Why Your Chronic Ankle Instability Keeps Coming Back

You’ve sprained your ankle before and you don’t want to do it again. Unfortunately, ankle instability happens when the stabilizing structures of your ankle aren’t allowed to fully heal. Without full rehabilitation between ankle sprains you may experience recurrent weakness, giving way, and lack of confidence when moving your ankle.

Your ankle sprain didn’t REALLY heal.

Although swelling and pain may resolve fairly quickly with rest, the deeper structures of your ankle including ligaments, muscles, and nerves can lose their quick response reaction time. This means that your ankle may feel fine walking the dog, but catch you off guard when stepping onto an uneven sidewalk or cutting while playing basketball.

Healing isn’t the same thing as rehabilitation.

Resting allows the torn ligament tissues to go back together, but what about your balance, coordination, and strength? As long as these supporting systems remain impaired your ankle will lack stability no matter how good it feels day-to-day.

Your ligaments are loose.

Stretching or tearing the ligaments on the outer aspect of your ankle joint can lead to instability. The anterior talofibular ligament is most commonly injured when your ankle rolls. When this ligament heals in an elongated position your ankle loses its natural restraint and allows more movement than it should when placed in awkward positions.

Patients often describe their symptoms as…

• Rolling again and again

• Swelling with activity

• Stiffness

• Won’t trust it

• An ache on the outside of my ankle joint

• Pain with side-to-side motion

• Altered walking patterns.

When your ankle hurts you may take shorter steps, increase weightbearing on the opposite leg, or adjust where you place your foot when walking. Although these movement adaptations may decrease pain in the short term they can contribute to poor mechanics and chronic instability.

Rest and bracing allow you to move without pain, but they don’t fix the problem.

Unless you retrain balance, coordination, and reactionary time your ankle will rely on bracing or taping to feel stable. Instability requires active treatment and rehabilitation to reverse the cycle.

Strong muscles keep your ankle from rolling.

Sideways or rotational motions of the ankle joint are controlled by muscles. These muscles, along with ligaments, help prevent your ankle from rolling again.

Balance training restores joint awareness.

Balance and proprioception exercises teach your brain to recognize where your ankle is positioned in space and how to respond without you having to think about it.

Once your diagnosed, we tailor our treatment to your needs.

Physical therapists at Wasatch Foot & Ankle Clinic evaluate patients with chronic ankle instability to determine if their condition is functional or structural. Structural ankle instability is diagnosed with a combination of advanced imaging and physical examination to help us decide if you are a candidate for surgery or can be treated non-operatively.

Surgery may be an option if…

Your ankle continues to give way after several attempts at rehabilitation or if you have physical exam findings or an MRI that suggests a structural problem. Surgical treatment for chronic ankle instability has advanced over the years to allow early range of motion and maintain normal ankle biomechanics.

Three ways to avoid reinjury…

• Stay committed to your home exercise program.

• Wear shoes that fit well and provide good support/arch control.

• Modify high risk activities, and consider bracing your ankle when participating in sports.

There’s no reason you should have a weak ankle. At Wasatch Foot & Ankle Clinic we’ll help you identify the underlying cause of your chronic ankle instability and develop a comprehensive treatment plan to keep you from rolling your ankle again.

FREQUENTLY ASKED QUESTIONS

Q: Why does my ankle keep rolling even after physical therapy?

A: This is typically due to balance, coordination, strength, or ligamentous stability not returning to normal. Some people have an underlying structural issue that was either undetected or does not respond to physical therapy.

Q: Can chronic ankle instability get better on its own?

A: Most cases of chronic ankle instability will not improve without treatment. The majority of people actually experience worsening symptoms over time.

Q: How long does it take to rehab your ankle?

A: In general patients require between six and twelve weeks of progressive therapy. The severity of your injury and your activity demand will dictate how long treatment takes.

Q: Are braces a good long term solution for keeping my ankle from rolling?

A: Braces can help decrease your risk of reinjury while you are active. However they should be used to complement your rehabilitation program not replace it.

Q: When should I make an appointment to be seen for recurrent ankle sprains?

A: If your ankle keeps giving way, swells frequently, or is limiting you from doing your daily activities, it’s time to see one of our specialists.