Towards the strategies of return to sport after lateral ankle Sprain: a systematic review.

Deciding when someone is ready to return to sport after a lateral ankle sprain is a familiar challenge in rehabilitation, but there has never been a clear, agreed-upon way to make that call. This review pulled together 20 published studies looking at how rehabilitation is delivered, what criteria are used to judge readiness, how performance is assessed after returning, and how those criteria relate to the actual timing of return. Rather than testing one treatment against another, the authors mapped out what the existing research says about this whole process. What they found is that return to sport after this injury is shaped by many interacting factors, including how severe the injury was, how it happened, what treatment was given, and which recovery benchmarks were used.

Across the studies, there was no single standard approach. The average quality score of the included papers was moderate, meaning the evidence base itself is inconsistent, which limits how confidently any one pathway can be recommended over another.

If you've sprained your ankle playing sport, one of the biggest questions is simply: when is it safe to get back out there? This review looked at 20 existing studies to see how researchers and clinicians have tried to answer that question, covering things like rehabilitation approaches, the tests or criteria used to judge readiness, and how performance is checked once someone does return. The overall picture is that returning to sport after an ankle sprain isn't governed by one simple rule. It depends on how bad the injury was, how it happened, what treatment was received, and which recovery markers were used to decide someone was ready.

The review found that a clear, agreed-upon standard for this process still doesn't exist in the research. Because the quality of the underlying studies varied, and there was no single consistent method used across them, this review can't offer a firm timeline or checklist. It does, however, lay out the range of approaches currently being used, which may help inform future guidance.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

Physiotherapists managing athletes after lateral ankle sprain often face the same open question: what combination of criteria and timing actually indicates readiness to return to sport. This systematic review addresses that gap not by testing a new protocol, but by synthesising 20 published studies covering rehabilitation measures, return-to-sport criteria, post-return performance assessment, and how those criteria relate to recovery timelines. The key contribution is descriptive rather than comparative: the review confirms that return-to-sport decisions in this population are influenced by multiple interacting factors, including injury severity, mechanism, treatment approach, and the specific criteria applied, and that no standardised paradigm currently exists across the literature.

The included studies scored a mean of 75.36% (±10.40%) on the Downs and Black quality checklist, indicating moderate and variable methodological quality rather than a uniformly strong evidence base. Because this is a synthesis of heterogeneous studies rather than a trial testing a specific intervention, it cannot establish which criteria or timelines produce better outcomes, only that considerable variation exists in current practice and reporting. Clinicians should read the mapped procedures and timelines as a summary of existing approaches rather than a validated decision framework, given the acknowledged lack of standardisation and the moderate quality ratings across included studies.