Written by Laura Howden
Do you have a history of rolling your ankles? Do you feel like your ankles give-way on a regular basis? You’re not alone. Chronic ankle instability is the term used to describe long-standing ankle instability that results in recurrent ankle sprains.
Ankle sprains are one of the most common sporting injuries, and are also very prevalent amongst the general community. Unfortunately, because of their common presentation and often-quick resolution of symptoms, they tend to be viewed as minor injuries that will heal themselves over time. While this may be true for some, a large number of ankle sprains lead to persistent problems including increased laxity, long-standing pain, and chronic instability. In fact, following an initial ankle sprain risk of re-injury increases by up to 70%.
So what can be done to prevent recurrent ankle sprains? Lets begin by understanding where ankle stability comes from. The ankle is supported by three main structures: bone, muscle, and ligament. The word “sprain” describes damage to a ligament. Therefore, an ankle sprain indicates that one or more of the ligaments in the ankle has been stretched or damaged. This results in increased laxity or an increased readiness for the ankle to “give-way”. To make up for this increased laxity, the muscles around the joint are required to provide extra stability. This is where an effective rehabilitation program comes into play.
When muscles contract, they help to create stiffness around the joint. The stronger the muscles are, the more stability and support they can provide. Individuals with chronic ankle instability have been found to have deficits in ankle strength, highlighting the importance of incorporating strength training in your rehab program. Retraining the coordination of your muscles is also very important. This is often referred to as motor control and proprioception training (the ability to detect where and how your body is positioned). The quicker your muscles are able to detect and react to an unexpected movement such as rolling your ankle, the more likely they are to be able to prevent injury.
Collectively strength, motor control and proprioception are all important components of balance. Decreased balance is frequently seen following ankle sprains and in individuals with chronic ankle instability. Have you ever sprained your ankle before? Try standing on one leg for 30 seconds. Does your ankle feel wobbly or are you unable to maintain your balance for the full 30 seconds? Compare this to the other side. Is one side easier than the other? If so, perhaps you have some chronic ankle instability.
The good news is there’s lots that can be done! Rehabilitation programs have been shown to significantly reduce the risk of recurrent ankle sprains. This may also help to prevent the development of early ankle osteoarthritis, which is closely associated with ankle instability. Don’t risk long-standing problems in your future, take action today!
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Gribble PA, Bleakley CM, Caufield BM, Docherty CL, et al. 2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med 2016;50:1493–1495.
Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train 2002;37:364–75.