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All About Chronic Ankle Instability

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The ankle joint is made up of numerous bones, tendons, and ligaments. All of these help the ankle produce a multitude of movements. They play an integral part in maintaining the ankle’s stability. Ankle instability can result when these bones, ligaments, or tendons are damaged or compromised in some way.


The ankle joint and its surrounding structures are very complex. Any injury to the tendons, ligaments, bones, or tendons can result in instability. Dislocations or fractures of the fibula or tibia can cause ankle unsteadiness. Damage to the tendons that support the ankle joint can also cause ankle instability. Overuse can result in tendonitis and produce chronic and significant unsteadiness.

Repeated ankle sprains that do not properly heal are often the cause of chronic ankle instability. If the ankle joint continues to give away easily after the initial sprain, the instability is considered chronic. Unstable ankle joints are more likely to be sprained again. Each additional sprain results in more damage to the joint.


Chronic instability produces symptoms of chronic pain, swelling, and dysfunction within the ankle. Other symptoms that occur frequently include the ankle giving way or an unsteady feeling. A decreased range of motion is also common.

Chronic ankle instability can be diagnosed by an evaluation with a foot specialist. They will examine your ankle to check for swelling, tender areas, and instability of your ankle. They might take X-rays or other imaging studies to rule out other problems.


There are a number of treatment options for ankle instability. Conservative treatment measures include

  • Physical Therapy – Physical therapy is used to help strengthen the ankle, improve range of motion and balance, and retrain your muscles. One common approach in physical therapy is neuromuscular training. The aim of neuromuscular training is to improve the stability, strength, and coordination of the ankle. Neuromuscular training has been shown to be effective in speeding up the improvement of ankle mobility and stability in the first few weeks.
  • Medications – Your physician may prescribe nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen, in order to decrease inflammation and pain. Other medications include an injection of a steroid medication. This is done in a physician’s office.
  • Bracing – Bracing can help patients gain support for the ankle and prevent the ankle from turning. Bracing is also helpful to prevent additional ankle sprains, especially when engaging in sporting activities.

In some cases, surgery is needed. The need for surgery is typically based on the degree of instability in the ankle or lack of response to more conservative approaches. Surgery usually involves reconstruction or repair of the damaged ligament or tendon. The exact surgical procedure is based on the type and severity of the instability. The length of the recovery period depends upon the type of surgery performed.

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