Chronic ankle instability is developed after multiple sprains or a single severe sprain that was not properly healed. The ankle easily gives way to the lateral side, especially during sports activities or walking on uneven surfaces. This condition is common among athletes and people with high physical demands as they may have resumed their activities before the previous injury is fully recovered. Because of the ankle instability, people who are affected may find themselves incurring more sprains and developing other conditions such as arthritis and tendon tear over time.
When an ankle is sprained, the ligaments are stretched or torn and balance is affected. If the ankle muscles are not strengthened to regain the ability to balance, it would be prone to repeated sprains. With multiple sprains, the ligaments are weakened and more difficult to heal, leading to chronic ankle instability.
Patients of chronic ankle instability experience a constant ache and swelling in the ankle, with pain and tenderness when engaged in physical activities. The ankle would be unstable and often rolls over to the lateral side. Usually, patients would complain about these persistent symptoms after the ankle has been sprained several times.
The doctor would first take a history of your condition to find out if you had any previous ankle injuries and how long the symptoms have persisted. A physical examination is then carried out to check for swelling, tenderness and instability. X-rays or other tests, such as bone scan or MRI, may be ordered.
Based on the degree of instability, the recommended treatment may be surgical or non-surgical. For severe cases and if the condition does not improve or recur after non-surgical treatment, surgery would be required.
Physical therapy incorporates different exercises to help strengthen the ankle muscles. This would retrain the tissue to regain balance and range of motion. For athletes, the rehabilitation may include exercises that specifically help them get back to their sport.
To help support the ankle, a brace is worn to keep it in position and prevent further injury. Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed to reduce the pain and inflammation.
The goal of the surgery is to reduce the symptoms of the condition to prevent more serious injuries. As such, the surgeon would excise loose fragments and debride the ankle joint of any scar tissue or fibrous bands. The ligaments are then repaired or reconstructed. Tendons may also be transferred to align the ankle for better motion.