Pilates hasn't been properly tested after a sprain
Our searches found no trial in a fresh sprain. In the one study in unstable ankles, 51 footballers chose Pilates or balance training, and balance training did better on reach tests.
Pilates guide
Pilates after an ankle sprain: when to start, the first days, footwork and standing work, balance and stopping the next sprain, what the evidence shows, and a class
Most sprained ankles recover with early, protected movement rather than rest, and the bigger problem is the next sprain: balance training cuts repeat sprains, and it's the part of rehab with the best evidence. Pilates hasn't been properly tested after a sprain. The one study, in footballers with ankles that kept giving way, let players choose their group, and plain balance training did better on reach tests.
So this guide shows how to fit what works into Pilates: what you can do on the mat in the first days while the foot rests, band work and footwork from about week 2, standing and one-leg balance from about week 6 (timings borrowed from our sprained ankle guide), the moves that roll the ankle in, the reformer, and a 25-minute class. It starts with the signs that mean an X-ray or a check, including an ankle that keeps giving way.
The short version
Early, protected movement beats rest
A brace or tape, gradually more weight through the foot, then exercise for range, strength and balance is the US physiotherapy guideline's top-graded treatment, and gentle exercise from the first week was safe in a trial.
Most mat work can start within days
Breathing, curl-ups, bridges, leg circles and side kicks leave the ankle alone. Band work and footwork come in from about week 2, and one-leg balance and jumping from about week 6, as in our sprained ankle guide (timings borrowed from that guide, not tested in Pilates).
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Balance training is the part with the evidence
In the largest trial, a home balance programme cut repeat sprains from 33% to 22%. Mat Pilates alone didn't improve one-leg balance in older adults, so add standing and one-leg work.
Hip and trunk work is an extra
Adding hip strengthening to ankle rehab helped balance a little in two 2026 reviews, which differ on how much; on its own it didn't beat balance training.
The next sprain is the bigger risk
Up to 40% of people develop an ankle that keeps giving way after a first sprain. Keep the balance work going after you're back, wear a brace for sport, and see a GP or physiotherapist if your ankle keeps giving way.
Ankle sprains, and where Pilates fits
What a sprain is
A sprain is an injury to the ligaments. Most happen when the foot rolls inwards, injuring the ligaments on the outside of the ankle, which may be stretched, partly torn or fully torn. The NHS says most sprains feel better after 2 weeks, but to avoid strenuous exercise such as running for up to 8 weeks, and severe sprains can take months.
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How common, and who
Across 181 studies, sprains were more common in women than men, in children and teenagers than adults, and in indoor and court sports. The US guideline lists being female, weak hip muscles, poor balance and hopping tests, and playing court sports as risk factors.
Recovery is slower than people expect
Across 31 studies, 5% to 33% of people still had pain a year after a sprain, and 3% to 34% sprained again. Up to 40% go on to an ankle that keeps giving way (chronic ankle instability). In 82 people, not being able to manage jump-landing tests 2 weeks after a first sprain predicted it.
Weak hips go with unstable ankles
People with unstable ankles have weaker hips in every direction than people without, in studies that measured them at one time point. That's the honest link to Pilates hip work.
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Is it broken?
Clinicians use the Ottawa ankle rules, which almost never miss an ankle or midfoot fracture (27 studies, 15,581 people). They aren't a self-test: our sprained ankle guide explains them, and the warning signs below say when to get help.
High ankle sprains take longer
Pain above the ankle, between the shin bones, is a high ankle sprain. In 83 professional American football players, return to play took a median of 27 days without a major tear or fracture and much longer with one, so get it assessed.
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What Pilates asks of the ankle
Most mat work leaves the ankle unloaded. Footwork, on the reformer's footbar or with your feet on a wall, points and flexes the ankle while you lie down. Standing work, wall work and one-leg balance load it fully and train balance. A few positions put the ankle back into the sprain position or press on its front: side-sitting, sitting on the outer edges of your feet and kneeling with the tops of your feet flat (our reading).
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Can I do Pilates with a sprained ankle? Stage by stage
The stage timings are borrowed from our sprained ankle guide, which follows NHS hospital leaflets; they are ranges, not tested Pilates rules. Move on when the ankle is ready, not by the calendar.
