What is ankle instability?

Ankle instability is a condition characterised by a recurrent giving way after an ‘ankle sprain’ which ruptures the ligament complex on the outside of the ankle. This instability often leads to discomfort and an increased likelihood of ankle injuries.

Risk factors for ankle instability

Several factors can increase the risk of developing ankle instability:

  • Individuals who have had one or more severe ankle sprains
  • Occupations or sports activities that require frequent or intense use of the ankles (e.g. basketball or volleyball).
  • Genetic factors associated with ligamentous laxity.
  • Anatomical factors

Symptoms of ankle instability

People with ankle instability often report the following symptoms:

  • Recurrent ankle sprains
  • A recurrent sensation of the ankle 'giving way' or feeling unstable.
  • Persistent discomfort and pain, especially during activities that require ankle movement.
  • Swelling around the ankle region

Causes of ankle instability

The primary cause of ankle instability is the rupture or stretching out of some or all of the ligaments on the outer side of the ankle. This can occur due to an ankle sprain or repeated sprains, which can stretch or tear these ligaments. The two main ligaments commonly associated with ankle instability are the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL).

Diagram illustrating the commonly associated ankle ligaments

Diagnosis of ankle instability

Dr Graff will take a history and examine your ankle, and organise imaging such as:

  • X-Rays: This can help detect any fractures or abnormalities in the ankle, stress x-rays may also be conducted to review the joint appearance while stressing the ankle.
  • MRI Scan: This may provide a detailed view of the ligaments and assess for damage to these.

Management and treatment of ankle instability

Treatment for ankle instability aims to restore strength and balance to the ankle.

This usually involves:

  • Physiotherapy: Specific exercises that can strengthen the ankle muscles and improve balance and coordination.
  • Bracing: An ankle brace can provide additional support and prevent further injury.
  • Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to manage pain and inflammation.
  • Surgery: In cases where the above treatments are ineffective, surgery may be considered to repair or reinforce the ligaments.

Preventing ankle instability primarily involves reducing the risk of initial sprains and subsequent reinjury. This can include regular ankle-strengthening exercises, wearing suitable footwear, and being mindful of surfaces and activities that might increase the risk of ankle injury.

If you have any concerns or questions regarding ankle instability or have recently injured your ankle and require review, please contact us and book an appointment with Dr Graff for review.

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