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Chronic Ankle Instability

chronic ankle instability

Chronic ankle instability is a life-changing condition for many of our patients, who are faced with watching their steps very carefully, sitting out high-risk activities or sports that require lots of side-to-side movement or quick changes in direction, and generally being wary of their movements in everyday life. Our Brisbane podiatrists work extensively with those suffering from chronic ankle instability to help them move with confidence and comfort, and without pain or injury.

What Is Chronic Ankle Instability?

Chronic ankle instability describes weakness and instability in your ankles to the point that they are prone to giving way during walking and everyday activities, leading to ankle sprains where you roll onto the outside of your ankle. 

Signs & Symptoms Of Chronic Ankle Instability

Chronic ankle instability affects anyone, not just athletes. When we see patients that are affected, there is often a:

  • History of repeated ankle sprains
  • Complaints of the ankle feeling wobbly, unstable, or regularly feeling like it may give way
  • Regular occurrence of pain, tenderness, discomfort or swelling at the outer ankle

What Causes Chronic Ankle Instability?

Your ankle is supported by a number of ligaments that play an important role in stabilising the ankle joint, controlling excessive side to side motion, and enabling you to walk confidently and comfortably with every step. During an ankle sprain, we roll onto the outside of our ankle and stretch the ligaments and tissues past the point that they can safely handle, causing damage to the ligaments and pain. This is where proper rehabilitation is needed to help restore full strength and function to the ankle and the ligaments, yet unfortunately also where many people fail to seek proper rehabilitation due to ankle sprains being common. Remember, there’s a big difference between ‘common’ and ‘normal’, and ankle sprains are never normal, nor should they be accepted as a regular occurrence or possibility.


When someone experiences repeated ankle sprains, especially without the right rehabilitation, this can lead to further damage and weakening of the ligaments, leaving the ankle in a weakened and unstable state. This is known as chronic ankle instability. Additionally, the inflammation that can occur following ankle sprains can also contribute to the progression of chronic ankle instability because of the effect that a prolonged inflammatory process can have on tissues.

How To Diagnose Chronic Ankle Instability

Our podiatrists diagnose chronic ankle instability by going through a detailed description of your medical and injury history, looking particularly at your history of ankle sprains and the measures taken to rehabilitate your ankle following these incidents. Next, we’ll perform a comprehensive assessment of the foot and ankle, including a video gait analysis and in-shoe pressure analysis. The goal is to understand the strength, stability and function currently available at the ankle, check for any symptoms, and use these findings to also rule out other causes of ankle pain such as a fracture, sinus tarsi syndrome, osteochondral defects (injuries to the talus bone that forms part of your ankle), peroneal tendinopathy (which can lead to weakness of the ankle stabilisers) and more. 

If needed, we can refer you for medical imaging such as x-ray or ultrasound to better understand the state of your ankle ligaments, as well as the surrounding bones. An initial assessment is usually sufficient for our podiatrists to confidently diagnose chronic ankle instability.

Treatment For Chronic Ankle Instability

At home

If you suspect that you have chronic ankle instability, something you can do immediately at home to help best support your ankle is switch to a supportive pair of shoes like running shoes that wrap around the ankle and support the ankle so it cannot freely roll. If you have strapping tape at home, you can also try strapping your ankle to increase stability - here is an example of an ankle stability strapping technique. If you’re experiencing pain, you may choose to use NSAIDs to help temporarily improve your comfort. Next, book an appointment with your podiatrist.

How we can help

Our Brisbane podiatrists offer a variety of treatment options for chronic ankle instability in line with rehabilitation guidelines. Our goal is to help you:

  • Enjoy walking without constantly having to watch the ground
  • Restore your confidence to participate in sports and other activities
  • Help restore strength to your ankle
  • Help reduce the likelihood of ankle sprains in the future
  • Teach you about the best ways to help care for the health of your ankle long-term
  • Help you make the best footwear choices for your ankle


During your appointment, we may discuss options with you including:

Custom Foot Orthotics

Custom foot orthotics are medical devices that sit inside the shoe and can contain features, such as a raised lateral border, that best support the ankle, add stability during movement, and reduce the likelihood of a sprain. All of our orthotics are custom-made from a 3D scan of your foot paired with a comprehensive assessment, so we can prescribe the best features for your ankles and feet.

Exo-Brace - Custom Ankle Instability Brace

The Exo-Brace is a leading slimline ankle brace that is proven to prevent up to 95% of ankle sprains, while allowing your ankle to move freely and comfortably. Think of it like a seatbelt, kicking in when you need it most - the moment just before you roll your ankle and sprain your ligaments. The Exo-Brace is a custom device made from a 3D scan of your ankle and an assessment. It cups the back of your ankle and uses the side of your shoes as an anchor point.

Ankle Instability Exercises

Part of your treatment will always involve a program to work on your ankle ligament strength, as well as proprioception training (balance and stability) and neuromuscular training to help retrain how your muscles activate.

Footwear Assessment

We’ll also assess your footwear and give you recommendations of the best footwear to help support your ankle in light of your foot type and ankle characteristics.Given the success that we see of these conservative modalities in helping improve the quality of life of those with chronic ankle instability, we view ankle surgery as a final resort, due to the invasive nature of the procedure, the recovery time, and the risk factors.

Prevention

The simplest way to help prevent chronic ankle instability is by comprehensively and effectively rehabilitating ankle sprains when they occur. This includes seeking professional help early from your podiatrist,who may use strategies like a neuromuscular training program which has demonstrated success in reducing the risk of an ankle sprain by between 20% to 60%. Another important preventative measure is wearing supportive and stabilising footwear in place of shoes that offer poor ankle support and let the ankle roll freely.

Prevention is an important way to help stop ankle sprains and ankle instability from becoming a normal part of your life, as just because a problem can be common, does not mean that it is normal.

Other Ankle Problems We Treat

Alongside chronic ankle instability, we help treat a wide range of ankle problems including:

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