5 Things to Know About Soccer-Centric Ankle Health

“Ankle sprains are among the most common injuries in soccer players, accounting for approximately 20% of all soccer-related injuries,” explains Dr. Roukis, a board-certified and fellowship-trained foot and ankle surgeon specializing in reconstructions, ankle joint replacements, revisions and trauma of the foot and ankle.

Other common causes of ankle sprains and injuries include overuse injuries, trauma from kicking and fractures during collisions.

In general, ankle sprains can be graded on a three-grade classification scale with three main ligament groups that could be affected: lateral ankle ligaments, syndesmotic or high-ankle ligaments and medial or deltoid ligaments. Dr. Roukis elaborates, “Key activities during soccer that can damage the lateral ankle ligaments are player-to-player contact, noncontact or indirect mechanisms, like sudden changes in direction, pivoting or quick acceleration and other miscellaneous scenarios, including slide tackling, tripping or getting kicked.”

“Soccer players face a higher risk of ankle sprains due to the sport’s inherent demands, which combine rapid, high-intensity movements with frequent physical contact and unpredictable situations on the field,” shares Dr. Roukis.

Unlike other sports, soccer requires multidirectional running and a contact-heavy nature, making the ankles particularly vulnerable to injury. Video studies of elite soccer players identified four main situations that cause ankle sprains, which include:

• Being tackled
• Landing from a jump
• Sliding
• Tackling or pressing another player

According to Dr. Roukis, “A history of previous ankle sprains is the strongest and most consistent risk factor. Prior ankle injuries lead to lingering issues like mechanical instability, muscle weakness and delayed reaction times.”

Surprisingly, even soccer cleats can increase the risk of ankle sprains or other injuries. While this special type of footwear is designed to enhance a player’s grip, it can hold the foot in place as the body or leg twists, leading to sprains or other injuries.

Dr. Roukis responds, “Soccer players can significantly reduce their risk of ankle sprains and other injuries through a combination of neuromuscular training, strength and balance work, proper equipment choices and smart training habits. Evidence from multiple scientific studies, confirms that these strategies are highly effective, with some programs reducing ankle injuries by 40%.”

Other ways that soccer players can prevent ankle sprains and injuries include:

• A structured 20-minute warm-up before playing
• Using prophylactic ankle support, such as bracing or taping
• Optimizing your footwear for proper fit and stability

While you can’t fully prevent an ankle sprain or injury, these safety measures ensure you’re as protected as possible when you’re on the field.

“Most Grade 1 (mild) and some Grade 2 (moderate) ankle sprains can be effectively managed at home, during the first 24- to 72-hours, by using initial protection and symptom control,” explains Dr. Roukis.

However, distinguishing a mild ligament stretch from a more severe Grade 3 sprain, a high ankle sprain, fracture or other injury requires a visit to the doctor. If you’re unsure about the extent of your injury, it’s best to have it checked. Our providers can complete a comprehensive assessment of your ankle and perform diagnostic imaging tests, such as X-rays, to ensure you receive the right treatment.

If you’re a soccer player, you’ve likely heard of the RICE method, which stands for rest, ice, compression and elevation. This commonly recommended treatment option provides short-term symptom relief from a mild ankle injury.

Dr. Roukis shares an alternative treatment method: “Evolving guidelines recommend the PEACE and LOVE method, which stands for protection, elevation, avoid anti-inflammatories, compression and education; followed by load, optimism, vascularization and exercise.”

For a suspected Grade 1 or mild sprain, the initial treatment over the first one to three days would be:

• Protect/rest: Limit weight-bearing, but avoid complete immobilization.
• Ice: Apply for 20 minutes every two hours for pain relief.
• Compression: Use an elastic bandage starting from the toes; move up toward the knee, without cutting off circulation.
• Elevation: Keep the ankle at heart level when sitting or lying down.
• Over-the-counter medications: Acetaminophen (or Tylenol) is preferred.
• Continue with progressive loading: Focus on balance exercises to strengthen muscles.

When it comes to recovering from an ankle sprain or injury, it’s best to give your body time to heal. “I always tell patients to avoid rushing back to playing soccer after a sprain. With patience and consistency, most players return to pre-injury performance levels after a few weeks,” says Dr. Roukis.