Ankle sprains are a fairly common injury that occurs in people of all ages and activity levels. And for most people who suffer a sprained ankle, traditional RICE therapy (rest, ice, compression, and elevation) is sufficient to have them moving again in about a month or two.
But sometimes, that’s not enough. If someone rushes their recovery faster than their ankle can heal or suffers multiple sprains to the same ankle, they may develop what’s known as chronic ankle instability.
What Is Chronic Ankle Instability?
Chronic ankle instability is a condition in which the outer, or lateral side of the ankle can’t hold weight and keeps rolling towards that side. Around 15 to 20% of ankle sprains ultimately lead to some form of chronic instability. Some of the symptoms of this condition include:
- Pain on the outside of the ankle
- Trouble walking or standing, with the ankle consistently rolling to the outside
Why does this occur? When an ankle is sprained, connective ligaments are either stretched or torn, affecting the ability to balance. If the muscles and ligaments aren’t given time to properly regain their strength, a chronic, or ongoing, condition can develop.
The majority of ankle sprains are caused by landing awkwardly after jumping, but they can also be caused by falls, by running on an uneven surface, or by someone else landing on your ankle during a sporting activity.
How Does Chronic Ankle Instability Relate to Sprained Ankles?
In most cases, chronic ankle instability is directly related to a sprain that wasn’t allowed to heal properly before weight was applied. It can also happen when someone has repeated ankle sprains. It’s especially common in athletes involved in high-impact sports.
When a sprained ankle isn’t given time to properly heal, the outside of the ankle is much more likely to suffer a chronic condition. This can happen during physical activity, but it can even happen when standing still.
If you’ve suffered a sprained ankle, there are several things you can do to help make sure you don’t develop chronic ankle instability.
- Wear proper shoes. Wear properly fitting shoes that are tightly laced if you’re doing anything strenuous. Choosing a shoe with proper arch support is especially important, as rolling your ankle will likely reaggravate the injury.
- Use an ankle brace. If you have an ankle that’s previously been sprained, it’s a good idea to wear a brace on that ankle in the future. A good brace still allows for movement, but stops the joint from giving out.
- Stretch before activity. Making sure your ankle is limber will go a long way towards preventing an injury. Before you do anything strenuous, make sure you stretch. This will give your joint the maximum range of motion.
- Incorporate daily or weekly strength training. Strong muscles mean increased support, so make sure ankle strengthening exercises become a part of your routine.
What Can a Podiatrist Do to Treat Chronic Ankle Instability?
The general rule of thumb is that if an ankle sprain is still hurting three months after the injury, it’s probably time to seek a doctor’s help. After that amount of time, pain means there’s probably damage to the bone, ligament, or tendon that won’t heal on its own.
There are several ways a doctor may treat chronic ankle instability, ranging from simple exercises to surgery.
Your podiatrist will walk through a history of any previous injuries with you and physically examine your ankle to find any areas that are tender, spots that are swelling, or any signs of instability. Then, you’ll discuss what treatment options are most appropriate for your specific needs.
Non-Surgical Treatment Options
In almost all cases, physical therapy will be the first resort to help heal an ankle injury. If the injury is sports-related, this therapy will likely utilize exercises or stretches relating to that sport. If it’s not related to sports, general exercises to increase range of motion, promote balance, and strengthen the ankles will be used.
Should physical therapy not be enough, the doctor will likely recommend a brace for a short period of time to give the ankle maximum support as it heals. A prescription to reduce swelling will probably be written too.
Surgical Treatment Options
If physical therapy and medication aren’t helping chronic ankle instability, it may be time to consider surgery. There are three different avenues a doctor could take depending on the severity of the injury and the lifestyle of the person injured.
- Scar tissue removal. Many injuries leave scar tissue behind, and if that tissue isn’t removed, it can lead to nagging pain. If you have pain only on the outside of the ankle after a sprain, it’s likely related to scar tissue.
- Tendon repair. If you have pain more towards the back or inside of your ankle after a sprain and physical therapy and a brace don’t help, you could have a torn tendon.
- Nerve damage. People who have a stabbing sensation in front of their ankle for several months after a sprain could have nerve damage.
Should your injury require surgery, you can expect a full recovery period of six months to a year, however, a return to moderate physical activity can happen as soon as six to eight weeks. Complications from this type of surgery are generally very low, with infection and blood clots being the only possible issues. Between 85 to 95% of chronic ankle instability surgeries happen with zero complications.
Omaha Foot & Ankle Specialists Can Help Relieve Your Chronic Ankle Pain
If you think you have chronic ankle instability or have any questions related to joint pain, let Omaha Foot & Ankle Specialists develop a plan to restore your health. Dr. Michael Cullen and Dr. Nathan Penney are experts in the field and can help you get back to your normal life as soon as possible. And the longer pain lingers, the more involved treatment will be, so use our online contact form or call our office at 402-333-8856 today to schedule an appointment.