An ankle sprain is a common athletic injury, and around 20% of patients develop ankle instability. Poor posture control and deficits in muscle strength following an ankle sprain can lead to ankle instability. This article will help you understand ankle instability, from its causes to symptoms, diagnosis, and treatment.
What is Chronic Ankle Instability?
Chronic ankle instability (CAI) is a medical condition characterized by recurring turning of the lateral or outer side of your ankle. The problem develops after repeated ankle sprains. Usually, the “giving away” or turning occurs while walking or performing other activities, but it can also occur when you are just standing.
What are the Symptoms of Chronic Ankle Instability?
Ankle instability patients have a variety of symptoms, such as:
Repeated twisting of the ankle during athletic activities or while changing direction quickly or standing on uneven surfaces.
Wobbly or unstable ankle
Inflammation and chronic discomfort
Pain or tenderness. However, as the ankle becomes chronically damaged, you feel less pain with this giving away as it requires less energy to twist or roll the ankle.
Some CAI patients experience fewer strains and can prevent ankle sprains by modifying their daily activities. However, they continue to have pain, and downhill walking can be particularly painful as it makes the ankle bones more vulnerable to shifting out of place.
What Causes Chronic Ankle Instability?
CAI can result from various factors, including ligament injury, inadequate rehabilitation, ankle overuse, or repetitive microtrauma.
Ligament Injury
Repeated injuries and sprains can cause chronic ankle instability. Due to repeated injuries, the ligaments can become stretched out and unable to provide stability,
Lack of Proper Rehabilitation
The inability to complete a comprehensive rehabilitation program following an ankle injury can weaken lower leg muscles and lead to ankle instability.
Structural Problems
Individuals suffering from anatomical problems such as loose ligaments are at a higher risk of developing CIA at some point in life.
Overuse
Individuals with physically demanding jobs, such as athletes, tend to overuse their ankle joints or suffer from repeated microtrauma. This can also contribute to ankle instability.
How will a Foot and Ankle Specialist Diagnose Ankle Instability?
CAI is a clinical diagnosis based on history and examination. So, your physician can diagnose ankle instability by taking your medical history and then performing a physical exam. During the exam, the doctor checks the strength and movement of your ankle. They often ask for a standing X-ray to determine changes in the bone alignment that might have developed from instability. Stress X-rays can also help get an idea of the amount of looseness present. Doctors often recommend MRI for ankle instability patients as it is helpful in identifying other associated problems like:
Tendon tears
Cartilage damage
Scarring of the anterior talofibular ligament
How to Fix Chronic Ankle Instability?
Your foot and ankle specialist can determine the best course of treatment for ankle instability depending on the amount of pain and the extent to which it interrupts your day-to-day activities.
Non-Surgical Treatment for Chronic Ankle Instability
Some non-surgical treatments for CAI include:
Bracing:
Some patients wear an ankle brace to support the ankle and keep it from turning. Bracing can also prevent additional ankle sprains. Crutches may be needed until you start walking again without pain.
Medications:
Most physicians recommend anti-inflammatory medicines like ibuprofen or naproxen. Take these drugs as prescribed by your physician. Other minor painkillers like acetaminophen or a topical cream can also be used for pain management.
Physiotherapy:
Physical therapy involves chronic ankle instability exercises that improve the range of motion, retrain muscles, and strengthen the ankle. The physiotherapist may also provide training that specifically targets your activities or spots.
Rehabilitation:
The doctors retrain ankle instability patients for balance skills to prevent future injury. Your physician may refer you to an athletic trainer for more treatment.
Heat and Cold Therapy:
You can apply a cold compress or an ice pack for 10-15 minutes every 2 to 3 hours. As recommended by your physician, you can also use heat therapy to soothe your damaged muscles before stretching or strengthening activities. Apply a heat pack or a warm soak to the affected area for 10-15 minutes.
Surgery
Doctors recommend surgery to patients whose symptoms cannot be controlled with non-operative management. The surgeon chooses the best procedure for you depending on the severity of the instability and the level of physical activity. The following surgical treatments can be used to fix your damaged ankle:
Custom Procedure:
It involves anatomical repair of the outside ankle ligament. The stretched-out ligaments on the lateral side of the ankle are repaired to provide stability.
Tendon Reconstruction:
Tendon reconstruction involves strengthening the stretched-out ligaments through reconstructive surgery.
An adequately performed ankle reconstruction surgery has a very high success rate. However, the Brostom procedure can fail when performed on severely deficient ligaments or if mechanical anomalies are left uncorrected. Even after the successful surgery, CAI patients pursuing high-risk activities can sprain their ankles again.
Consult a Foot and Ankle Sprain Specialist Today!
Athletes or individuals in other physical activities can suffer from ankle instability due to repeated ankle sprains. Ankle instability patients often complain about recurring twisting ankles and inflammation, pain, and discomfort associated with it. Both surgical and non-surgical treatments are available for chronic instability. Generally, physicians recommend surgery when all the non-surgical methods fail. Are you worried because of recurring sprains or a turning ankle? Contact a trained foot and ankle specialist today!
