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Dealing with chronic ankle instability

treating chronic ankle instabilityRepeatedly spraining or otherwise injuring an ankle can lead to chronic ankle instability, a condition in which the ankle becomes lax and prone to rolling to one side or the other, usually outward or laterally. Chronic ankle instability may affect athletes and nonathletes alike. For some patients, chronic ankle instability can become so pronounced, that not only does the affected ankle become more prone to a sprain or rolling while walking, running, or doing other activities, it may even occur while simply standing still. If you suffer from repeated ankle sprains, or feel as if one of your ankles is less stable than the other, you may have chronic ankle instability.

Common symptoms of chronic ankle instability

Those with chronic ankle instability often find that only one ankle is affected, although a few patients suffer from instability in both ankles. The ankle may also be prone to tenderness or swelling. In addition, the affected ankle may simply feel unstable, as if it could give out or roll at any moment. Left untreated, future ankle sprains or worse injuries are likely to occur.

Causes of chronic ankle instability

The most common cause of chronic ankle instability is repeatedly spraining or injuring an ankle. With each injury, it becomes more difficult for the ankle to heal properly. Excess scar tissue may develop along the ligaments on the outer, or lateral side of the ankle, or the ligaments may become so stretched that they are unable to return to their natural state. The ultimate result is instability, and can be associated with difficulty keeping balance while standing or walking. Each new sprain may add to or worsen the instability as the ligaments stretch and weaken more and more with each subsequent sprain or injury.

Diagnosing chronic ankle instability

In diagnosing chronic ankle instability, your podiatrist may also rule out other possible injuries or causes for your ankle problems. During your appointment, your podiatrist may ask you about prior injuries, as well as your current concerns. You may be asked to show your podiatrist your shoes, and to walk or stand in front of your podiatrist so that the motion or alignment of your ankles can be evaluated.

In addition, your podiatrist will do a physical examination of your ankles, often assessing both the problematic ankle and the normal ankle. Your podiatrist may palpate, or touch and press on, different areas of the ankle, lower legs, and feet to locate painful or tender areas. Your podiatrist will also look for bruising, swelling, or other signs of injury. It is common for your podiatrist to move your foot and ankle to measure your range of motion and test for instability or laxity of the ankle joint. Depending on your podiatrist’s findings, your podiatrist may send you for x-rays, a CT-scan or an MRI to further investigate your ankle symptoms.

Treatment of chronic ankle instability

As with many other diagnoses, treatment of chronic ankle instability is often categorized as either conservative (non-surgical) or surgical.

Non-surgical treatment of chronic ankle instability may include physical therapy to improve balance, strength, and range of motion of the affected ankle. Physical therapy may also include sport or activity-specific training based on any active pursuits you may have. Some patients may have such a degree of ankle instability that they require a brace for support and to prevent further rolling or turning of the ankle. A brace may help prevent future sprains and further instability; however, some braces may limit the normal range of motion of the ankle or may alter your gait (the way you walk). Although medications typically won’t help repair ankle laxity, they may help with associated pain or swelling. Typically nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed.

For significantly unstable ankles, or those that don’t respond to treatment, surgery may be required. Surgery is usually a last resort, however. Surgical treatment of ankle instability often, but not always, starts with an MRI of the affected ankle to assess the amount of damage present in the ankle and whether or not it is limited to ligaments. Typically, ankle instability surgery involves repairing or reconstructing the damaged ligaments. The particular surgical approach used depends on the severity of instability, the activities in which you participate, and on whether or not other damage exists beyond that of the ligaments. Recovery from surgery often involves wearing a brace or post-surgical boot and physical therapy with a progressive return to activity.

If you are suffering from ankle pain, repeated sprains, or other symptoms, or if you have any other foot or lower leg concerns, please call Kansas City Foot Specialists today at (913) 338-4440 to schedule an appointment.