Chronic Ankle Instability
Foot & Ankle Care of Colorado
Chronic ankle instability is a condition where patients experience recurrent episodes of the outer (lateral) side of the ankle giving way. This instability frequently develops following repeated ankle sprains. The episodes of giving way can occur during activities such as walking or running, and in some cases, even while standing. This condition is commonly seen in athletes, but it can affect anyone who has sustained multiple ankle sprains.
Causes of Chronic Ankle Instability
Chronic ankle instability typically develops after an ankle sprain that has not healed properly or was not fully rehabilitated. During an ankle sprain, the ligaments, which are the connective tissues, are stretched or torn. This injury often affects balance. Proper rehabilitation is essential to strengthen the muscles around the ankle and retrain the tissues that influence balance. Without adequate rehabilitation, the risk of recurrent ankle sprains increases.
Repeated ankle sprains contribute to and perpetuate chronic ankle instability. Each subsequent sprain further weakens or stretches the ligaments, leading to greater instability and an increased likelihood of additional ankle problems.
Chronic Ankle Instability Symptoms
People with chronic ankle instability often complain of:
- A repeated turning of the ankle, especially on uneven surfaces or when participating in sports
- Persistent (chronic) discomfort and swelling
- Pain or tenderness
- The ankle feeling wobbly or unstable
Chronic Ankle Instability Diagnoses
In evaluating and diagnosing your condition, the foot and ankle surgeon will ask you about any previous ankle injuries and instability. Then s/he will examine your ankle to check for tender areas, signs of swelling and instability of your ankle as shown in the illustration. X-rays or other imaging studies may be helpful in further evaluating the ankle.
Nonsurgical Treatments
Treatment for chronic ankle instability is based on the results of the examination and tests, as well as on the patient’s level of activity. Nonsurgical treatment may include:
- Physical therapy. Physical therapy involves various treatments and exercises to strengthen the ankle, improve balance and range of motion and retrain your muscles. As you progress through rehabilitation, you may also receive training that relates specifically to your activities or sport.
- Bracing. Some patients wear an ankle brace to gain support for the ankle and keep the ankle from turning. Bracing also helps prevent additional ankle sprains.
- Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to reduce pain and inflammation.
When Is Surgery Needed?
In some cases, the foot and ankle surgeon will recommend surgery based on the degree of instability or lack of response to nonsurgical approaches. Surgery usually involves repair or reconstruction of the damaged ligament(s). The surgeon will select the surgical procedure best suited for your case based on the severity of the instability and your activity level. The length of the recovery period will vary, depending on the procedure or procedures performed.
