Lateral Ankle Sprain Recurrence: What the Evidence Shows

A lateral ankle sprain is often treated like a short-term problem.

Pain settles. Swelling improves. Activity resumes.

But that is not always the end of the story.

Re-injury after a lateral ankle sprain is common, and a meaningful proportion of people go on to develop chronic ankle instability (CAI). That is why rehab should not stop once symptoms calm down. The real goal is restoring enough strength, balance, control, and confidence to reduce the chance of recurrence.  

Why Recurrence Matters

Lateral ankle sprains are among the most common injuries in sport and physical activity, but their long-term impact is often underestimated. Recurrence matters because each new sprain can contribute to ongoing instability, repeated time away from sport or training, and lower long-term function.  

Across the literature, recurrence rates remain high. In elite football, a recent 2025 study reported a 25.6% recurrence rate over a 12-month follow-up period. Earlier meta-analytic work in elite male football reported an average recurrence rate of about 17%, showing that repeat injury is not unusual even in high-level settings.  

The Link to Chronic Ankle Instability

The concern is not just another sprain. It is what repeated sprains can lead to.

Evidence suggests that a substantial number of people develop chronic ankle instability after an initial lateral ankle sprain. A 2021 systematic review reported a 46% prevalence of CAI in people with a history of ankle sprain, while broader review articles commonly cite figures around up to 40% after a first-time sprain, depending on the population and how CAI is defined.  

That matters because CAI is associated with recurrent episodes of giving way, reduced confidence, persistent symptoms, and lower function during sport and daily activity.  

What This Means in Practice

If someone has had a lateral ankle sprain, the job is not simply to reduce pain and get them moving again. The bigger aim is to reduce the risk of the next sprain.

That means rehabilitation should address more than basic symptom resolution. Programmes should include:

• strength

• balance and proprioception

• dynamic control

• functional movement tasks

• progression back to sport or activity demands

These areas are repeatedly emphasised in clinical guidance and review literature because they influence both short-term recovery and longer-term recurrence risk.  

The Practical Takeaway

Lateral ankle sprains are common, but recurrence is common too.

That is the key message.

If you are working with clients after a lateral ankle sprain, treat rehab as an opportunity to rebuild capacity, not just settle symptoms. The more objective and structured the process is, the better your chance of reducing repeat injury and improving long-term ankle function.

Reference

• Flore, Z., et al. (2025). Time-loss and recurrence rate of lateral ankle sprains in male professional football players depending on the severity grade: Do we trivialise LAS? BMJ Open Sport & Exercise Medicine.  

• Hershkovich, O., et al. (2015). A large-scale study on epidemiology and risk factors for chronic ankle instability in young adults. Journal of Foot and Ankle Surgery.