Check first
If you couldn't take four steps after the injury, if pressing a bony point of the ankle or midfoot hurts, or if the ankle looks out of shape, get it checked before any exercise (the warning signs below).
Days 0 to 14: the mat, with the foot resting
Wear the brace or tape you've been given and walk as comfort allows. For the first 2 to 3 days the NHS advises protection, rest, ice, compression and raising the ankle. Mat work that leaves the foot alone is fine, plus gentle ankle circles and holds that don't move the ankle.
About weeks 2 to 6: bands, footwork and the first balance
When you can walk with little or no limp, add band work in every direction, calf raises, footwork on a wall or a light reformer spring, and standing balance with a hand on a counter.
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From about week 6: one leg, hips and the jump board
When you can do 12 calf raises without pain and stand on the injured leg for 30 seconds with your eyes closed (our sprained ankle guide's check), add one-leg reaches, standing leg lifts and, later, hops and the jump board.
The reformer
Footwork in parallel on a light spring, heels moving straight, is a gentle way to load the ankle once walking is easy. Leave rising high onto the balls of the feet, one-foot work and the jump board until the later stage (our suggestion).
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Back to sport
An international consensus bases the return to sport on pain, ankle strength and range, confidence, balance and sport tests, not on time alone. Our sprained ankle guide has the hops and drills.
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Balance: the part with the evidence
A home balance programme cut repeat sprainsStrong evidence
In the 2BFit trial of 522 athletes, an 8-week home balance programme cut repeat sprains from 33% to 22%: one fewer sprain for every 9 people who trained, even though only 23% did all of it. Sessions were three a week of up to 30 minutes, from a flat floor to eyes shut to a wobble board. Several meta-analyses agree that exercise and balance training cut repeat sprains by roughly a third to a half.
A brace for sportStrong evidence
In 384 athletes, 15% sprained again with a brace against 27% with home balance training alone. The US guideline recommends both a brace and balance training after a first sprain.
Hips and trunk: an extra, not a replacementEmerging evidence
Two 2026 reviews of 9 trials each found that adding hip strengthening to ankle rehab improved reach balance and function a little; they differ on how much, and one found no extra benefit from hip work on its own. In 45 people, hip strengthening alone didn't beat balance training.
Strong hips and trunk go with fewer sprainsEmerging evidence
In 133 youth footballers, stronger hip extension went with fewer sprains, and in 152 young athletes lower back-muscle endurance predicted sprains. These were small studies with few sprains, and they show a link, not cause.
How to build it into Pilates
Add a balance block to every class: stand on one leg near a counter, then without a hand, then with your eyes closed, then on a cushion, about three times a week (our suggestion, from the 2BFit programme).
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What the evidence says
No Pilates trial after a fresh sprainStrong evidence
Our searches of PubMed, Europe PMC and ClinicalTrials.gov in November 2026 found no trial of Pilates after an acute sprain and none that counted repeat sprains. One Pilates trial in footballers with unstable ankles was registered in 2025 and wasn't yet recruiting.
The one Pilates study in unstable anklesMixed evidence
In South Korea, 51 male college footballers with unstable ankles did 6 weeks of mat Pilates or balance training, 60 minutes 3 times a week. Players chose their own group, and there was no group that didn't train. Both groups improved; Pilates did better on a triple hop test, and balance training did better on two reach tests. The Pilates was all lying and sitting mat work. It can't show that Pilates works.
Source 2
Mat Pilates alone isn't balance trainingEmerging evidence
In 48 healthy people of about 70, 8 weeks of balance training beat mat Pilates on reach and one-leg balance, and Pilates against no exercise was unclear. Reformer Pilates once a week improved balance and walking tests in 55 adults aged 65 to 95, and across 39 studies Pilates improved balance in older adults about as much as other exercise.
Pilates for limb problems generallyMixed evidence
Across 11 small studies of 444 people with arm and leg muscle and joint problems, Pilates eased pain and disability, at very low certainty; balance couldn't be pooled.
