The ankle is highly stable in a neutral standing position. But in a downward-flexed, on-your-toes position, the joint depends more on support from injury-prone ligaments and tendons.
Top Threat: Sprain
What it is: A tear in one of the ligaments — usually on the outside of the ankle — that supports the joint. Severe sprains that leave the ankle unstable may eventually damage the joint’s bones and cartilage.
Cause: Stretching the ligament beyond its limits, usually by rolling the foot as you walk or run on an uneven surface, making a cutting move, or stepping on someone’s foot. Just a month ahead of Portugal’s 2018 World Cup bid, star forward Cristiano Ronaldo sprained his ankle and had to leave the game. “Outside of sports, the most common scenario for men is rolling the foot while going down a step,” says Rocco Monto, M.D., spokesman for the American Academy of Orthopaedic Surgeons.
Treatment: Rest and compress the ankle, possibly with help from a brace. Rehab will build supporting muscles and increase balance with exercises like standing on one foot with eyes closed— important for preventing repeat sprains due to ankle instability. Surgery to reconstruct the ligament and brace the ankle is rarely needed.
Defense: Build calf muscles with exercises like calf raises to increase support around the ankle and improve balance. “They’re like stirrups that hold the ankle in,” says Dr. Monto.