Balance Training After an Ankle Sprain

The short answer

Ankle sprains often come back because the injury dulls your ankle's sense of position, not just its ligaments. Balance training retrains that sense. Research shows that doing at least six weeks of balance training after an acute ankle sprain substantially lowers the risk of spraining it again. Once a professional has cleared you, a SlackBoard is a way to keep that training going at home.

Why ankle sprains come back

Your ankle constantly sends your brain information about its position, a sense called proprioception. A sprain can disrupt that feedback, so your ankle reacts a fraction of a second late on uneven ground, a bad landing or a sudden cut. Strength may come back while that reaction time doesn't, which is why so many people sprain the same ankle twice.

What the research shows

• After a sprain: a systematic review in the Journal of Athletic Training found that completing at least six weeks of balance training after an acute ankle sprain substantially reduced the risk of another one (McKeon & Hertel, 2008). The benefit was greatest in people with a previous sprain.

• In athletes: a meta-analysis of randomized trials found balance training reduced ankle sprains by 38% compared with no training, and also improved reach distances on the Star Excursion Balance Test, a common measure of dynamic stability (de Vasconcelos et al., 2018).

• In pivoting sports: a systematic review found balance training alone significantly reduced the risk of ankle sprains, and that training programs worked even better in athletes who had been injured before (Hübscher et al., 2010).

One honest caveat: the evidence is weaker for people with long-term chronic ankle instability, where the McKeon and Hertel review found too few studies to judge whether balance training prevents repeat sprains.

Where a SlackBoard fits

A SlackBoard isn't a treatment for an ankle sprain. It's a balance-training tool, and the research above is about balance training in general. Where it helps is the long tail of recovery: the weeks and months of balance work that keep a healed ankle from getting hurt again, done at home in a few minutes a day.

The line moves slightly under your foot in every direction, so your ankle has to keep making the small, fast corrections it needs on the field, the trail or the stairs.

Before you start, make sure a doctor or physical therapist has cleared you for balance work. In general, that means you can walk and stand on the injured leg without pain.

A sample progression

Take each stage at your own pace and move on only when the current one feels steady and pain-free. Have something sturdy within reach.

The research behind these results used programs of at least six weeks, so think of this as a habit to keep, not a one-week fix. Stop and check in with your PT if you feel pain, swelling or the ankle giving way.

Next read: Balance Training for Basketball Players, and Balance Training for Soccer Players.

FAQ

Q: Does balance training help after an ankle sprain?

A: Yes. Research shows at least six weeks of balance training after an acute sprain substantially reduces the risk of spraining the same ankle again. Consult with your physical therapist before beginning any exercise program.

Q: When can I start balance exercises after a sprain?

A: When your doctor or physical therapist clears you, usually once you can stand and walk on the ankle without pain.

Q: How long should I keep doing balance training?

A: The studies used programs of at least six weeks. Many athletes keep a few minutes of balance work in their routine for good.

Q: Is a balance board good for ankle recovery?

A: A balance board can be a useful tool once you're cleared for balance work, but it isn't a treatment on its own. Use it as part of the plan your PT gives you.

Q: Should I start on one line or two?

A: Two. The SlackBoard Plus in two-line mode gives the most stable start; move to one line once two feels easy.

Sources

• McKeon PO, Hertel J. Systematic review of postural control and lateral ankle instability, part II: is balance training clinically effective? J Athl Train 2008;43(3):305–315. PMC

• de Vasconcelos GS, et al. Effects of proprioceptive training on the incidence of ankle sprain in athletes: systematic review and meta-analysis. Clin Rehabil 2018;32(12):1581–1590. PEDro record

• Hübscher M, et al. Neuromuscular training for sports injury prevention: a systematic review. Med Sci Sports Exerc 2010;42(3):413–421. PubMed