Source 31
Protect, then loadStrong evidence
The US guideline's top grade goes to a brace or tape with gradually more weight through the foot, and to structured exercise for range, strength and balance. For severe sprains, a short spell in a cast may help: in 584 people, a 10-day cast recovered faster than a bandage at 3 months, with no difference by 9 months. In 101 people with mild to moderate sprains, exercise in the first week improved function, and re-injury was 4% in each group.
IceEmerging evidence
In 60 active adults on standard rehab, ice for 3 days lowered pain at day 7 by about 1 point out of 10, less than the change patients notice, with no difference in function or re-injury.
Source 34
Tai chi in unstable anklesEmerging evidence
A 2026 review of 9 small trials found tai chi improved how stable people felt and one reach test, with results that varied a lot between trials. No mind-body trial has counted repeat sprains.
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The first days: on the mat, foot resting
Lateral breathing: "5 to 8 breaths at the start of every session" (the move page's dose). Ankle circles: 10 each way, 3 to 4 times a day, in a comfortable range (our sprained ankle guide's dose, from an NHS hospital leaflet). Seated calf raise: 2 sets of 10, and ankle eversion holds against a wall: 8 to 12 gentle holds of about 6 seconds (both from our sprained ankle guide's plan, editorial there). Heel slide: "10 slow repetitions each side, once or twice a day" (the move page's dose). Knee fold: "2 sets of 5 to 10 each side, every other day" (the move page's dose). Side kick: "8 to 10 each side" (the move page's dose), with the foot hanging free. Clamshell: 10 each side (our editorial starting point). Swan: "5 to 6 reps" (the move page's dose).
3D demoLateral breathing (Pilates breathing)Beginner · No equipment
3D demoAnkle CARs (controlled articular rotations)Beginner · No equipment
3D demoSeated bent-knee calf raise (soleus raise)Beginner · A bench or box
3D demoIsometric ankle eversion against a wallBeginner · A wall + A bench or box
3D demoSupine heel slideBeginner · No equipment
3D demoKnee foldBeginner · No equipment
3D demoSide kick (Pilates side kick series)Beginner · No equipment
3D demoClamshellBeginner · No equipment
3D demoSwan (Pilates swan dive)Intermediate · No equipmentAbout weeks 2 to 6: bands, footwork and the first balance
Band eversion: 2 to 3 sets of 5 to 8 (our sprained ankle guide's dose, from an NHS hospital leaflet). Band inversion: "After a sprain, 2 to 3 sets of 5 to 8" (the move page's dose), in a pain-free range. Knee-to-wall rock: "10 slow rocks per side, daily" (the move page's dose). Wall bridge: "8 to 10 reps" (the move page's dose); press through the whole foot, heels level, as a footwork exercise. Slow calf raise: 12, 3 times a day, and single-leg stand: up to 30 seconds, holding a counter, then without, then eyes closed (our sprained ankle guide's doses, from NHS hospital leaflets). Tibialis raise: 2 to 3 sets of 8 to 10 (our sprained ankle guide's plan). Heel-to-toe walk: 3 to 5 lengths, and calf and soleus stretches: 3 holds of 20 to 30 seconds (our sprained ankle guide's doses).
3D demoBand ankle eversionBeginner · A band + A bench or box
3D demoBand ankle inversionBeginner · A band + A bench or box
3D demoKnee-to-wall ankle rockBeginner · A wall
3D demoWall bridge (feet-on-wall bridge)Beginner · A wall
3D demoSlow calf raiseBeginner · A wall
3D demoTibialis raiseBeginner · No equipment
3D demoSingle-leg standBeginner · A wall
3D demoTandem stance and heel-to-toe walkBeginner · A wall
3D demoWall calf stretch (gastrocnemius)Beginner · A wall
3D demoSoleus wall stretchBeginner · A wallFrom about week 6: one leg, hips and the habit that prevents the next sprain
Single-leg reach matrix: "3 rounds of 5 reaches in each direction, each leg" (the move page's dose); its page says to ease off the deep reaches in the first weeks after a sprain. Wall side leg lift: "10 to 12 each side" (the move page's dose), standing on the injured leg. Hip airplane: "2 sets of 5 slow turns each leg" (the move page's dose), once one-leg standing is steady. Single-leg calf raise from a step: 12, 3 times a day (our sprained ankle guide's dose, from an NHS hospital leaflet). Side-lying leg circles: "8 each direction, each side" (the move page's dose). Hops and sport drills are in our sprained ankle guide.
