needs attention. Orthopedic + Fracture Specialists can find the cause and help you get a steadier ankle.
Schedule a visit with the foot and ankle specialists at Orthopedic + Fracture Specialists in Portland. Request an appointment online or call (503) 214-5200. Same-day appointments may be available for sprains and other injuries.
Frequently Asked Questions
Why does my ankle keep rolling?
Most often, it’s because the ligaments healed stretched out after earlier sprains and no longer hold the ankle steady. FootCareMD says weak muscles or a foot shape problem, such as a high arch, can also play a part.
How many ankle sprains are too many?
The sources do not give a set number. FootCareMD says an ankle that gives out repeatedly may have chronic ankle instability. Talk with a foot and ankle surgeon about your options.
Can exercises fix a weak ankle?
FootCareMD says exercises and bracing can help a moderately unstable ankle feel steadier. They do not strengthen the ligaments themselves.
Is it safe to keep playing sports on an ankle that keeps rolling?
Talk with a healthcare professional first, as Mayo Clinic recommends before you return to sports after a sprain. FootCareMD lists bracing as one option for risky activities such as running, basketball, and volleyball. Ask your provider whether a brace is right for you.
Will I need surgery for a sprained ankle that keeps rolling?
Not always. Mayo Clinic says surgery is rare. It may be needed if the ankle stays unstable after long physical therapy. Orthopedic + Fracture Specialists notes that most foot and ankle conditions can be treated without surgery.
Where can I find a foot specialist in Portland for an unstable ankle?
Orthopedic + Fracture Specialists has foot and ankle specialists serving Portland, Oregon. Request an appointment online or call (503) 214-5200. Same-day appointments may be available for sprains.
