Ankle instability is not a common condition but is estimated to affect 10% of the general population who sustain an ankle sprain and up to 30% of the athlete population. The most frequent cause of ankle instability is due to a previous ankle injury that has not been properly rehabilitated. Returning to play or high-level activities to early can lead to further injury. Ankle instability does not normally occur after one or two sprains. The patient often has a history of several sprains to the same ankle causing increased laxity and increased ease for the ankle to roll.
The ankle joint is made up of three bones. The talus bone in the foot, the fibula on the outside and tibia on the inside. The shape of the bones as well as several ligaments and tendons create stability and helps to prevent excessive movement. Ligaments, a fibrous tissue that cross a joint, are designed to resist tension like forces like when you roll your ankle. However, they are only able to resist so much force before they start to stretch and tear. The most common ankle sprain is a plantarflexion inversion (toes pointed and turned inwards) sprain. This puts tension on the lateral ankle ligaments. Once the tension exceeds their normal force strain, a tear occurs. Without adequate time and rehabilitation, the ligaments will not be as strong and stable as prior to the injury putting you at greater risk of injuring the same area again.
Many people do not see an ankle sprain as a big deal and often wait for pain to settle down enough that they can function, get it strapped up and return to sport. The reduction in pain is not a sign of a complete recovery. Depending on the grade, full recovery can take anywhere between 4-12+ weeks and requires specific strengthening and stability exercises. Returning to sport and high-level activity prior to full healing puts someone a risk of another ankle sprain. This is due to the ligaments ability to resist tension is not a high as normal. A subsequent injury can occur much easier with less force. Patients often report that the more often they sprain the same ankle the pain becomes less severe, settles much quicker, and the time they spend on the sideline is less than previous sprains. This is due to the ligaments becoming more and more stretched and less stable with each new sprain, but this will also result in increased loading on the joint itself increasing wear and tear.
The best treatment option for ankle instability is to stop it happening in the first place. Ensuring you do proper rehab with our highly trained physiotherapists after each injury to return to the highest possible level prior to returning to sport. If you are further down the line of ankle instability, work can still be done to help build stability using active factors such as the muscles to help the ligaments that have become overstretched. Focusing on stability training, such as using a wobble board or bosu ball, is very beneficial in regaining a sense of balance in the ankle. Adding in other exercises that focus on plyometric and change of directions helps in building stability especially for when you are getting back into sport.
If you have sprained your ankle or feel you are suffering from ankle instability, then it is best to get it assessed and treated with one of our skilled physiotherapists. Book your appointment today and allow us to keep you moving.