Chronic ankle instability is a condition which causes the outer side of the ankle to give out on a recurring basis. This develops after repeated ankle sprains. The ankle gives out while walking or doing normal activities.
Causes
Chronic ankle instability typically develops after an ankle sprain and has not adequately healed or was not rehabilitated completely. The ligaments on the outside of the ankle are stretched or torn. Balance is often affected. Each sprain leads to further weakening and stretching of the ligaments, resulting in an even greater instability and the likelihood of developing additional pathology in the ankle.
Symptoms
- Repeated turning of the ankle (inversion injuries) on level or uneven surfaces
- Constant discomfort or swelling to the outside of the ankle
- Ankle feels unstable or wobbly
Diagnosis
In evaluating and diagnosing your condition, your surgeon will ask about any previous ankle injuries and instability on level or uneven surfaces. Your surgeon will examine your ankle to check for tender areas, signs of swelling, and instability of your ankle.
X-rays are ordered to evaluate any bony abnormalities. An MRI will likely be ordered to evaluate the soft tissue around the ankle as well as the ankle joint. This is to determine the extent of the pathology to the outside of the ankle as well as determine surgical planning should surgery be warranted.
Non Surgical Treatments
- Rest. Limit the amount you are on the injured ankle.
- Immobilization. A cast or splint may be used to keep the foot and ankle from moving and allow the injury to heal.
- Ice. Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
- Compression. An elastic wrap may be recommended by your surgeon to control swelling.
- Bracing. The ankle should be supported in a low profile ASO brace as rehabilitation develops.
- Elevation. The ankle should be raised slightly above the level of your heart to reduce swelling.
- Physical therapy. Your surgeon will start you on a rehabilitation program as soon as possible to promote healing and increase your range of motion. This includes doing prescribed exercises.
- Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), may be recommended to reduce pain and inflammation. In some cases, prescription pain medications are needed to provide adequate relief.
Surgery
In more severe cases, surgery may be required to adequately treat the chronic ankle sprain and/or the peroneal damage. Surgery often involves repairing the damaged ligament or ligaments, repairing the tendons, deepening the groove of the tendon, repairing the seatbelt over the groove. Your surgeon will select the surgical procedure best suited for your case based on the type and severity of your condition as well as your activity level.