3D demoSingle-leg reach matrixIntermediate · No equipment
3D demoWall side leg lift (standing side kick at the wall)Beginner · A wall
3D demoHip airplaneAdvanced · No equipment
3D demoSingle-leg calf raise from a stepIntermediate · A step + A wall
3D demoSide-lying leg circles (Pilates side kick series)Beginner · No equipmentMoves to change for now
No study has tested any of these after a sprain; they are our suggestions, from how sprains happen and the moves' own cautions.
Rolling the sole inwards hard
Our peroneal stretch's page says to skip it in the first weeks after an ankle sprain, because turning the sole inwards is the movement that sprains the outer ankle. On the mat, that also means sitting on the outer edges of your feet and deep cross-legged sitting.
Kneeling with the tops of your feet flat
Child's pose, the kneeling side kick and side-sitting in the mermaid stretch the front of the ankle. Pad under the ankles, sit on a block, or use a chair for the first weeks.
Toes tucked under your weight
The knee hover, leg pull front and Pilates push-up bend the ankle under load: use forearm or wall versions until it bends comfortably.
Jumps and the jump board
Wait until you can do 12 calf raises without pain and stand on the injured leg for 30 seconds with your eyes closed, as our sprained ankle guide's check says.
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Socks on a smooth floor
For standing work, use bare feet or grip socks, as our Pilates for the feet guide suggests.
Classes to follow
Our 25-minute class puts the parts with evidence into a Pilates session: footwork on a wall, band work in every direction, side-lying hip work, then calf raises and balance, with a stop point before the one-leg block. No trial has tested it: its order and doses are our editorial choice, from NHS hospital leaflets in our sprained ankle guide and the balance trials. The balance routine and the foot and ankle routine suit the later stage; the yoga class is our yoga page's version.
Ankle-steadying Pilates after a sprain: a 25-minute class for ankle strength, hips and one-leg balance
A 25-minute Pilates class for the weeks after a sprained ankle: footwork on a wall, band work in every direction, side-lying hip work and a balance progression.
25 minBeginner18 movesA bench or box, A wall
Balance exercises routine
Balance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.
10 minBeginner7 movesA wall, A bench or box
Foot and ankle strengthening routine: toes, arches, calves and balance
A 15-minute barefoot routine for stronger toes, arches, calves and ankles, finishing with balance. You need only a towel, a wall and a resistance band.
15 minBeginner11 movesA wall, Other / check instructions
Yoga after an ankle sprain: a 25-minute class for ankle range, calf strength and balance, built up step by step
A 25-minute yoga class after an ankle sprain: ankle range, calf and ankle strength, short standing poses and a one-leg balance progression, with no jumping.
25 minBeginner16 movesA bench or box, A wallFeet-first Pilates for flat feet: a 25-minute class for the arches, ankles, hips and balance
A 25-minute Pilates class for flat feet: seated foot and ankle work, standing heel raises and balance, then Pilates for the hips and a gentle calf stretch.
25 minBeginner14 movesOther / check instructions, A bench or box
Standing Pilates for balance: a 25-minute counter and mat class
A 25-minute Pilates class for steadier balance: standing balance and leg strength at a kitchen counter, then mat work for your trunk and hips.
25 minBeginner17 movesA wall, A bench or boxAnkle mobility routine: the knee-to-wall test, calf stretches and full-range calf raises
A 12-minute routine to improve how far your ankle bends: test it against a wall, rock it, stretch both calf muscles, strengthen through the full range, then use it.
12 minBeginner8 movesA wall, A stepWarning signs: when to get help
The ankle lines are from our ankle pain and sprained ankle guides, word for word, and the heart lines from our other Pilates guides. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.
Call 999 or go to A&E
- Call 999 or go to A&E: after an injury, you heard a crack, the foot or ankle has changed shape or points at an odd angle, a bone is sticking out, there is a bad cut over it, you're in severe pain, or the toes look blue or white, feel numb or are cold to touch. These can mean a broken bone. Don't drive yourself.
