What is Ankle Instability?

A stable ankle is instrumental to a person’s ability to walk and run. When an ankle becomes sprained, the ligaments and muscles that support the ankle can become weak. Ankle instability occurs when a person’s ankle has become too weak to be reliable when walking, often following a series of sprains. A person with ankle instability may feel as if their ankle will give out when on rough or uneven terrain. This can make it difficult to walk, run or participate in normal activities.

Normally, an ankle has limited movement up and down and side to side. This range of motion is protected by ligaments and bones that keep the joints responsible for these movements steady. When a person sprains his ankle, the ligaments, or connective tissue that helps hold bones together, can stretch or tear. Repetitive spraining of the ankle can cause the ankle to become weak and feel unstable when a person is walking.

Spraining the ligaments in the ankle can also cause damage to the nerve sensors that tell the brain the position of the ankle. Sensors such as the ones found in the ankle ligaments are responsible for the brain knowing the position his hands, arms, and other parts of the body, even when a person is not paying attention to them. When these nerves sensors are damaged, it is easier for a person to misstep and do more damage to the ankle as a result.

Treatment options for ankle instability range from special shoes to rehabilitation to surgery. In some cases, it is possible to use braces or shoes with high tops or special heels to help keep the ankle steady while walking. It is also possible to treat ankle instability with strengthening exercises as prescribed by a physical therapist. The exercises strengthen the ligaments and muscles on the outside of the ankle to help keep it from buckling. These exercises can also help a person regain sensitivity by healing the nerve sensors, so he can tell where his foot is being placed.

There are times when rehabilitation is not enough to treat ankle instability. In these cases, surgery may be the method of choice. During surgery, the surgeon can either tighten the ligaments or graft in another ligament—usually harvested from around the little toe—to strengthen or replace the ankle ligament. In either case, surgery is usually followed by rest and rehabilitation. After rehabilitation, the patient usually is able to return to normal activities without experiencing ankle instability.