Ankle instability is a condition characterized by a recurring “giving way” of the outer (lateral) side of the ankle. This condition often develops after repeated ankle sprains. Usually the “giving way” occurs while walking or doing other activities, but it can also happen when you’re just standing.
People with ankle instability often complain of:
- A repeated turning of the ankle, especially on uneven surfaces or when participating in sports
- The sensation of the ankle about to give way without actually instability
- Persistent (chronic) discomfort and swelling
- Pain or tenderness
Ankle instability can develop after an ankle sprain that has not adequately healed or was not rehabilitated completely. When you sprain your ankle, the connective tissues (ligaments) are stretched or torn. The ability to balance is often affected. Proper rehabilitation is needed to strengthen the muscles around the ankle and “retrain” the tissues within the ankle that affect balance.
Repeated ankle sprains often cause chronic ankle instability. Having an ankle that gives way increases your chances of spraining your ankle repeatedly. Subsequent sprains lead to further weakening (or stretching) of the ligaments—resulting in greater instability and the likelihood of developing additional problems in the ankle.
Diagnosis can be made by taking a proper history and performing a standard orthopaedic exam. The patient’s ankle may feel wobbly or gives way repeatedly. Chronic ankle instability that is left untreated leads to continued instability, activity limitations, arthritis, and tendon problems. Standard x-rays are obtained to access the bones of the ankle. An MRI may be ordered as well to check the other soft tissue structures of the ankle.
Treatment for ankle instability is based on the results of the examination and tests, as well as on the patient’s level of activity.
Non-surgical 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) may be prescribed to reduce pain and inflammation.
Surgery may be recommended if non-operative measures fail. Typically ankle ligament repair is performed to correct the problem, however other underlying issues may need to be addressed, such as mal-alignment of the ankle, tendon tears, and cartilage damage. Surgery usually involved a short period of non-weight bearing on the affected leg. The patient is usually full weight bearing by 2 to 3 months with return to sports by 4 to 6 months.