Ankle Instability

How Does Ankle Instability Affect Your Body?

The giving way at the ankle occurs while walking or doing other activities, but it can also happen when you’re just standing. Ankle instability can also affect balance.

Ankle stability is dependent on the ankle bones, and supporting ligaments and tendons. While the bones and ligaments provide static stability, dynamic stability is allowed by the tendons.

The ankle joint is composed of three bones: the tibia, fibula and talus. The joint is protected by a fibrous membrane called a joint capsule, and filled with synovial fluid to enable smooth movement.

What Causes Ankle Instability?

Chronic or Repetitive Instability is often caused by repeated injury of the ankle ligaments on the same side is the most common cause of ankle instability.  When you sprain your ankle, the connective tissues (ligaments) are stretched or torn. The ability to balance is often affected.

Other causes include:

• Inadequate healing of the sprained ligament
• Incomplete rehabilitation of the affected ligament can result in instability of the ankle.

Recurrent injury of the ligaments further weakens them and aggravates the instability, predisposing the development of additional ankle problems.

Symptoms of Ankle Instability

Ankle Instability in the affected ankle joint is often characterised by:

• Tenderness
• Pain
• Swelling
• Persistent Discomfort

The ankle is unstable and may turn repeatedly while walking on uneven surfaces or during sports activity.

How is Ankle Instability Diagnosed?

Medical History

Your doctor will ask questions about:

• Current symptoms and their severity
• If an injury was sustained
• Your medical history including family or genetic links
• Your current and past medications
• The impact of the problem on your occupation and lifestyle

Physical Examination

Your doctor perform comprehensive physical evaluation that will include:

• Examining the affected area for swelling, pain, bruising or other features
• Assessing your range of motion, walking pattern and other relevant features

Diagnostic Testing

Once your doctor has completed the physical examination further tests maybe required. These tests can help your doctor determine or eliminate possible causes. These can include:

• X-Ray
• Ultrasound (US)
• Computerised Tomography (CT)
• Magnetic Resonance Imaging (MRI)

Once a final diagnosis has been completed your doctor can discuss with you and recommend any treatment options.

Non Surgical Treatment for Ankle Instability

Treatment for your condition can begin immediately and can include:

• Rest: Resting the affected area or pausing athletic activity until the symptoms of ankle pain have faded
• Pain medication: Paracetamol or Nonsteroidal anti-inflammatory medications (NSAIDs) can relieve some pain or discomfort
• Physiotherapy: A physiotherapy program focused on restoring balance, strength, range of motion and proprioception is in most cases the best form of treatment. Your physiotherapist can also tailor your program depending on your type and level of sport  / physical activity.
• Bracing: An ankle support brace can often prove useful when combined with an effective physiotherapy progra

Surgical Treatment for Ankle Instability

In cases where either a conservative treatment has not resolved the problem, surgery may be required . Surgery is recommended in patients with a high degree of instability and in those who have failed to respond to Nonsurgical treatments. Surgery typically involves reconstruction of the damaged ligament. These involve either tightening the stretched/damaged ligament, and may involve using another tendon or synthetic tape to supplement the reconstruction.

What if Ankle Instability goes Untreated?

Left untreated, an unstable ankle joint significantly affects function and overall quality of living. It can eventually lead to chronic pain and arthritis.