If you've spent any time in a PT clinic, you already know: ankle sprains are the single most common injury I see walk through the door, regardless of sport. Whether its basketball, volleyball, soccer, or tennis, ankle injuries happen all the time. Anytime an athlete cuts, jumps, or lands on an uneven surface, the ankle is at risk. One of the biggest issues with ankle sprains is how often you can reinjury the ankle once it has been sprained. That initial injury changes everything for the integrity of the ankle. It stretches the lateral ligaments, blunts proprioceptive feedback (your ankle's ability to sense its position in space), and often leaves subtle weakness that never gets fully addressed before returning to play.
So, the real question patients ask me isn't "how do I treat a sprain" — it's "how do I keep this from happening in the first place, or happening again." Here's what I actually tell them, and what I build into every prevention program I write.
Why Are Ankle Sprains So Common in Sports
Before we get to prevention, it helps to understand the mechanism. Most ankle sprains (roughly 80-85% of them) are inversion sprains, meaning the foot rolls inward and the outer ligaments primarily the anterior talofibular ligament (ATFL) get overstretched or torn.1 This usually happens in a fraction of a second, during landing, cutting, or contact with another player's foot. The ankle simply doesn't have time to react and correct before the ligament is already under excessive load.
That's the key insight that shapes everything about prevention: you're not trying to build an ankle that can never be put in a bad position. You're trying to build a system: muscular, neurological, and mechanical that reacts fast enough to correct that position before injury occurs, and that has the structural support to tolerate it when it can't.
How Can Athletes Prevent Ankle Sprains?
1. Train Balance and Proprioception, Not Just Strength
Strong ankles aren't enough if they can't react fast. Single-leg balance work, wobble board drills, and reactive hopping exercises retrain the neuromuscular pathways that fire in the split second before a roll becomes a sprain. I have athletes start with a simple single-leg stance (eyes open, then closed) and progress to unstable surfaces like foam pads or wobble boards, then to sport-specific cutting and landing drills under fatigue. The fatigue part is a huge component when it comes to injury — because most sprains happen late in games or practices, when neuromuscular control is already compromised. This progression is non-negotiable in any prevention program I build, and it's the single most evidence-supported category of ankle injury prevention work out there. Tools like the BlazePod, Reaxboard, and other reactive training devices can help reduce risk for injury.
2. Strengthen the lower leg and improve ankle mobility
The peroneal muscles on the outside of your lower leg are your primary dynamic defense against inversion sprains. When they fire quickly and strongly enough, they can correct an ankle roll before it becomes a ligament injury. Resistance band eversion work, calf raises, and controlled lateral hops build the strength and reaction speed needed to check that motion.
Equally important and often overlooked is ankle dorsiflexion mobility. Stiff ankles change how athletes absorb landing forces, often shifting stress into positions where the joint is more vulnerable to rolling. I regularly assess dorsiflexion range in athletes with recurrent sprains and am consistently surprised how often it's the missing piece rather than strength alone. Simple wall-based dorsiflexion mobilizations, calf stretching, and joint mobilization work (sometimes done manually in clinic) can restore this range over a matter of weeks.
3. Warm Up with Purpose
A static stretch and some warm up laps just doesn’t cut it today for a purposeful dynamic warmup to reduce risk of injury. Instead, a dynamic warm-up that mimics the demands of the sport is more suited for athletes. A Skips, B Skips, Lateral shuffles, bounding, cutting drills, single-leg hops prime the neuromuscular system in a way passive stretching simply can't. The goal of a warm-up isn't just raising tissue temperature; it's "waking up" the reactive stabilizing muscles around the ankle so they're ready to fire the moment the game starts, not five minutes in.
4. Respect Footwear and Court/Field Surfaces
Worn-out shoes lose the structural support that helps control excessive ankle motion, particularly in the midsole and outsole, which flatten and lose their ability to resist inversion forces over time. Also, with a worn-out shoe it can lose stability on the court which could cause an inversion ankle sprain. If you're playing on uneven turf, worn hardwood, or transitioning between surfaces mid-season, that's exactly when I see the injury spikes in the clinic. Rotate footwear appropriately, inspect it for wear (especially asymmetric wear patterns on the outsole), and choose shoes appropriate for the specific sport and surface rather than an all-purpose trainer.
5. Use External Support During High-Risk Activities
Taping and bracing aren't crutches, they're tools, and I use both depending on the athlete and situation. Athletic taping is effective in the short term but loses a meaningful amount of its mechanical support within the first 20-30 minutes of activity as the tape stretches.2 Athletic tape may gradually lose some mechanical support because of movement, perspiration, and material deformation. Braces hold their support profile far longer, which matters over the course of a full game, tournament, or multi-hour practice.
For athletes with a history of mild-to-moderate lateral ankle sprains, I'll often recommend something like the Zamst A1 ankle brace. It's low-profile enough to fit in most athletic shoes while still providing three-way strap support (L-strap and Y-strap configuration) during return-to-sport phases, without meaningfully restricting the range of motion athletes need for cutting and jumping.
For athletes managing more significant or recurrent instability, multiple prior sprains, chronic "giving way" sensations, or high ankle sprain history a stronger option like the Zamst A2-DX offers a dual X-strap system providing three-way support (anterior, lateral, and medial) specifically designed for higher ankle sprains and chronic instability. The reason you would want to move from a moderate support to a higher-support option is because of the severity of the ankle sprain.
I want to be clear about something, though: neither brace replaces rehab. Bracing is most effective when combined with strength, balance, and proprioception training rather than used as a substitute for rehabilitation.
6. Build Endurance so Fatigue Doesn’t Become a Factor
This is a piece I don't think gets talked about enough. A significant portion of ankle sprains happen in the second half of games, late in tournaments, or toward the end of practice — not because mechanics change, but because the muscles responsible for reactive stabilization fatigue faster than the larger prime movers. If your conditioning program only trains the ankle stabilizers in a fresh state, you're not preparing the athlete for the conditions where sprains actually happen. Incorporating balance and reactive drills after a conditioning circuit, when the athlete is already fatigued, better simulates game-realistic demand on the ankle.
7. Don't Rush Return to Play
The single biggest predictor of re-injury I see clinically is returning too early — before proprioception and strength have actually been restored, not just before pain has resolved. Pain-free is not the same as ready. A proper return-to-sport progression should include single-leg hop testing, cutting drills, power testing and sport-specific movement assessment before an athlete is cleared for full, unrestricted competition.
Putting It All Together
Prevention isn't glamorous, and it's rarely the exciting part of training that athletes want to spend time on. But it's the difference between a season that continues and one that ends in a walking boot. Build the balance work, the strength foundation, the mobility, and the smart use of support tools like bracing before you need them not after the first roll sends you into a PT clinic.
Cavazos GJ Jr., Harkless LB. The epidemiology, evaluation, and assessment of lateral ankle sprains in athletes. J Sports Med Ther. 2021; 6: 008-017.
Bragg RW, Macmahon JM, Overom EK, Yerby SA, Matheson GO, Carter DR, Andriacchi TP. Failure and fatigue characteristics of adhesive athletic tape. Med Sci Sports Exerc. 2002 Mar;34(3):403-10. doi: 10.1097/00005768-200203000-00004. PMID: 11880802.