The ankle is the part of the body most injured in sports activities — accounting for 10-30% of all sports injuries — and a sprain is one of the most common ankle injuries.
A sprain occurs when you twist, turn, or roll your ankle beyond its normal limit, which can stretch or tear the ligaments. These tough bands of tissue hold your ankle bones in place, stabilize the joint, and work to prevent excessive movement.
Symptoms of a sprained ankle depend on the injury’s severity and may include:
- Pain, especially when you put weight on the foot
- Tenderness in the ankle
- Swelling and bruising
- Restricted range of motion
Treatment for a sprain also depends on its severity. Sometimes all you need is rest and over-the-counter pain medications, and it will resolve on its own. If the sprain is bad, though, you’ll probably need to see a doctor, who can determine the proper treatment. Treatment is important, as about 20% of patients develop chronic ankle instability from lack of stabilization and functional rehabilitation.
At Monroe Foot & Ankle Care in Jamesburg, New Jersey, podiatric physician and surgeon Dr. Elliott Perel understands the importance of treating sprains before instability sets in. He encourages patients to come in and get their injury evaluated to prevent any further damage.
What is chronic ankle instability?
Chronic ankle instability is a “wobbliness” of the ankle joint that occurs following an ankle sprain that hasn’t fully healed (such as when you’ve returned to a sport or workout routine too soon), or with a sprain that wasn’t treated completely. The outside (lateral) side of your ankle repeatedly gives way, and this often leads to one sprain after another. The instability can show up any time, including when you’re simply walking or even when you’re standing still.
Chronic ankle instability often results in:
- A repeated turning of the ankle beyond its natural limit, especially when playing sports or walking on uneven surfaces
- Chronic discomfort and swelling in the joint
- Pain or tenderness
- A “wobbly” or unstable feeling
Your ankle requires proper rehabilitation following the initial sprain to strengthen the muscles around the ankle and retrain the ligaments and other tissues that affect balance to provide full support. Failure to do one or the other can result in repeated sprains.
Repeated ankle sprains often lead to a vicious cycle of instability, further sprains, and more instability. Each subsequent sprain further stretches and weakens the ligaments.
How is chronic ankle instability diagnosed?
When you come in to see Dr. Perel, he’ll take a medical history, including any previous ankle injuries and instability you may have had. Then he’ll examine your ankle and foot for tender areas, swelling, and other signs of instability. He may want to take a few X-rays, too, to further visualize the situation.
What are the treatments for chronic ankle instability?
Dr. Perel will base his treatment recommendations on the results of his examination and any tests he’s done, as well as on your overall level of activity. He’ll first start with the most conservative, least invasive treatments. These may include:
Physical therapy involves exercises and modalities designed to strengthen your ankle, improve its balance and range of motion, and retrain your muscles to support the ankle joint. This may include some physiotherapy, and even orthotics, which are custom-made shoe inserts designed to stabilize the foot and ankle and assist with proper walking techniques. If you’re an athlete, you may also receive training that relates to your specific sport.
Bracing and taping
A brace is an appliance you wear over your ankle to provide support and prevent the ankle from turning, preventing additional sprains. Taping is a more flexible method of support. Dr. Perel will determine which of these is right for you.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as acetaminophen and ibuprofen, both available over the counter, are the most commonly prescribed medications used to reduce both pain and inflammation.
When conservative methods fail to provide enough support for chronically unstable ankles, and they fail to recover, Dr. Perel may consider a surgical procedure. The most common is the lateral ankle ligament reconstruction, also known as the Brostrom procedure, which tightens the ligaments located on the outside of your ankle. It’s usually performed as outpatient surgery, so you can go right home following the procedure.
What else can I do to prevent chronic ankle instability?
Some other options you can try include:
- Warming up before sports
- Being extra careful on uneven surfaces
- Using an ankle support brace
- Wearing shoes that fit well
- Maintaining good muscle strength and flexibility
- Practicing stability training, including balance exercises
Is your ankle weak and wobbly? Have you had repeated sprains? Give Monroe Foot & Ankle a call at 732-328-6798 or book an appointment online today to get the support you need.