Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

The Repeated Sprain Problem

If you’ve sprained the same ankle multiple times, you’re not just unlucky — you likely have chronic lateral ankle instability (CLAI), a mechanical and neuromuscular dysfunction that dramatically increases re-sprain risk. Studies show that up to 40% of patients who sustain an initial ankle sprain go on to develop chronic instability, and many simply accept repeated sprains as inevitable. They don’t have to be.

What Happens After an Incompletely Treated Sprain

The lateral ankle ligaments — particularly the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) — heal after a sprain, but often elongate rather than returning to their original length and stiffness. This ligamentous laxity allows the talus to shift and tilt excessively in the ankle mortise. Simultaneously, the proprioceptive nerve endings within the damaged ligaments — which normally signal the brain about ankle position — are disrupted, reducing the reflexive protective muscle responses that prevent inversion injuries. The combination of mechanical laxity and proprioceptive deficits creates an ankle that sprains at provocations that a healthy ankle would handle.

Breaking the Cycle: Rehabilitation

Appropriate rehabilitation after an ankle sprain — not simply resting until pain resolves — addresses both the mechanical and neuromuscular deficits. Phase 1 (days 1-5): RICE protocol and protected weight-bearing as tolerated. Phase 2 (weeks 1-3): Range of motion restoration and progressive weight-bearing. Phase 3 (weeks 3-8): Progressive proprioceptive training (single-leg balance, unstable surface training, sport-specific movement patterns) and peroneal muscle strengthening. Skipping Phase 3 — the most commonly skipped phase — leaves the proprioceptive deficits unaddressed and sets the stage for the next sprain.

Bracing and Support

A lace-up functional ankle brace worn during sports for 6-12 months after a significant sprain reduces re-injury risk by approximately 50% in research studies. The brace substitutes for the proprioceptive function lost from ligament injury while neuromuscular rehabilitation is ongoing. Brace use should be combined with — not substituted for — rehabilitation exercises.

When Surgery Is Indicated

Patients with documented ligamentous laxity on stress X-rays, continued functional instability despite 6+ months of appropriate rehabilitation, and repeated sprains limiting sports participation are candidates for surgical ligament reconstruction. The Broström procedure — anatomic repair of the ATFL and CFL — has excellent outcomes with high return to sport rates. Augmentation techniques with allograft tissue are available for patients with excessive ligament laxity. Evaluation at Balance Foot & Ankle in Howell or Bloomfield Township includes functional instability assessment and a personalized plan from conservative rehabilitation through surgical consultation when indicated.

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Balance Foot & Ankle — Howell & Bloomfield Township, MI

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Ankle Sprains Keep Coming Back? Break the Cycle

Chronic ankle instability affects up to 40% of people after an ankle sprain. Dr. Tom Biernacki provides comprehensive stability assessment, physical therapy protocols, custom bracing, and surgical ligament reconstruction when needed to stop recurring sprains.

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Clinical References

1. Hiller CE, et al. Prevalence and impact of chronic musculoskeletal ankle disorders in the community. Archives of Physical Medicine and Rehabilitation. 2012;93(10):1801-1807.
2. Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. Journal of Athletic Training. 2002;37(4):364-375.
3. Gribble PA, et al. 2016 consensus statement of the International Ankle Consortium on chronic ankle instability. British Journal of Sports Medicine. 2016;50(24):1493-1495.

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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.