An ankle that keeps giving way is usually the result of an earlier sprain that left stretched ligaments and, just as important, poorer balance and slower muscle reactions. AAOS OrthoInfo calls incomplete rehabilitation the most common cause of chronic ankle instability. Supervised balance, strength and hopping work is the standard first treatment, and an Indiana-licensed physical therapist near Carmel can start it without a referral.
Last reviewed By the Monon Therapy Collective editorial team
Why does my ankle still roll months after the sprain healed?
The pain healed, but the ankle’s sense of position and its reflexes often did not. Ligaments carry nerve endings that tell the brain where the joint is; when they are stretched, that signal becomes less precise, and the muscles on the outside of the ankle fire a fraction too late to catch a roll. AAOS notes that abnormal proprioception, the body’s sense of joint position, is a common complication of ankle sprains and can lead to repeat sprains.
Each new roll stretches the ligaments again, so the cycle feeds itself. APTA’s ChoosePT guide makes the same point: once an ankle ligament is sprained, it is more prone to reinjury.
Is it loose ligaments, weak muscles, or something else?
Most giving-way ankles have a mix of loose ligaments and poor control, and the therapist’s job is to work out the proportions. A few less common problems can mimic or add to instability.
| Likely cause | What it tends to feel like | Read more |
|---|---|---|
| Chronic ankle instability after sprains | Rolls on uneven ground or quick turns; a wobbly, untrustworthy feeling between episodes | Chronic ankle instability |
| Recent sprain not yet rehabbed | Swelling and pain still present after 4 to 6 weeks, weak push-off | Ankle sprain |
| High ankle sprain | Pain above the ankle bone with twisting and pushing off, slow to settle | High ankle sprain |
| Peroneal tendon irritation | Pain and sometimes snapping behind the outer ankle bone, weakness turning the foot out | Peroneal tendonitis |
| Ankle impingement | Pinching at the front of the ankle in deep lunges or landings, often after many sprains | Ankle impingement |
How can I test my own ankle balance at home?
Stand barefoot next to a counter, lift the other foot and hold for 30 seconds with eyes open, then try with eyes closed, and compare sides. An ankle that has given way repeatedly usually shows more wobble, more toe gripping and earlier loss of balance on the injured side, especially with eyes closed. AAOS describes standing on one foot with eyes closed as a balance exercise used for this very problem.
Keep a hand hovering over the counter the whole time. If you cannot stand on the leg without pain, or the ankle swells afterward, stop the test and let a therapist take it from there. The single-leg balance exercise page describes the movement and its common mistakes in more detail.
What tests will a therapist run on an unstable ankle?
A therapist checks ligament laxity by gently drawing the foot forward and tilting the heel, then measures ankle bend, strength turning the foot out and pushing up on the toes, and how you balance and reach in several directions on one leg. Later tests add hopping forward and side to side, and a timed change of direction, because a return to court or field needs more than steady standing.
APTA’s guide notes that therapists also observe walking and test for other foot injuries, since a missed fracture or tendon problem changes the plan. Treatment then builds from balance on firm ground to foam, catching throws, landing drills and agility work. Exercises such as banded ankle inversion may appear early; your therapist decides when to progress.
Will I need a brace or surgery for an ankle that keeps rolling?
Most people do not need surgery. A brace or tape can reduce rolls during sport while training catches up, and a well-run rehab program is normally tried first. If the ankle still gives way after that, a surgeon may discuss ligament reconstruction, and the Broström surgery rehab guide explains what recovery from that operation usually looks like.
Grand Park weekends, pickleball on outdoor courts and icy Carmel curbs in January are typical places an unstable ankle shows itself. The ankle and foot questionnaire lets the matching team suggest a therapist in the network who focuses on sport and balance retraining.
Get the ankle checked by a physician first if
- You cannot take four steps on it, or the bone on either side of the ankle is tender to press
- The ankle or foot looks deformed, or the foot is cold, pale or numb
- You felt a pop at the back of the ankle and cannot push up onto your toes
- Swelling and pain keep getting worse after the first few days rather than easing
If you think it is an emergency, call 911.
