Background: Ankle injuries account for 23,000 inversion sprains daily. Lateral ankle sprains are predisposed by previous injury and a decrease in balance. This prospective randomized clinical trial compared the use of high-velocity, low-amplitude (HVLA) manipulation and Muscle Energy Technique mobilization in the treatment of chronic ankle sprains Methods: Forty candidates diagnosed with chronic recurrent ankle sprain were randomized into the trial. The primary outcome measures were the One Leg Standing Test and the Numerical Pain Rating Scale-101. Results: The One Leg Standing Test and Numerical Pain Rating Scale-101 had statistically significant and clinically meaningful intra-group changes. The One Leg Standing Test eyes closed showed an increase with High Velocity Low Amplitude manipulation of 10.24 seconds and with Muscle Energy Technique mobilization of 10.05 seconds, both t-tests p=.003 suggestive of a centrally mediated positive neurological effect on the function of the locomotive system. The Numerical Pain Rating Scale-101 showed significant decrease in High Velocity Low Amplitude manipulation of 37.1 points and Muscle Energy Technique of 39.6 points, both t-tests p<0.000. Conclusion: Both High Velocity Low Amplitude manipulation and Muscle Energy Technique mobilization significantly increased balance, range of motion, and function while decreasing shortterm pain. These promising results merit further research with a fully powered trial.