Chronic Ankle Instability

What chronic ankle instability?

Ankle sprains are a very common injury which often occurr  in children and adults, particularly when playing sport. 

Nearly all ankle sprains involve an inversion injury.  This involves the ankle rolling outwards and the sole of the foot turning inwards as the foot lands on the ground. This mechanism of injury causes the lateral ligaments (on the outside of the ankle)  to stretch and in some instances to tear. 

Chronic Ankle Instability involves repeated episodes of an ankle sprain. Sometimes, this can be caused by inadequate rehabilitation of an initial ankle sprain.

Who gets it?

Chronic ankle instability most often occurs in children who are active and are involved in playing sport.

How does the injury present?

Children with chronic ankle instability experience repeated episodes of ankle injuries. They report a feeling of ankle instability or giving way at the ankle. The affected ankle may feel weak and there is often ongoing ankle swelling and pain. In some cases the ligaments on the outside of the ankle are stretched and damaged.

Children with chronic ankle instability will usually have reduced proprioception at the ankle joint which causes reduced ability to balance on the affected limb.

What is the treatment?

Physiotherapy is the first line treatment for chronic ankle instability. Physiotherapy will involve an exercise program to strengthen the muscles around the ankle and retrain the ankle proprioception (balance).

When can my child return to sport?

Children can usually return to sport when the affected ankle regains adequate strength and ankle proprioception retraining. Sport specific proprioceptive retraining is important to minimise the chance of ongoing recurrent ankle sprains.

An ankle stabilising brace or ankle taping can be useful to help a child to return to sport.

If a child fails to respond to appropriate physiotherapy treatment and experiences ongoing pain or ankle instability, referral to an orthopaedic surgeon may be required.

What tests will need to be done?

MRI (Magnetic Resonance Imaging) may be used to assess the ligaments supporting the ankle joint.\