Ankle instability is a chronic condition characterized by a recurrent slipping of the outer side of the ankle. It usually results from repeated ankle sprains. It is generally noticed during movement of the ankle joint but can also occur during standing as well.
Repetitive injury of the ankle ligaments on the same side is the most common cause of ankle instability. Inadequate healing of the sprained ligament or incomplete rehabilitation of the affected ligament can result in instability of the ankle. Recurrent injury of the ligaments further weakens them and aggravates the instability which predisposes to the development of additional ankle problems.
The feeling of the ankle being unstable, a lack of confidence in the ankle and repeatedly ‘rolling over’ (giving way). Giving way (instability) is more common while walking on uneven surfaces or during a sporting activity, but may occur without warning on flat surfaces and in heels. Pain may be a feature after an episode of giving way, which then may settle after minutes or days. During this episode there may be swelling and tenderness of the ankle. There may also be a persistent discomfort in the ankle, usually on the lateral (outer) aspect.
A complete medical history, including a history of any previous ankle injuries, and a physical examination is essential for an accurate diagnosis of the condition. An X-ray may be ordered to confirm the diagnosis. Other imaging tests such as an MRI may also be used to evaluate the injury.
The management of ankle instability depends on the findings of physical examination and the activity level of the patient.
Conservative treatment includes physical therapy for improving the strength, balance and range of motion of the joint, bracing to support the affected ankle and prevent further sprain, and non-steroidal anti- inflammatory (NSAIDs) to reduce the pain and inflammation.
Surgery is recommended in patients with instability who have failed to respond to non-surgical treatments. Usually, a 3 month rehabilitation programme should be completed first prior to considering surgery. Commonly used surgical procedures involve repair or reconstruction of the damaged ligament. Find out more here
Ankle braces with rigid side supports. Lace up types: LP Elite by McDavid (left) or Ankle Brace by Mueller.
Velcro type: Airsport by Aircast (middle)
Rigid walking boot (right) AirSelect Short Walking Boot by Aircast