Chronic Ankle Instability: What Is It?

Have you ever been playing a sport, walking, or simply standing still and felt your ankle give way? Or do you have a history of recurrent ankle sprains? If so, you may be suffering from a condition called chronic ankle instability.

Chronic ankle instability is the result of weak ankles due to previous injury or genetic disposition. People who have previously sprained an ankle may develop long-lasting instability. It is considered chronic if the ankle joint still has too much give six months after an injury, or if the ankle is re-injured within that six-month period. Overstretched or torn ligaments in the ankle grow back together too loosely, and that instability is coined mechanical instability. Genetics also play a role. Some people have naturally slack ligaments in the ankle joint and must be cautious when performing certain activities, such as sports or running.

Unstable ankle joints are at risk of being re-injured. The interaction between the bones in the ankle and the surrounding tissue is disrupted by the initial injury, and the spatial orientation within the body, known as proprioception, shifts to compensate for the weakened ankle. The coordination of movements of the ankle joint, with its reflexes and stabilization responses, can dramatically change when a sprain or fracture occurs. In turn, the ankle remains weak, even after healing, as a defense mechanism.

Because it is difficult to restore a weak ankle to its former glory, so to speak, functional treatments are usually the best method of treatment for as full of a recovery as possible. These include physiotherapy to strengthen the joint and wearing an ankle brace can stabilize the joint during physical activity and prevent a sprain. Studies also show that improving coordination can also speed up the recovery of a weak ankle’s mobility.

If after non-invasive treatments no improvement is seen, surgery might be considered an option. Shortening and tightening the ankle ligaments is one way to surgically repair chronic ankle instability, while another option might be to reroute a tendon from the lower leg and use it as an outside ligament on the ankle, as they are made of similar tissue. In most cases, patients can begin moving and re-conditioning the ankle about three to four weeks after surgery, and in some cases, sooner. The key to a good recovery is to promote movement and articulation of the ankle as soon as is safe and as recommended by your Podiatric Surgeon.

Exercise and stretching is a very crucial part of the rehabilitation of the ankle after a surgery. An ankle brace also provides pressure to the joint and can help with re-developing good muscle coordination again.

Without an examination by a podiatrist, it is difficult to determine whether you will find success with physical therapy and strengthening exercises or surgery. It is also not clear which surgical procedure will be your best option as well as how long recovery will take. Either way, patience is important with this condition. Chronic ankle instability, by definition, is a long-term problem with long-term recovery. However, by following the protocols prescribed to you by your podiatrist, you can enjoy stronger ankles that will allow you to get back on your feet and enjoying the activities you love.

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