- Call 999 or go to A&E if breathing suddenly becomes difficult, if pain in your chest or upper back comes on suddenly with breathlessness or a very fast heartbeat, or if someone passes out. Do not drive yourself. It can be a blood clot that has reached the lungs.
Not being able to put weight on it
Same day (NHS 111 or an urgent treatment centre): after an injury, you can't put weight on it or walk more than a few steps, the pain is very bad or getting worse, there is a lot of swelling or bruising or it is getting worse, it feels very stiff, or it's not feeling any better after treating it yourself. Get the same help if you also have a very high temperature, or feel hot, cold or shivery: this could be an infection. If you think it's broken, don't treat it yourself.
Contact NHS 111: after an injury, severe ankle pain, feeling faint, dizzy or sick from the pain, a snap, grinding or popping noise at the time of the injury, the ankle or foot at an odd angle, or not being able to walk. These might be signs of a broken ankle or an infection.
A snap at the back of the ankle
Same day: a sudden snap or pop at the back of the heel or calf, or a feeling of being kicked there, then walking flat-footed and being unable to push off, stand on tiptoe or climb stairs. It could be an Achilles tendon rupture or a broken heel bone. Go to A&E or a minor injuries unit, or contact NHS 111.
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A swollen, painful calf
Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin around the painful area, which may be harder to see on brown or black skin; or swollen veins. It could be a blood clot (DVT). Watch for it after an ankle injury or time in a cast or boot.
Same day: in a cast or boot, pain that is getting worse, toes that are numb or burning, a cast that feels too tight, toes that are swollen, blue or white, or a bad smell from under the cast.
See a GP or physiotherapist
- Pain that isn't better after 2 weeks of looking after it yourself, is getting worse, keeps coming back, or stops you doing normal things.
- An ankle that keeps giving way months after a sprain.
- Pain or swelling still there 6 to 12 weeks after a sprain, or deep pain inside the joint with catching or locking: see your GP. A damaged patch of cartilage and bone on the talus (an osteochondral lesion) is one cause, X-rays often miss it, and it has its own guide.
- Tingling or loss of feeling in the foot, or a foot that feels weak.
- Any foot pain if you have diabetes: foot problems can be more serious.
Source 36
The foot and ankle pain rule
Some discomfort during exercise is fine. Aim for pain you would call mild to moderate, no more than about 5 out of 10, that settles within an hour, with no more swelling or stiffness the next morning. If it's worse the next day, do a little less (a smaller range, fewer reps, a lighter band), not nothing.
After a sprain, NHS hospital leaflets say the exercises should not increase your pain, and gentle exercise from the first week was safe in a trial: re-injury was 4% with or without it.
Source 4
Ankles that keep spraining and loose joints
If you're hypermobile, don't use mobility work to push further: the NHS says "do not overextend your joints just because you can". See a GP if you think you have joint hypermobility syndrome: for example, your joints keep dislocating, or you keep getting sprains, strains, pain or stiffness.
Source 38
Chest pain or fainting: call 999
- You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
- The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
- You have chest pain and feel sweaty, sick, light-headed or short of breath.
- Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.
Breathlessness
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
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Stop the session if
You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.
Source 43
Before you start
The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
Source 43
Myths
"Rest a sprained ankle until it stops hurting"Strong evidence
A brace or tape, gradually more weight and early exercise are the guideline's top-graded treatment, and exercise in the first week improved function without more re-injury. The NHS's rest, ice, compression and elevation are for the first 2 to 3 days.
"Once it stops hurting, it's healed"Strong evidence
Up to 40% develop an ankle that keeps giving way, and many sprain again. Balance training after you're back is what cuts repeat sprains.
"Pilates will rebuild your ankle stability"Mixed evidence
It hasn't been properly tested: in the one study, balance training beat Pilates on reach tests, and mat Pilates alone didn't improve one-leg balance in older adults. Pilates helps when it includes standing, one-leg work and band work.
"A strong core means no sprains"Emerging evidence
Hip and trunk strength go with fewer sprains in young athletes, but hip work on its own didn't beat balance training. Do both.
"You need a reformer for ankle rehab"Strong evidence
The programme that cut repeat sprains used a floor, then eyes closed, then a wobble board at home. No study has tested reformer footwork after a sprain.
