Ankle instability

Ankle instability usually follows an injury or repetitive injuries to the ankle, in which the ligaments on the outside of the ankle may be ruptured or stretched.

What is ankle instability?

Ankle instability usually follows an injury or repetitive injuries to the ankle, in which the ligaments on the outside of the ankle may be ruptured or stretched. You may feel like you have a “sprained ankle”. This condition is often caused by an injury or from repetitive movement.

Recurrent ankle instability is commonly referred to as 'going over the ankle' and can cause real pain. In some cases further damage may occur within the ankle causing further pain. Over the long term repetitive episodes of instability can lead to early arthritis within the ankle.

Ankle instability symptoms

Common symptoms include:

Weakened ankle
Ankle pain
Experience the ankle repeatedly "give way"
Swollen ankle

Your GP, physiotherapist or consultant will advise you on the best course of action for your specific condition and they will want to understand if you are more susceptible than the average to ankle instability. As part of their investigations, an X-ray will indicate whether there is any damage within the ankle or any evidence of early arthritis. As an alternative an MRI scan may be required to confirm the full extent of the ligament damage at the ankle.

Ankle instability treatment

There are two options for treating ankle instability: non-operative and operative treatment. Your GP, physiotherapist or consultant will help determine which treatment option is best for your unique circumstances. Usually non-operative is for less severe cases, whereas operative treatment is recommended for severe cases of ankle instability and for patients who have not gotten the desired results from non-operative methods.

Non-operative treatment for ankle instability

Immediately after the initial incident where there is pain, rest, ice, compression and elevation of the ankle is recommended. If the instability continues regularly physiotherapy could be a chosen course of therapy to aid with strengthening exercises. On occasion supervised strapping or use of a brace may be required.

Operative treatment for ankle instability

If your consultant perceives that there is damage within the ankle then an arthroscopy of the area could be required. In addition, if the non-operative treatment as outlined above fails, then surgery to reconstruct the ligaments and stabilise the ankle would be required.

Surgery is performed under a general anaesthetic or spinal anaesthesia. A tourniquet is used, which is like a blood pressure cuff around the upper thigh to prevent blood from obscuring the surgeon’s view. In some cases the torn ligament can be repaired, but in other cases it cannot, and an adjacent tendon has to be used to reconstruct the torn ligament. The skin is sutured and an immobilising plaster of paris slab is applied. Patients are allowed to weight bear immediately with the protection of crutches.