Ankle Instability

What is chronic ankle instability?

Chronic ankle instability is a condition in which the ankle joint repeatedly "gives way," resulting in an inability to walk or stand on the affected foot without pain. The condition is often caused by repetitive ankle sprains and can lead to long-term problems such as arthritis.

If you have chronic ankle instability, you may be able to treat the condition with home care. However, in some cases, surgery may be necessary to repair the damaged ligaments.

What causes ankle instability?

Repetitive ankle sprains often cause ankle instability. When the ligaments that support the ankle joint are stretched beyond their normal range of motion, they can tear. The ankle can become unstable if the affected ligaments are not healed properly.

Those who play sports such as gymnastics, soccer, basketball, or football are at a greater risk of tearing or detaching their ligaments. Through repeated stretching and over-extension, ligaments may weaken over time. An ankle sprain will result in chronic ankle instability in about 20 percent of athletes. The muscle reaction time may slow down after a sprained ankle, which can lead to further sprains.

Other causes of ankle instability include:

• Bone fractures near the ankle joint
• Joint problems such as arthritis
• Nerve damage
• Muscle weakness

What are the symptoms of ankle instability?

The most common symptom of ankle instability is the sensation that the ankle is "giving way." This can occur when walking, standing, or even when the foot is at rest. Other symptoms may include:

• Loss of ankle stability
• Limited range of motion
• Chronic pain and instability
• A weak ankle that turns inward easily
• Unable to stand for any length of time
•  Ankle hurts when you put any weight on it
• Visible redness, tenderness, swelling, and bruising

How is ankle instability diagnosed?

A thorough medical history and an ankle examination are essential for an accurate diagnosis. Dr. Hassan will ask you about your previous strains and which activities resulted in ankle instability. He will also look for tenderness or swelling in the affected area.

Gentle manipulation of the ankle or foot can also reveal fractures or nerve damage. An X-ray is necessary to rule out fractures and confirm the diagnosis, and an MRI can rule out further soft tissue damage.

How is ankle instability treated?

Treatment for ankle instability will depend on the severity of your condition. In some cases, home care may be all that is necessary. This may include:

• RICE (rest, ice, compression, elevation)
• Wearing a brace or splint to immobilize the ankle joint
• Physical therapy to stretch and strengthen the muscles and ligaments around the ankle
• Ibuprofen and other anti-inflammatory drugs to reduce pain and swelling

If home care does not improve your symptoms, Dr. Hassan may recommend surgery. This may involve:

• Shortening or tightening ligaments
• Cleaning out debris from the joint
• Fusing the bones in the joint to stabilize it

After surgery, you will likely need to wear a cast or splint for several weeks. Physical therapy may also be necessary to regain strength and range of motion in your ankle.

How can I prevent ankle instability?

The best way to prevent chronic ankle pain and instability is to take care when making sudden movements and get previously sprained ankles treated. Avoid excessive twisting or turning movements that irritate joints and soft tissues. 

For athletes to maintain their performance levels, they might have to consider surgical options. Dr. Hassan will recommend treatment based on your goals and condition. 

These tips will help you avoid recurring ankle sprains

• Put on a brace or tape your ankle.
• Maintain your muscles' strength and flexibility.
• Slow down or stop when you are fatigued.
• Incorporate balance exercises into your stability training.