Does your ankle keep “giving way”?
Repeated ankle twisting is not something you necessarily have to live with.
Chronic ankle instability usually develops after recurrent ankle sprains in which the supporting ligaments become stretched or insufficient. Some patients may also experience functional instability related to muscle weakness, poor balance, tendon problems or an underlying foot deformity.
What does chronic ankle instability feel like?
Typical symptoms include:
- The ankle repeatedly “giving way”
- Recurrent ankle sprains
- Feeling unstable on uneven ground
- Difficulty with running, jumping or changing direction
- Pain around the outer side of the ankle
- Swelling after activity
- Reduced confidence while walking or playing sports
Why does the ankle become unstable?
The most common cause is a previous ankle sprain.
The lateral ankle ligaments, particularly the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL), are commonly involved in lateral ankle sprains.
Repeated injuries may cause the ligaments to heal in a lengthened or insufficient position. Other factors can contribute too.
How is ankle instability diagnosed?
Diagnosis is primarily clinical.
Assessment may include:
- Previous injury history
- Frequency of ankle sprains
- Location of pain
- Ankle range of motion
- Ligament stability testing
- Peroneal tendon examination
- Foot alignment
- Calf and Achilles assessment
- Balance and gait
Can ankle instability be treated without surgery?
Yes. Many patients improve with structured non-operative treatment.
Rehabilitation is particularly important after an ankle sprain because simply waiting for pain to disappear does not necessarily restore strength and neuromuscular control.
Treatment may include
- Ankle bracing during higher-risk activities
- Physiotherapy
- Peroneal and ankle muscle strengthening
- Balance and proprioception training
- Calf stretching
- Gradual return to sport
- Correction of contributing footwear or biomechanical factors
When is surgery considered?
Surgery may be considered when:
- The ankle remains mechanically unstable
- Repeated sprains continue despite appropriate rehabilitation
- Instability significantly affects work, sport or daily activities
- There is associated cartilage, tendon or structural pathology requiring treatment
Surgical treatment may involve repair or reconstruction of the lateral ankle ligaments.
In selected patients, additional procedures may be necessary to address an underlying deformity or associated pathology.
What happens after ligament surgery?
Depending on the procedure, treatment may involve a period of immobilisation followed by progressive rehabilitation.
Rehabilitation focuses on:
- Restoration of ankle movement
- Strength
- Balance
- Proprioception
- Sport- or activity-specific function
Why should repeated ankle sprains not be ignored?
Persistent instability can lead to repeated injuries and may be associated with damage to the ankle cartilage, tendons and surrounding structures.
Frequently Asked Questions
Is one ankle sprain enough to cause chronic instability?
Not necessarily. Many ankle sprains heal successfully without developing chronic instability.
Does every unstable ankle require surgery?
No. Bracing and structured rehabilitation are important first-line treatments for many patients.
Can physiotherapy make an unstable ankle stable?
Rehabilitation can significantly improve functional stability, strength and balance. Whether mechanical ligament reconstruction is required depends on the individual assessment.
Can I play sports with ankle instability?
Some patients can continue sports with appropriate rehabilitation and bracing, but recurrent giving-way episodes should be assessed.
Can an ankle brace cure ligament damage?
A brace does not restore a torn ligament anatomically, but it can improve functional stability and reduce the risk of recurrent sprains in appropriate situations.
Consultation
If your ankle repeatedly twists or gives way, identifying the underlying cause is important before simply treating each new sprain.
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