Chronic Ankle Instability
Your ankle joint is what enables your foot to move up and down when you
walk. As you might imagine, you use that joint rather a lot. (In fact, have
you thanked your ankles lately for everything they do for you? Sent them
flowers? Called on their birthday?) But, sometimes, you might get a little
overeager. Sometimes you twist around trying to get the ball back from that
other guy, come down a little too hard when jumping, or step carelessly
into a 15-foot pit with tigers prowling at the bottom. These are the kinds
of things that might cause trauma to your ankle.
Once you’ve sprained your ankle for the first time, your ligaments (bands
of tissue that connect things together) typically become overstretched, or
even torn. If the injury doesn’t heal properly, the ligaments are left kind
of loose, making your ankle more unstable, and more prone to being injured
again. So, the next time, it might not take a 15-foot pit to get another
sprain; it might only take a 10-foot pit, and so on, until merely stepping
off the curb (with or without tigers present) makes you sprain your ankle.
A weakening of the ligaments and repeated ankle sprains is a condition
called chronic ankle instability. It’s pretty much a vicious cycle, where
injury leads to more injury. It’s not a pleasant cycle to be in, and can be
a real nuisance, particularly for athletes who rely on the proper function
of their joints. The bones that make up the ankle joint may actually become
misaligned, namely the talus, which is the foot bone in the ankle joint.
After repeated ankle injuries, it might become tilted inward, whereas it is
normally supposed to rest squarely in the little box created for it by the
ends of your leg bones.
People with chronic ankle instability typically find it rather difficult to
walk on uneven surfaces, and may notice that their ankle turns inward
rather too easily. This may make your foot feel all wobbly when you try to
walk (not a great symptom, particularly if you’re a tightrope artist).
You’re also likely to get sprains over and over again, which will likely
cause swelling around the ankle, bruising, pain and discomfort. The pain
may become chronic, and over time, bone spurs may develop in the joint,
which means more pain and swelling.
Your podiatrist will likely examine the ankle by checking for swelling and
tenderness, and will probably ask you about a history of ankle injuries in
the past. He or she may also put pressure on your ankle joint by pushing it
inward to see if it moves farther than is normal, or exhibits other signs
X-rays may be used to get a peek at your bones (instability in the ankle
joint will sometimes show up as a misalignment of the talus in the ankle
joint), or your podiatrist may choose to use other imaging methods such as
a CT scan or MRI. (These images may be taken while your podiatrist puts
pressure on the ankle, which will help the instability to show up more
readily if it’s present.)
Basically, treatment revolves around getting your ligaments to heal,
treating the pain associated with ankle instability, and strengthening your
muscles to prevent further injury. Your podiatrist may encourage the
healing of your ligaments by immobilizing your ankle joint. This might be
done by using a cast or a brace (which can both be attractively decorated
using stickers, glitter, and/or sequins). You can usually combat the pain
in your ankles by using anti-inflammatory medication, such as ibuprofen, or
other prescription medications.
Your podiatrist may also recommend a round of physical therapy. This will
help rehabilitate your ligaments, strengthen the muscles that affect the
ankle, and provide greater stability as you move your foot.
If your ankle doesn’t respond well to the above treatments, your podiatrist
will likely discuss the possibility of surgery with you. Surgery may be
used to tighten up the ligaments in your ankle, or may use some tissues
from around your ankle to strengthen up the joint. Another method your
surgeon may use is to graft a tendon in from another part of your body and
use it to stabilize your ankle. All surgeries have benefits and
disadvantages; your podiatrist can help you decide which would be the best
The good thing about this condition is that it’s very treatable. And with
care, you’ll be back to your normal activities in next to no time. Just try
to avoid those tiger-filled pits from now on.
Call 719-543-2476 today to schedule your appointment!