Instability

Instability is the inability of a joint to support weight or maintain balance, a feat which requires coordination between functional ligaments and tendons. Chronic ankle instability often develops after repeated ankle sprains. This condition usually occurs while walking or during other activities, but it can also happen while simply standing. Many athletes suffer from chronic ankle instability.

Causes

Chronic ankle instability usually develops following an ankle sprain that has not adequately healed or was not completely rehabilitated. When you sprain your ankle, the connective tissues (ligaments) are stretched or torn. The ability to balance is often affected. Proper rehabilitation is needed to strengthen the muscles around your ankle and retrain your tissues within the ankle that affect balance. Failure to do so may result in repeated ankle sprains. Repeated ankle sprains often cause chronic ankle instability. Each sprain leads to further weakening (or stretching) of your ligaments, resulting in greater instability and the likelihood of developing additional problems in your ankle.

Symptoms

Contact a doctor if you notice:

• A repeated turning of the ankle, especially on uneven surfaces or when participating in sports
• Persistent (chronic) discomfort and swelling
• Pain or tenderness
• The ankle feeling wobbly or unstable

Potential Treatments

X-rays or other imaging studies may be helpful in examining your ankle. Based on the evaluation your doctor will determine the best treatment.

Treatments include:

• Physical therapy. Physical therapy involves various treatments and exercises to strengthen the ankle, improve balance and range of motion and retrain your muscles. As you progress through rehabilitation, you may also receive training that relates specifically to your activities or sport.
• Bracing. Some patients wear an ankle brace to gain support for the ankle and keep the ankle from turning. Bracing also helps prevent additional ankle sprains.
• Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to reduce pain and inflammation.

In some cases, your doctor may recommend surgery based on the degree of instability or lack of response to nonsurgical approaches. Surgery usually involves repair or reconstruction of the damaged ligament.