Chronic Ankle Instability

What is chronic ankle instability?

Weak and unstable ankles are subject to suddenly rolling, causing the band of lateral ligaments that stabilizes the outside of your ankle to stretch or even tear. Incomplete healing after an ankle injury may result in continued deterioration of the ligaments and a cycle of chronic instability and recurring ankle sprains.

The Cycle of Chronic Ankle Instability

1. The initial inversion injury occurs: your foot suddenly rolls inwardly and your weight shifts onto the outside edge of your ankle
   

2. The forced rotation of your ankle joint causes the supporting ligaments to stretch or tear
   

3. Stretched and torn ligaments are weaker and may not heal properly
   

4. Unable to play their role supporting the ankle joint, your ligaments give way easily, resulting in more sprains
   

5. The result is chronic ankle instability and an unending cycle of ankle sprains
   

6. Over time, and without treatment, repeated injury to the ankle ligaments can lead to degenerative changes and possibly osteoarthritis^9,10
   

Progression of Instability, Pain, and Arthritis

Normal Ankle

Sprained Ankle

Unstable Ankle After Treatment

Arthritic, Unstable

Preinjured, healthy ligament

Ankle roll stretches and tears ligament.

Ligament may heal in a weakened, stretched state that is prone to more sprains.

Ankle becomes increasingly unstable over time, leading to joint pain and possible arthritis.

How is chronic ankle instability diagnosed?

If you suspect you may have chronic ankle instability, schedule an appointment with a foot and ankle specialist for further evaluation. A standard exam consists of:

History

Physical Exam

Balance Test

Advanced Imaging

Your doctor will ask questions to determine whether you have the common signs and symptoms of chronic ankle instability, including repeated ankle sprains, pain, and fear of your ankle “giving way.”

A detailed physical exam and series of tests will be performed to check for ligamentous laxity or “overstretching” of your ankle ligaments, as well as muscle strength and ankle motion.

You may be asked to stand on one foot with open eyes and then again with closed eyes to determine whether your ankle instability affects your proprioception or “sense of balance.”

Finally, imaging studies like x-rays and magnetic resonance imaging (MRI) will be conducted to confirm the diagnosis.

So, you’ve been diagnosed with chronic ankle instability... Now what?

Know that chronic ankle instability is a long-term condition that may not heal on its own. Rest, ice, compression, and elevation may provide temporary relief of the pain from an ankle sprain, but they will not repair damaged ligaments. Surgical repair may be necessary. Ask your doctor if InternalBrace ligament augmentation procedure may be right for you.