Getting back in my heels

Posted on: 25 January 2016

A sprained ankle is a painful and debilitating thing to deal with, but at least it's only temporary. However, if an ankle sprain is not treated with due care and attention, you may find yourself afflicted with something far more long-term -- chronic ankle instability.

What is chronic ankle instability, and what causes it?

Chronic ankle instability is largely self-explanatory -- a condition characterised by recurring, spontaneous periods of instability in the affected ankle. This instability manifests itself as a 'giving way' sensation and affects the lateral (outer) side of the ankle. This lack of reliable stability results in a much higher risk of turning your ankle while walking, during sports or even just standing still, and can lead to further sprains and even tears in the affected ligaments attached to the ankle.

Chronic ankle instability can, in rare cases, be caused by idiopathic (unknown) causes, but generally speaking, the root of the condition is poor medical care after an ordinary ankle sprain. If for whatever reason, somebody with an injured ankle uses the ankle excessively while it is still healing (for instance by returning to the gym or training sessions too early), the overstretched ligament(s) can end up healing in a stretched position, resulting in in a significant loss of strength and stability in the affected ankle.

In addition to the aforementioned loss of ankle stability, people suffering from this condition may also experience pain and swelling around the ankle very similar to that suffered during an ankle sprain proper. This is caused by a constant buildup of small-scale damage in the ligaments, as the repeated ankle rolling causes cumulative damage.

How can my podiatrist help treat my chronic ankle stability?

If you are suffering from the symptoms of chronic ankle instability, getting yourself to a podiatrist is your first priority - the longer chronic ankle stability is left untreated, the more cumulative (and potentially irreversible) damage is caused.

The first thing a podiatrist will do is conduct a thorough examination of your foot. This will take the form of a physical examination to ascertain why ligaments are affected, but may also involve use of medical imaging such as x-rays or ultrasound scanning. Make sure to tell your podiatrist about the nature of your ankle instability as best you can, and how long you have suffered from it.

Once the extent of the damage has been established, treatment can begin. Depending on the severity of your condition, one or more of the following treatments may be recommended:

• Bracing and orthotics - The general aim of chronic ankle instability treatment is to restore the strength and tighten the elasticity of the unstable ligaments. To this end, your podiatrist may provide you with an immobilising ankle brace. This will help damaged ligaments heal in the correct positions and prevent accidental ankle turning. Once the ankle brace comes off, you may be provided with an orthotic shoe insert to keep your foot in a position conductive to healing while retaining mobility. 
• Physical therapy - Once your ankle has healed sufficiently, you may be referred to a physiotherapist. They will help you with exercises designed to strengthen the ankle and ensure consistent stability. They may also provide other services to promote healing, such as tissue massage and acupuncture.
• Medication - Chronic ankle instability can cause pain and inflammation even during the healing process, so you may be provided with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen.
• Surgery - if non-invasive treatment methods fail to provide results, you may be referred to a foot surgeon for surgical rebuilding of your ankle. Any kind of surgery naturally carries its own risks and complications -- however, chronic ankle instability surgery is generally minimally invasive and involves a simple shortening and reattachment of overstretched ligaments. However, if one or more of your ankle ligaments is damaged beyond repair, it may be replaced with tendon tissue from your lower leg or another part of your body.