"Ice is the treatment"Emerging evidence
Ice gave a small, short-lived drop in pain on top of rehab. Exercise is the treatment.
Source 34
Read next
- Sprained ankle: what to do and exercises
- Chronic ankle instability
- High ankle sprain
- Broken ankle
- Yoga for a sprained ankle
- Pilates after an ankle sprain: the 25-minute class
- Pilates for the feet and ankles
- Pilates for balance
- Pilates for vertigo and dizziness
- Reformer Pilates
- Pilates for hypermobility
- Pilates for basketball players
- Pilates for footballers
- Pilates for dancers
- The peroneal muscles
- Gluteus medius
- Foot and ankle exercises
- Balance exercises
- Single-leg balance test
- The Pilates guide
Questions people ask
Can I do Pilates with a sprained ankle?
Yes, most of a mat class, as long as the foot can rest: breathing, curl-ups, bridges, leg circles and side kicks don't load the ankle. Gentle exercise from the first week was safe in a trial. First check the X-ray signs: if you couldn't take four steps, or pressing a bony point hurts, get it checked.
When can I go back to Pilates after a sprained ankle?
Mat work that leaves the foot alone can start within days; standing work, footwork and band work from about week 2, once you can walk with little or no limp; one-leg balance and the jump board from about week 6. These timings are borrowed from our sprained ankle guide, so go by how the ankle feels, not the calendar.
Is Pilates good for ankle injuries?
It can carry the parts of rehab that work: ankle strength in every direction and balance training, which cuts repeat sprains. But Pilates itself hasn't been properly tested, and in the one study balance training did better on reach tests.
Can I do reformer Pilates with a sprained ankle?
Yes, with changes: keep footwork in parallel on a light spring, heels moving straight, and leave out the jump board and work on the balls of one foot until you can stand on that leg for 30 seconds with your eyes closed and do 12 pain-free calf raises. Tell your teacher which ankle it is.
Which Pilates exercises help after a sprained ankle?
Band work turning the foot in and out, calf raises, lifting the front of the foot, footwork with your feet on a wall and one-leg balance, plus side-lying hip work. Our ankle sprain class puts them in order; for weak ankles without a sprain, see our Pilates for the feet guide.
Which Pilates moves should I avoid after a sprain?
For the first weeks, anything that rolls the sole inwards or presses the front of the ankle: side-sitting, sitting on the outer edges of your feet and kneeling with the tops of your feet flat. Leave jumps and hops until the later stage.
Does Pilates prevent ankle sprains?
No trial has counted sprains after Pilates. What prevents another sprain is balance training, about three times a week for 8 weeks once you're back, and a brace for sport; Pilates hip and trunk work helps as an extra.
Should I wear a brace for Pilates?
Early on, a brace or tape with walking is the guideline's first choice, but on the mat you don't need it for moves that leave the foot alone. For sport afterwards, a brace cuts repeat sprains.
Is Pilates or yoga better after a sprained ankle?
Neither has been tested after a sprain, and both can carry balance and strength work. Our yoga for a sprained ankle guide covers yoga, and our sprained ankle guide has the full plan.
Why does my ankle still give way months later?
Up to 40% of people develop an ankle that keeps giving way after a first sprain. See a GP or physiotherapist: balance and strength work help, and other problems in the joint sometimes need checking.
Can I do Pilates with a broken ankle?
Only what your fracture clinic allows; the NHS says to move your toes and bend your knee gently in the boot or cast. Upper-body work and the other leg are often fine, but ask first; our broken ankle guide covers the recovery.
