Ankle Instability
Ankle instability occurs when the ankle frequently feels weak, unsteady, or gives way. Especially during walking on uneven surfaces or sports activity. It often develops after repeated ankle sprains or an injury that has not fully healed.
Causes
Ankle instability most often develops from:
- Repeated ankle sprains that stretch or tear the ligaments
- Incomplete rehabilitation after an injury
- Weakness or poor balance in the muscles around the ankle
- Loose ligaments (naturally or after trauma)
Anatomy
The ankle joint is supported by several ligaments that connect the tibia and fibula (leg bones) to the talus (foot bone). The most commonly injured are the lateral ligaments on the outside of the ankle — especially the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL). When these ligaments are stretched or torn, the joint can become unstable.
Ankle Instability
Symptoms
Common signs of ankle instability include:
- The ankle “giving way” during activity or on uneven ground
- Persistent discomfort or swelling
- Pain or tenderness along the outer side of the ankle
- Feeling of weakness or wobbliness
- Difficulty with running, jumping, or wearing high-heeled or unstable shoes
Diagnosis
Your doctor will examine your ankle for swelling, tenderness, and looseness compared with the other side.
Investigations may include:
- X-rays to rule out fractures or joint damage
- Ultrasound can often identify the torn ligaments
- MRI scan to assess ligament tears and associated injuries
Treatment
Treatment depends on the severity and duration of symptoms:
- Non-surgical management is effective for most patients and includes:
- Physiotherapy to strengthen the ankle and improve balance
- Bracing or taping during sport to prevent further sprains
- Activity modification and appropriate footwear
- Surgical treatment may be considered if instability persists despite rehabilitation.
- The most common operation is a lateral ligament reconstruction (Broström procedure), which tightens or repairs the stretched ligaments to restore stability.
Recovery
- With physiotherapy alone, recovery usually takes 6–12 weeks, depending on progress.
- After surgery, patients are typically in a boot or brace for 4–6 weeks, followed by rehabilitation exercises.
- Most people return to sport or full activity within 3–6 months, depending on the procedure and healing.
Possible Complications
While most patients recover well, possible issues include:
- Ongoing weakness or swelling
- Stiffness or limited motion
- Nerve irritation or numbness around the scar (after surgery)
- Recurrent sprains if rehabilitation is incomplete
When to Seek Help
See your doctor if you notice:
- Repeated ankle sprains or feelings of instability
- Persistent pain or swelling after injury
- Difficulty walking or trusting your ankle on uneven ground
