Recurring Ankle Sprains in Amsterdam: Why Your

You rolled your ankle months ago, maybe on a cobblestone, a football pitch or a padel court. The swelling went down, you walked normally again, and you assumed it was healed. Yet the ankle still feels “loose”, it gives way on uneven ground, or it aches after a run. If that sounds familiar, you are not alone. A lateral ankle sprain is one of the most common sports and everyday injuries, and a meaningful share of people go on to have lingering symptoms or repeat sprains.

This article explains why ankle sprains so often come back, what chronic ankle instability is, and what a structured physiotherapy plan looks like, especially if you already had some treatment and still don’t trust your ankle.

Why a “simple” ankle sprain often isn’t simple

Most ankle sprains happen when the foot rolls inward (inversion) and the ligaments on the outside of the ankle are overstretched or torn. The anterior talofibular ligament (ATFL) is the one most often injured.

Ligaments heal, but healing alone doesn’t restore everything. After a sprain, research consistently finds changes in:

Balance and position sense (proprioception): the ankle is slower to sense and correct a wobble.
Muscle reaction time and strength: especially the peroneal muscles on the outside of the lower leg and the muscles around the hip.
Range of motion: many people lose some dorsiflexion (bending the ankle upward), which changes how they land and squat.
Confidence: fear of re-injury changes how you move, often without you noticing.

Studies following people after a first sprain suggest that up to around 40% develop chronic ankle instability (Doherty et al., 2016, American Journal of Sports Medicine). The biggest risk factor for a new sprain is a previous one.

What is chronic ankle instability?

Chronic ankle instability (CAI) is the term used when, at least a year after the first sprain, someone still has repeated “giving way”, recurrent sprains, or the feeling that the ankle is unstable, together with reduced function. The International Ankle Consortium describes it as a mix of mechanical factors (ligament laxity) and functional factors (balance, muscle control and sensorimotor changes) (Gribble et al., 2016, British Journal of Sports Medicine).

Typical signs

The ankle rolls or “gives way” on uneven surfaces, kerbs or during sport
You avoid jumping, cutting or running on trails
Swelling or a dull ache after activity
You feel you need tape or a brace to trust it
Balancing on one leg is clearly harder on the injured side

When to get it checked first

See a doctor or physiotherapist promptly if you could not take four steps right after the injury, if there is pain directly on the bone, or if the ankle locks, catches or stays very swollen. Clinicians use the Ottawa Ankle Rules to decide whether an X-ray is needed, and persistent pain can sometimes point to a cartilage injury or a different problem that needs further assessment.

Why the first round of treatment didn’t fix it

Many people we see in Amsterdam received good initial advice: rest, ice, compression, maybe a brace, and a sheet of exercises. The problem is usually not the advice itself but what happens afterwards.

Rehab stopped when the pain stopped. Pain often settles in a few weeks, long before balance and strength are back to normal.
Exercises never got harder. Standing on one leg on a flat floor is a start, not a finish. Your ankle needs to cope with fast, unpredictable movement.
Only the ankle was trained. Hip and trunk control affect how the foot lands. Research in people with CAI shows changes further up the chain too.
Ankle mobility was overlooked. Stiffness in dorsiflexion is common after a sprain and is easy to miss.
Return to sport was based on time, not testing. “Six weeks” is not a test.

What the evidence supports

The good news is that recurrent ankle sprains respond well to the right kind of training.

Balance and neuromuscular training

A large randomised trial from the Netherlands found that an eight-week, home-based balance training programme after a sprain reduced the risk of a new sprain by about a third compared with usual care (Hupperets et al., 2009, BMJ). Systematic reviews support exercise therapy, particularly balance and neuromuscular training, for reducing recurrence (Doherty et al., 2017, British Journal of Sports Medicine).

Progressive strengthening

Strengthening the calf, the peroneal muscles and the hip muscles helps the ankle control load. Exercises should progress from slow and controlled to fast, reactive and sport-specific.

Restoring ankle mobility

If dorsiflexion is limited, joint mobilisation by a physiotherapist combined with mobility exercises can help restore normal movement, which matters for landing, running and squatting.

Bracing or taping as a support, not a solution

Wearing a brace or tape during sport can reduce the risk of re-injury, especially in the first year (Vuurberg et al., 2018, British Journal of Sports Medicine). It works best alongside training, not instead of it.

