Causes

Ankle instability usually follows from one or more injuries to your ankle and can result in your ankle frequently giving way. The instability can either be due to failure of the ligaments that hold your ankle together (structural instability) or from incorrect function of the muscles that control your ankle and allow you to “catch yourself” if your ankle begins to turn (functional instability). Often these muscles are either weak or not responding quickly enough to stop you going over. This can be due to pain in the ankle inhibiting the control of the muscles.

Diagnosis

Our experts will listen carefully to your description of how your ankle is unstable. From this we can often determine if you problem is structural, functional or a combination of the two. Examining your ankle will allow us to assess if the ligaments are working properly and how strong the muscles controlling the ankle are. An MRI scan may be required both to look at the ligaments in more detail and to look for other problems such as cartilage damage, which may causing functional problems with your ankle.

Treatment

The first line of treatment for instability of any kind is usually physiotherapy. This strengthens and retrains the muscles stabilising the ankle, making it less prone to giving way. If your foot shape predisposes you to rolling your ankle we will arrange for you to have orthotics to support your foot. If your instability continues despite appropriate rehabilitation we may suggest surgery.

Surgery will be targeted towards the cause of your instability. The most common procedure is to tighten and reconstruct the damaged ligaments (a Broström-Gould procedure). We will also need to address any causes of pain which may be inhibiting your ankle control. This is usually done with a key-hole (arthroscopic) procedure at the time of your other surgery. You will normally need to be in some form of cast or removable boot for a month after surgery and then into a brace to protect the repair as you return to function. The hard work you put in before surgery with the physiotherapist will accelerate your post-operative recovery. This surgery is a reliable technique with a high success rate at returning athletes back to their pre-injury level of performance.