Chronic ankle instability is a condition that often develops after recurrent ankle sprains. It can be characterised as when the ankle gives
way while walking, or doing other activities. While the defining trait of ankle instability is the instability itself, often pain can be
felt as a symptom.
Usually, an unstable ankle feels wobbly and unstable and can significantly increase the likelihood of the patient spraining their ankle
An ankle sprain occurs when the ankle is twisted, rolled, or turned in an awkward way. When this movement tears or stretches the ligaments
in the ankle, it’s considered a sprain. When an ankle is sprained, muscle reaction time and strength in the joint are usually both reduced.
If these factors aren’t properly rehabilitated, they can cause ankle stability.
Furthermore, if a sprain isn’t treated properly and left to heal on its own, the stretched or torn ligaments may not heal properly, which
can result in ankle instability. After an ankle sprain has healed, if it’s not rehabilitated properly, scar tissue can build up and make the
joint very stiff. Proper treatment and rehabilitation of an ankle sprain is of utmost importance.
Acute ankle instability can be defined as a new case of ankle instability, whereas, chronic ankle instability is a condition that progressed
over a period of time.
Fortunately, most cases of chronic ankle instability can be treated through physical therapy, bracing and medications. However, in rare
severe cases, surgery may be required to repair or reconstruct the damaged ligament.
Common symptoms of an ankle instability
People with ankle instability may experience some, or all, of the following symptoms:
- An ankle that rolls inwards or outwards without notice
- An ankle that gives way all of a sudden
- The inability to bear weight on your affected leg
- Pain in the ankle
- Tenderness in the ankle
- Swelling in the ankle
Strengthening exercises for rehabilitating ankle instability
Single leg stance
- Stand behind a chair, and place your hands on the chair for balance if you need to.
- Lift one leg off the ground and balance on your injured foot.
Hold this position. You should gradually increase how long you can hold it for. On the first day you can try ten seconds, and then try to
increase it by ten seconds each day until you reach sixty seconds.
- Repeat the same exercise twice more to complete a set of three.
- Sit on a chair with your feet flat on the floor.
- Extend your injured leg so that it’s straight out in front of you in the air.
- With your big toe spell out each letter of the alphabet from A-Z.
If you don’t feel pain, you can repeat this exercise 2-3 more times. However, if you do feel pain you should wait until your ankle is
Find a surface, like a step, where you can lower the heels of your feet below the line of your toes. and have something nearby that you can
hold with your hands for balance.
Stand on the step with your feet shoulder-width apart and ensure the balls of your feet are on a flat surface, and your heels and hanging
over the edge.
- Slowly lower your heels below the level of your toes, and hold onto something, like a chair, for balance if you need to.
- Hold this position for 2-3 seconds, and then slowly raise yourself back so you’re feet are in line with your toes again.
- Repeat this exercise ten times to complete one set.
- Rest between each set, and carry out a total of three sets.
Ankle instability stretching exercises
- Sit on the floor with both of your legs out straight in front of you.
- Loop a long bath towel around both of your feet and hold the ends with both hands, while keeping your back straight.
- Slowly pull the towel towards you and make sure that your leg stays straight.
- Pull the towel until you can feel the stretch in the arch of your foot.
- Hold this position for 30 seconds.
- Return to the starting position.
- Repeat this stretch twice more.
Standing calf stretch
Stand in front of a wall, so that your palms can be pressed flat against the wall, but your arms remain straight out in front of you.
- Move your right leg forward, with your knee bent slightly.
- Move your left leg behind you so that it’s straight, and make sure your heel is pushed flat to the ground.
- You should be able to feel a stretch in your calf, hold this position for 30 seconds.
- Return to the starting position.
- Repeat this stretch twice more.
- Put a rolled-up towel or a foam roller on the ground.
- Sit on the ground with your left leg straight out in front of you and your right knee bent.
- Put your left leg straight out in front onto the towel or foam roller.
- Turn your ankle slowly ten times in a clockwise circular motion.
- Reverse this action and turn your ankle slowly ten times in a circular anti-clockwise motion.
- Repeat the stretch on the other leg.
- Repeat this stretch twice more on each side.
Aerobic Exercise for chronic ankle instability rehabilitation
Aerobic exercise can be useful to rehabilitate an injured ankle and to help with ankle instability. However, to ensure that the specific
exercise is right for your condition, you should always check with a medical professional first.
Usually, a podiatrist, physical therapist or doctor will suggest a low-impact exercise for rehab, like swimming or riding a stationary bike.
Tips to prevent ankle instability
Always complete ankle sprain rehabilitation exercises properly
If you’ve sprained your ankle in the past and had it treated properly, then you’ve probably been given a range of strengthening exercises,
balance exercises and stretches to do to rehabilitate it. Many people assume that they don’t need to do the exercises once their ankle is
feeling better again, however, this couldn’t be further from the truth. Completing the exercises assigned by your doctor or physio is
critical to ensure that the ankle has full movement and won’t face further problems down the line – like ankle instability.
Don’t ignore ankle pain
While you should never ignore any ankle pain – in this case, it’s especially true that you shouldn’t ignore ankle pain that’s come on
suddenly as an injury. If the ankle injury is an acute ankle sprain, and it’s ignored and not treated properly, the ligament can tear
further. This makes both treatment and rehabilitation harder. It will also leave you more prone to developing ankle instability. So, it’s
extremely important to see a doctor or podiatrist immediately if you experience an ankle injury.
Brace your ankles when playing sports
Ankle braces aren’t only for ankle injuries – they can also work as a preventative measure. High contact sports with a lot of stops and
starts, like hockey, soccer and basketball, have a high risk for players to sprain their ankle. To avoid this, you can strap your ankle
before playing sports so that your ankle is supported and won’t’ twist in an awkward way that can cause an injury. Furthermore, a brace will
train the body to avoid moving the ankle in a way that may cause injury. To support your ankle you can wear an ankle brace, or you can strap
it with tape.
Always warm up before exercising
To avoid developing ankle instability, you should avoid an ankle sprain and other ankle injuries in the first place. Ensuring that your warm
up before exercising will help to raise the temperature of your muscles which allows for more flexibility. In turn, this prevents stress on
the ligaments, tendons, and joints, and can help you avoid sprains. To warm-up, you should do a gentle to moderate endurance activity for
5-10 minutes. This could be a jog, star jumps or some walking lunges.
When to see a podiatrist about ankle injuries
Podiatrists specialise in medical conditions that involve the feet and lower limbs and are experts in diagnosing and treating ankle
instability. A podiatrist can run a physical exam to confirm our diagnosis. If they deem that you have ankle instability, they will work out
the best treatment for your condition. Usually, this will involve a combination of racing and physical therapy through a functional
A podiatrist is also able to determine how severe your ankle instability. If they suspect it may need surgery, they can run further tests
and answer any questions that you may have.
If you suspect you have ankle instablity and would like to make an appointment with one of our expert podiatrists, you can do so on our website