Ankle sprains are among the most common musculoskeletal ailments treated. While the vast majority of patients go on to heal without long term sequelae, some may go on to develop chronic ankle instability.

Ankle instability is a debilitating condition incorporating recurrent sprains, persistent pain and repeated instances of giving way. When left untreated, this condition decreases one’s level of function and quality of life with the potential to lead to arthritis and chronic pain. Ankle instability arises from the same mechanism as that of simple ankle sprains.

The congruency of the ankle joint imparts a high degree of stability. Malalignment of the ankle due to hindfoot valgus or cavovarus has been correlated with ankle instability.

Patients with ankle instability present with persistent pain, recurrent ​sprains, and a feeling of giving way. Patients should be queried about a history of ankle sprains, previous treatment of their ankle, and any surgical interventions performed.

After a diagnosis of ankle instability is established, conservative treatment is the first line of therapy.

• Physical therapy: Physical therapy involves various treatments and exercises to strengthen the ankle, improve balance and range of motion and retrain your muscles. As you progress through rehabilitation, you may also receive training that relates specifically to your activities or sport.
• Bracing: Some patients wear an ankle brace to gain support for the ankle and keep the ankle from turning. Bracing also helps prevent additional ankle sprains.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to reduce pain and inflammation.

Dr. foot will always recommend and attempt conservative treatment when appropriate. However, when ankle instability becomes painful, contributes to more damage, daily activities become a struggle, and conservative treatments have failed, surgical repair may be indicated.

Considering surgery can be intimidating. Ankle surgery including surgery to correct ankle instability is not supposed to be painful during recovery.

The goal of ankle instability surgery is to tighten the ankle ligaments, realign the ankle joint, clean out the ankle joint, repair any cartilage damage, repair any tendon damage, and allow a return to all activities.