You rolled your ankle months ago. At first, it was swollen and sore, but you assumed it would heal with time. But here you are, still dealing with pain, stiffness, or instability. So why has it not gone away?
If this sounds familiar, you are not alone – and there are valid reasons why ankle pain can persist long after the initial injury.
What happens when you sprain your ankle?
An ankle sprain occurs when the ligaments supporting the joint are overstretched or torn, usually from a sudden twist, roll, or awkward landing. The ligaments on the outside of the ankle are most commonly affected.
Mild sprains often heal with time and rest, but that does not mean they heal well. Without proper rehabilitation, many people return to activity too soon or do not restore full strength and function – which can lead to longer-term problems.
Why is it still hurting months later?
There are several reasons why ankle pain can persist after a sprain:
- Incomplete healing
Ligaments need progressive loading and rehabilitation to recover fully. Skipping this step can result in weak, poorly healed tissue. - Chronic ankle instability (CAI)
Ongoing feelings of wobbliness can indicate that the supporting structures have not regained stability.
According to a recent study, up to 70% of people who suffer an ankle sprain report ongoing symptoms such as pain, instability, or limited mobility months or even years after the injury (Wang et al., 2023). - Scar tissue and stiffness
Scar tissue from the injury can limit movement and affect how the joint functions. - Different movement patterns
Limping or avoiding certain motions can lead to muscle imbalances and put stress on other joints and tissues. - Nerve involvement
In some cases, nerves around the ankle can become irritated or hypersensitive, contributing to ongoing pain.
What does chronic ankle pain feel like?
If your symptoms have lasted longer than three months, your pain might be chronic and you might notice:
- A lingering ache in the ankle
- Pain during or after activity
- Instability or weakness
- Morning stiffness or discomfort after sitting
- Reduced confidence in the ankle when walking or exercising
The treatment plan
The key to resolving chronic ankle pain is to treat the cause, not just the symptoms. A physiotherapist will assess your strength, range of motion, joint function, and balance to pinpoint the underlying issues. Treatment might include:
- Joint mobilisation and soft tissue therapy
To improve range of motion, reduce stiffness, and ease pain. - Strength training
Exercises restore stability and help prevent future sprains. - Proprioceptive training
Retraining your body’s ability to sense joint position and react quickly is essential for preventing re-injury. - Shockwave or laser therapy
In persistent cases, these modalities may help stimulate healing in damaged tissues. - Education and recovery planning
Knowing how to load the ankle safely during recovery is vital for long-term success.
Chronic ankle pain after a sprain is more common than most people realise – but it is also very treatable. If your ankle still gives you trouble months after the injury, it is a sign that something has not healed properly. The right rehabilitation can make a significant difference.
We want to help you get back on your feet! Click here to book an appointment at Hein Viljoen Physiotherapy.
