Simplifying Performance Rehab Part 9: Ankle Sprain

Presented by Phil Plisky and Nate Denning

Video Runtime: 45 Minutes; Learning Assessment Time: 38 Minutes

This course is part of a series designed to be taken sequentially. It is recommended that learners view the series in the following course order:

A lateral ankle sprain is often dismissed as a minor injury, yet delaying performance work can cost an athlete critical windows for restoring speed, power, and agility. This course applies performance programming to a real case—a 19-year-old Division II basketball player with a grade II lateral ankle sprain—and shows how to keep the whole athlete developing while the ligament heals. It defines the clinical goals and progression criteria for each phase, then details how power and plyometrics, speed, and agility are progressed from early rehab to return to sport, with strength and metabolic conditioning layered in. Along the way, it challenges common assumptions and emphasizes restoring closed-chain dorsiflexion and hip strength, not just the ankle. Physical therapists, athletic trainers, and other clinicians managing acute ankle injuries will be able to plan phase-specific goals and progress a complete performance program, treating rehabilitation and performance as one path rather than two.

Learning Outcomes
  • Plan phase-specific clinical goals and progression criteria based on the physiological stages of healing following a lateral ankle sprain
  • Implement core rehabilitation essentials necessary to protect and support adequate tissue healing of ligamentous ankle structures
  • Modify lower extremity strength training progressions throughout the healing timeline to safely optimize an athlete’s return-to-sport readiness
  • Apply power training and plyometric variables safely across all phases of lateral ankle tissue recovery
  • Prioritize speed, agility, and metabolic conditioning pathways across the phases of healing to prepare the athlete for full sport return

Meet your instructors

Man with short brown hair in a blue polo shirt smiles with arms crossed, standing against a white background for medbridge digital healthcare.

Phil Plisky

Dr. Phil Plisky is a professor in the University of Evansville’s Doctor of Physical Therapy and PhD in Health Professions Education programs. He is the host of the Medbridge Rehab and Performance Lab podcast and founder of the Coaches Club at

Read full bio

Smiling man with short hair in a red polo shirt, standing against a white background.

Nate Denning

Dr. Nathan Denning is the founder of Integrated Performance and a partner at Athlete Development Solutions. His mission is to revolutionize human performance and rehabilitation through the integration of physical, mental, and educational support. Nate believes that peak performance—whether for an athlete or a clinician—is the…

Read full bio

Chapters & learning objectives

Lateral Ankle Sprain Instability: The Essentials

1. Lateral Ankle Sprain Instability: The Essentials

This chapter introduces the recurring case—a 19-year-old Division II basketball player with a grade II lateral ankle sprain—and establishes phase 1 priorities: beginning athlete development immediately; restoring closed-chain dorsiflexion; taping and bracing; balance work; starting performance drills as soon as the athlete is weight-bearing; and testing and restoring hip strength. It also examines the evidence on balance and proprioception, including why unstable-surface training shifts control to a hip strategy rather than targeting the ankle. Establishing these essentials protects the healing ligament, keeps the athlete progressing, and corrects a common misconception about balance training.

Power and Speed

2. Power and Speed

This chapter details power and plyometric progressions from phase 2 to return to sport—advancing from lower-impact bilateral drills toward unilateral, depth, and reactive plyometrics—alongside speed progressions built on A and B series, sled and prowler work, and sprints. It emphasizes that speed can begin as soon as the athlete is weight-bearing. Because delaying speed and power work forfeits important neurological and physiological windows, progressing both of them early and in phases restores the explosive qualities that the athlete’s sport demands.

Agility

3. Agility

This chapter builds agility from its foundations—gait reeducation and wall and marching drills across linear, lateral, and crossover categories—through the fundamental change-of-direction strengths and into true, reactive agility that progresses from simple single-stimulus reactions to complex, chaotic, partner-driven cutting. Because agility can start as early as day one with slow assisted drills, developing the fundamentals rather than jumping to high-tech complexity prepares the athlete for the unpredictable demands of live sport.

Strength and Metabolic Training

4. Strength and Metabolic Training

This chapter covers lower extremity strength progression and metabolic conditioning across the phases, including how quickly different performance qualities decay when training stops and how cross-training on a stationary bike, in a pool, or on an unweighted treadmill maintains conditioning with normal mechanics and low or no pain. Because qualities such as speed begin decaying within about a week, continuing to train strength and metabolic capacity and replacing missed practice load keeps the athlete ready and reinforces that rehabilitation and performance are one path, not two.

Frequently asked questions

Everything you need to know about Medbridge courses.