When can I return to running after an ankle sprain without risking a re-injury? I hear this question a lot after taking an x-ray of an ankle injury from patients.
The truth is returning to running after an ankle sprain will be different for everyone. This will depend on the type of sprain you have, your health and activity levels before injury.
With this article, I hope to help you sort through all the different information we have had about when to resume running based on my knowledge as a radiographer and the findings from scientific studies.
Happy reading!😀 and feel free to ask questions in the comments or share your own experience.🙏
Last updated: July, 2025. Written by Juliet Semakula, a diagnostic radiographer.
▶️Why not go back to running straight away?
When you have had an injury to your ankle, you will need time to allow bones, muscles, tendons and ligaments to readjust and rebuild strength as they heal.
Most of the time ankle sprains cause ligament tears and muscle weakening, they are less stable, so they will need time to heal before you resume running.
Here’s why you shouldn’t go back to running straight away
⚪Muscle weakness
Muscles weaken during periods of inactivity, including the core, glutes, and muscles surrounding the ankles and knees after the injury, they need time to heal.
⚪Increased injury risk
Returning to running at the same level as before a sprain can overstress these weakened muscles, leading to injury.
⚪Joint strain
Joints, tendons, and ligaments also need time to adapt to the impact of running.
⚪Psychological factors
You might feel demotivated or struggle with imposter syndrome after a sprain, a fear of returning to running straight away.
According to D’Hooghe,2020:
A stretched or torn ligament needs time to heal, the risk of a new sprain is quite high, it is noted that in 1 in 10 to 3 in 10 people playing contact sports such as football have at least one new sprain episode after having had one.
To avoid the risk of reinjury because jumping back into running at the same intensity and duration as before is impossible. If consolidation is well underway, the ideal solution is to start again gradually.
▶️Will running on a sprained ankle make it worse
Yes, running on a sprained ankle is likely to make the injury worse and delay healing.
It’s best to avoid running or any strenuous exercise that puts pressure on the ankle until it has fully recovered.
Here are some of the reasons:
⚪Delayed healing: Continuing to stress the injured ankle can hinder the body’s natural healing process, potentially prolonging the time it takes for the ligaments to repair
⚪Further damage: Running can cause additional tearing or stretching of the already damaged ligaments, leading to increased pain, swelling, and a longer recovery time
⚪ Increased risk of re-injury: Running on a weakened ankle can make it more susceptible to re-sprains in the future, especially if you return to activity too soon
⚪Potential for chronic problems: In some cases, running on a sprained ankle can contribute to chronic instability or other long-term complications
Picot et al .2022
▶️How soon after a bad ankle sprain can you go back to running.
The decision in your case when you can resume running will depend on the severity of the sprain and how well your sprain is healing.
Returning to running after a bad ankle sprain can take anywhere from a few weeks to several months.
Patients that come and seek advice from our physiotherapist are usually given this advice but remember, it is personalised.
♦️ Always rely on your pain levels and listen to your body.
If you experience pain during exercise, it’s a sign that you may be pushing too hard, stop or reduce the intensity.
Pay attention to any pain or discomfort and adjust your activity accordingly.
♦️ Completely healed:
If you think your ankle sprain is completely healed, it is advisable you start with short intervals of jogging and walking, then gradually increase the duration and intensity of your runs.
▶️How long does it take for people to resume running after a sprain.
For this question I am going to rely on scientific studies that have followed up people who have had ankle sprains and how long it took them to resume running.
Scientific studies and reviews seek to answer this question in a descriptive way: how many days, weeks or months after an ankle sprain do people return to running.
The reason why I rely on these studies rather than my experience as a radiographer.
✅They are based on a larger sample of people.
✅And they are a little better at limiting bias than someone making an estimate on their own.
So here are a few facts and figures that may give you a more concrete idea of the usual turnaround times.
Recent findings show that ankle sprain is the most common injury in the world of sports.
Bony fractures, cartilage defects, and syndesmotic lesions are frequently seen in association with the more severe type of ankle sprains.
Your ankle sprain needs time to rest and heal before you resume running.
The reported return to running for a football sport for a minor or external ankle sprain has been:
⬜Between 7 days plus 19 days, respectively for amateurs.
⬜15 days plus 19 days for professionals (Waldén,2013)
Another study done by Cho,2015 about returning to running had this to say.
Using the Sefton grading system, 92% of 24 patients who had undergone ligamentoplasty for ankle sprains achieved satisfactory results
The period to return to exercise was as follows:
⬜ Within 8.4 weeks patients were able to return to jogging.
⬜ Within 12.5 weeks, it was possible to return to a higher intensity training (spurt running)
| Take home! 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 running.
Several factors determine when it’s safe and beneficial to resume running after an ankle sprain.
Note! Most of the athletes’ ankle sprains are managed conservatively with excellent outcomes and full return to their pre-injury level of play.
However, it is essential to differentiate having a single ligament sprain from a more complex injury to the ankle joint.
So here are factors that may determine when you can resume running.
1️⃣How severe the sprain was will determine how quick it will be healed and for you to resume running.
2️⃣Individual factors like fitness level and previous running experience.
3️⃣A gradual return to running, guided by pain levels and specific criteria, is generally recommended.
▶️How to reintroduce running after an ankle sprain?