When surgery is discussed

A minority of people with clear mechanical instability keep giving way despite a full, well-run rehabilitation programme. In that case referral to an orthopaedic surgeon for an opinion on ligament repair may be appropriate. Most guidelines recommend a solid course of exercise therapy first.

A practical rehab roadmap

Every ankle is different, but a typical progression for recurring sprains looks like this:

Phase 1: Calm it down and move it (weeks 0–2)

Reduce swelling, protect the ankle if needed
Gentle range-of-motion work, especially dorsiflexion
Walking as normally as comfort allows

Phase 2: Build control (weeks 2–6)

Single-leg balance, eyes open then closed
Balance on softer or uneven surfaces
Calf raises, resisted ankle eversion with a band, hip strengthening

Phase 3: Make it reactive (weeks 6–10)

Hopping in different directions, controlled landings
Balance while catching a ball or turning your head
Faster change-of-direction drills

Phase 4: Return to sport and stay there

Sport-specific drills (cutting for football, lateral moves for padel, trail running progressions)
Objective tests before full return: single-leg hop tests, side hop, Y-balance, and how confident you actually feel
A short maintenance routine two or three times a week

The total time varies, but people with long-standing instability often need two to three months of consistent work. That is less than it sounds if you compare it with another year of rolling your ankle.

Simple tests you can try at home

These are not a diagnosis, but they can show whether your ankle still needs work:

Single-leg stance: can you stand on the injured leg for 30 seconds with your eyes closed, about as well as on the other side?
Knee-to-wall test: in a lunge position, can you touch the wall with your knee with your toes as far from the wall on both sides?
Single-leg calf raises: can you do a similar number on both sides (many healthy adults manage 20 or more)?

A clear difference between sides is a good reason to have a proper assessment.

Ankle sprains and life in Amsterdam

Cycling, cobblestones, kerbs, the canal-side paths, five-a-side football and the growing padel scene all put ankles to the test. Many of our patients are expats who sprained an ankle, saw a GP, were told it would heal by itself, and never received a structured rehab plan. In the Netherlands you can book a physiotherapist directly without a GP referral, so you don’t need to wait for a referral to get your ankle assessed.

How we help at Alter Physio

At Alter Physio in Amsterdam Zuid we start with a thorough assessment of how your ankle moves, how well you balance, and how your hip and trunk contribute. From there we build a progressive, personal plan with clear goals and objective tests, so you know when you are ready to return to sport. Sessions are in English, and we accept international insurance.

If you have already had physiotherapy for your ankle but it still gives way, a fresh look can make a difference. Our second opinion service is designed for exactly that situation.

FAQ

How long does a sprained ankle take to heal?

Mild sprains often feel much better within two to four weeks, but ligament healing and recovery of balance and strength take longer, often six weeks to three months. Feeling better is not the same as being fully rehabilitated.

Should I keep wearing a brace?

A brace or tape can lower the risk of re-spraining during sport, especially in the first year after injury. It works best combined with balance and strength training rather than as a long-term replacement for it.

Do I need an X-ray or MRI?

Usually not. An X-ray is considered when there is bone tenderness or you can’t bear weight, according to the Ottawa Ankle Rules. An MRI may be useful if pain, locking or swelling persists despite good rehabilitation.

Can I still run or play sport while doing rehab?

Often yes, with adjustments. Your physiotherapist can help you decide what load is sensible at each stage, so you stay active without setting back your recovery.

Is it too late if I sprained my ankle years ago?

No. Studies on chronic ankle instability include people with long-standing symptoms, and many improve with structured balance and strength training.

Book an assessment

If your ankle keeps rolling or you no longer trust it, book a session with an English-speaking physiotherapist at Alter Physio in Amsterdam Zuid. We will assess what is really holding you back and give you a clear plan to get your stability back. Contact us or book your first session.

This article is for general information and does not replace an individual assessment by a healthcare professional.

References

Doherty C, et al. Recovery from a first-time lateral ankle sprain and the predictors of chronic ankle instability. Am J Sports Med. 2016.
Gribble PA, et al. 2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med. 2016.
Hupperets MDW, Verhagen EALM, van Mechelen W. Effect of unsupervised home based proprioceptive training on recurrences of ankle sprain: randomised controlled trial. BMJ. 2009.
Doherty C, et al. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. Br J Sports Med. 2017.
Vuurberg G, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018.