Sources
- PubMed, Europe PMC and ClinicalTrials.gov · Our searches for Pilates studies in ankle sprains and unstable ankles (November 2026)
- Jiang 2022 · Pilates against balance training in 51 footballers with unstable ankles (non-randomised trial, Int J Environ Res Public Health; read in full)
- Martin 2021 · Lateral ankle sprains (US physiotherapy clinical practice guideline, J Orthop Sports Phys Ther; read in full)
- Bleakley 2010 · Exercise in the first week after an ankle sprain: 101 people (randomised trial, BMJ)
- NHS · Sprains and strains
- Hupperets 2009 · A home balance programme to prevent repeat sprains in 522 athletes: the 2BFit trial (randomised trial, BMJ; read in full)
- Donath 2016 · Mat Pilates against balance training in 48 healthy older adults (randomised trial, Int J Sports Med)
- Chen 2026 · Hip strengthening in unstable ankles: 9 trials (systematic review and meta-analysis, Complement Ther Med)
- Suttmiller 2025 · Balance against hip strengthening in 45 people with unstable ankles (randomised trial, J Sport Rehabil)
- Hertel 2019 · An updated model of chronic ankle instability (review, J Athl Train)
- Janssen 2014 · A brace against balance training to prevent repeat sprains in 384 athletes (randomised trial, Br J Sports Med)
- Doherty 2014 · How common ankle sprains are: 181 studies (systematic review and meta-analysis, Sports Med)
- van Rijn 2008 · How ankle sprains recover: 31 studies (systematic review, Am J Med)
- Doherty 2016 · Recovery from a first ankle sprain and what predicts instability: 82 people (cohort study, Am J Sports Med)
- DeJong 2020 · Hip strength in people with unstable ankles (systematic review and meta-analysis, Med Sci Sports Exerc)
- Bachmann 2003 · How accurate the Ottawa ankle rules are: 27 studies (systematic review, BMJ)
- NHS · Broken ankle
- Kuhn 2025 · High ankle sprains in 83 professional American football players (cohort study, Sports Health)
- Smith 2021 · Return to sport after an ankle sprain: the PAASS framework (international consensus, Br J Sports Med)
- Bleakley 2019 · Exercise after an ankle sprain and re-injury: 7 trials (systematic review and meta-analysis, Arch Phys Med Rehabil)
- Wagemans 2022 · Exercise-based rehabilitation and re-injury after ankle sprains: 14 trials (systematic review and meta-analysis, PLoS One; read in full)
- Schiftan 2015 · Balance training to prevent ankle sprains: 7 trials (systematic review and meta-analysis, J Sci Med Sport)
- Xiang 2026 · Neuromuscular training to prevent ankle injuries in athletes: 13 trials (systematic review and meta-analysis, Front Physiol)
- Hou 2026 · Hip strengthening for balance and function in unstable ankles: 9 trials (systematic review and meta-analysis, BMC Musculoskelet Disord)
- Smith 2018 · Hip strengthening in 26 people with unstable ankles (randomised trial, J Sport Rehabil)
- De Ridder 2017 · Hip strength and ankle sprains in 133 youth footballers (cohort study, Am J Sports Med)
- Heydari Sodejani 2026 · Core endurance, balance and ankle sprains in 152 young athletes (cohort study, Phys Sportsmed)
- ClinicalTrials.gov NCT07266649 · Pilates against balance training in footballers with unstable ankles (registered 2025, not yet recruiting)
- Roller 2018 · Reformer Pilates and falls risk in 55 older adults (randomised trial, J Bodyw Mov Ther)
- de Campos Júnior 2024 · Pilates and balance in older adults: 39 studies (systematic review and meta-analysis, Complement Ther Clin Pract)
- Barnet-Hepples 2025 · Pilates for arm and leg muscle and joint problems: 11 studies (systematic review, Ann Phys Rehabil Med)
- Lamb 2009 · Supports for severe ankle sprains in 584 people: the CAST trial (randomised trial, Lancet)
- Doherty 2017 · Treating and preventing ankle sprains: 46 reviews (overview of reviews, Br J Sports Med)
- Halder 2026 · Ice added to standard rehabilitation after an ankle sprain in 60 adults (randomised trial, J Sci Med Sport)
- Hao 2026 · Tai chi for unstable ankles: 9 trials (systematic review and meta-analysis, Foot Ankle Surg)
- NHS · Ankle pain
- NHS · DVT (deep vein thrombosis)
- NHS · Joint hypermobility syndrome (past its review date: reviewed August 2023, review due August 2026)
- NHS · Chest pain (past its review date: reviewed August 2023, review due August 2026)
- NHS · Fainting
- NHS · Heart attack
- NHS · Shortness of breath
- NHS · Pilates for beginners (exercise video, with safety information)
- Cambridge University Hospitals NHS · Achilles tendon rupture: management and rehabilitation (patient information, 2026)
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.