The first time you rolled onto the outside of your ankle and sprained it while playing ball, your ankle took a while to heal, but, after a few months, it felt normal again. And then came the second sprain in the same ankle—that took longer to get better, but it did. The third sprain was a surprise, because your ankle gave way when you were out for a leisurely walk. It’s been a year since then, and you’ve noticed many of the daily activities you didn’t think twice about before now make your ankle ache and swell. In fact, wearing an ankle brace has become part of your daily routine. Yet, you’ve never broken your ankle. What’s going on?
Chronic Ankle Instability
Chronic ankle instability is a condition that can develop after repeated ankle sprains, especially sprains to the outside of the ankle. Symptoms include:
- Feeling weakness or unsteadiness in the ankle
- Swelling, pain, or tenderness that never completely goes away
- Reinjuring the ankle during basic activities, such as standing, walking, or climbing stairs
What Causes Chronic Ankle Instability?
Repeated ankle sprains are the most common cause of chronic ankle instability. Reinjury can happen when an ankle injury hasn’t fully healed, even though it might feel like it has. When a sprain occurs, the ligaments in the ankle are stretched or torn, particularly the outer ankle ligaments. It typically takes longer for ligament injuries to heal compared to bone injuries, like broken bones. That’s because ligaments (and tendons) have low vascularity, which means they don’t receive much blood flow. In cases where the ligaments don’t heal completely, they can remain looser than undamaged tissue. This often leads to chronic instability and easier reinjury.
Will I Need Ankle Surgery?
After a thorough examination, you and your physician will decide whether surgery is the best option. Nonsurgical treatments are usually tried first. These treatments might include:
- Physical therapy to strengthen and exercise the ankle, improve balance, and increase range-of-motion
- Bracing to provide additional support
- Anti-inflammatory medication to reduce pain and swelling
Surgery might be recommended if conservative therapy fails, or in cases of severe instability, and it typically involves repair or reconstruction of the damaged ligaments.
Should I Visit a Foot + Ankle Specialist?
Delaying ankle care may result in a treatable injury becoming permanent. Foot and ankle surgeons are experts at determining the severity of ankle damage, and they are up-to-date with the latest treatment options. A physician trained to treat foot and ankle injuries will help ensure the function of your ankle is restored to the greatest extent possible.