Ankle instability

What is it?

The ankle joint acts as a hinge, and functions between the shin bone and the foot. The shape of these bones means the ankle joint is not particularly stable, and is held in place by strong ligaments. If these ligaments are either injured or stretched over time, the ankle can become unstable and susceptible to recurrent sprains.

Why does it occur?

The most common cause is when the joint has not healed properly following some trauma, such as the foot rolling under the ankle. The soft tissue between the bones becomes over-stretched or torn, and without treatment and rehabilitation, the ligaments and surrounding tissue remain weak.

What are the symptoms?

Minor ankle sprains often cause pain, swelling and bruising around the joint, which can make some types of physical activity uncomfortable. More serious injuries, when ligaments are torn, can lead to more severe bruising and swelling and make even walking difficult. If ligaments are fully ruptured, the entire ankle becomes unstable, which can make the joint more prone to fracture or dislocation.

How is it diagnosed?

Your consultant will give you a careful examination to gauge the severity of the problem and possible injury. Occasionally x-rays or MRI scans are required to give the consultant a clearer picture of how serious or not the injury is.

How is it treated?

Non-surgical treatment

The vast majority of minor ankle sprains and cases of  instability can be treated with ice and a splint. Physiotherapy will improve the muscle strength and range of movement, as the joint heals. 

Surgical treatment

More severe ankle injuries, which lead to recurrent instability, or fractures that lead to a displacement of the ankle joint, may require surgical intervention. This will be either to reconstruct a ligament or mend a more severe fracture.

Treatment options

Bostrom and lateral ligament repair

Gait analysis

Brace and boot treatment

The One Orthopaedic team specialists

Julie Kohls

Consultant Orthopaedic Foot and Ankle Surgeon FRCS (Tr & Orth)