To safely reintroduce running after an ankle sprain:
🟠Start with low-impact activities like walking, cycling, or swimming to build endurance without stressing the ankle.
🟠Gradually incorporate walk-run intervals, increasing running time while monitoring for pain.
🟠Consult a healthcare professional for guidance on taping and strengthening exercises for the ankle muscles before you resume intensive running.
A study done by Picot et al 2022 and Smith 2021
Which aimed to identify the most appropriate tools to target sensorimotor impairments, athlete perception and functional performance after an ankle injury/sprain instability (smith,2021)
Different tests were introduced to assess balance, foot lift and star excursion balance. 4 tests were selected to the best in assessing how well your ankle is healing and what you can do (Picot et al 2022)
Single leg stance test on firm surface and a foot test
➡️Participants stand barefoot on the tested limb, look straight ahead and are then instructed to keep their eyes closed and their hands on their hips for 20s.
➡️With weight-bearing leg at ~5° of knee flexion and with the hip and knee of the non-weight-bearing limb slightly flexed
Single leg stance on firm surface or foot lift test of the left limb: image source Picot,2022.
Star excursion balance and a side hop test.
➡️ A star excursion balance is a reliable functional test to evaluate dynamic postural control of the lower limb and help spot how healthy you are balancing on your ankle.
➡️And a side hop test places higher demands on the ankle joint on the frontal plane; it identifies more functional stability deficits among individuals with ankle sprain injuries
(A): Star excursion balance test of the right limb and Side hop test of the right limb (B): source Picot,2022
The figure of 8 tests.
➡️The patient is instructed to hop on one limb in a pattern as fast as possible between two cones 5 meters apart.
➡️The patient must perform two consecutive laps (for a total distance of 20 m) to complete this test.
Side hop test of the right limb: source Picot,2022
What does all these tests mean:
The aim of the review is to help clinicians in their daily practice, to make decisions during rehabilitation sessions of their patients who have had chronic ankle instability.
Clinicians are encouraged to use different tests and follow-up tests throughout rehabilitation since all studies that have used it show higher scores > 13s to 12s< or better improvement.
However, the authors do not propose measurement thresholds that even with these tests you are ready to return to sports.
No objective return to sport criteria exists after lateral ankle sprain. But the decision can be based upon the experience, expertise and clinical reasoning of the clinician managing your care.
▶️How do you know when to run again after an injury in your case?
Are you lost when faced with all these criteria to consider? How do you decide?
Usually, your doctor or physiotherapist will guide and discuss these different criteria with you, your personal preferences and an assessment may be done.
objective scientific criteria with cut-off scores are still lacking.
However, some people prefer to do things their way, I have seen people resume running when they feel they can:
➡️Walk 30 minutes comfortably without pain.
➡️When they can perform exercises like single leg dips and calf raises without pain or instability.
| Ensure you can walk, stand, and move around without pain or discomfort before even considering running. But if you decide to run and you experience any pain during or after a run, this should be a mild awareness that you should take it easy. |
We have come to the end of this article ,any experience or questions, let’s meet in the comments section. wishing you a quick recovery🙋
📚Sources:
Waldén M, Hägglund M, Ekstrand J. Time-trends and circumstances surrounding ankle injuries in men’s professional football: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med. 2013 Aug;47(12):748-53. doi: 10.1136/bjsports-2013-092223. Epub 2013 Jun 27. PMID: 23813486.
Cho BK, Kim YM, Shon HC, Park KJ, Cha JK, Ha YW. A ligament reattachment technique for high-demand athletes with chronic ankle instability. J Foot Ankle Surg. 2015 Jan-Feb;54(1):7-12. doi: 10.1053/j.jfas.2014.09.008. Epub 2014 Oct 30. PMID: 25441285.
D’Hooghe P, Cruz F, Alkhelaifi K. Return to Play After a Lateral Ligament Ankle Sprain. Curr Rev Musculoskelet Med. 2020 Jun;13(3):281-288. doi: 10.1007/s12178-020-09631-1. PMID: 32377961; PMCID: PMC7251008.
Picot B, Hardy A, Terrier R, Tassignon B, Lopes R, Fourchet F. Which Functional Tests and Self-Reported Questionnaires Can Help Clinicians Make Valid Return to Sport Decisions in Patients With Chronic Ankle Instability? A Narrative Review and Expert Opinion. Front Sports Act Living. 2022 May 26;4:902886. doi: 10.3389/fspor.2022.902886. PMID: 35721875; PMCID: PMC9204606.
Smith MD, Vicenzino B, Bahr R, Bandholm T, Cooke R, Mendonça LM, Fourchet F, Glasgow P, Gribble PA, Herrington L, Hiller CE, Lee SY, Macaluso A, Meeusen R, Owoeye OBA, Reid D, Tassignon B, Terada M, Thorborg K, Verhagen E, Verschueren J, Wang D, Whiteley R, Wikstrom EA, Delahunt E. Return to sport decisions after an acute lateral ankle sprain injury: introducing the PAASS framework-an international multidisciplinary consensus. Br J Sports Med. 2021 Nov;55(22):1270-1276. doi: 10.1136/bjsports-2021-104087. Epub 2021 Jun 22. PMID: 34158354.