Chronic Ankle Instability

Chronic ankle instability is an encompassing term used to classify an individual who presents with both mechanical and functional instability of the ankle joint following an initial lateral ankle sprain injury.

 

Mechanical Instability refers to measurable laxity of the ligaments, i.e. ligaments that are less stiff following injury, with some joint restrictions and synovial changes. Functional Instability is the lingering feeling of giving way or unsteady feeling which is generally attributed to neuromuscular and proprioceptive deficits.

 

Research has identified a number of potential reasons for long term issues with ankle instability after a sprain. One theory is that the ankle proprioception, where the joint is in space, is impaired creating an impaired reflex arc of the muscles that help stabilise the ankle joint. Swelling of the joint can cause the feedback system of the ankle joint to also alter and cause long term neuromuscular deficits.

 

So clinically, what can we do to help and reduce this occurring?

 

  • Reduce pain and swelling of the joint
  • Loading in functional tasks as soon as possible e.g. walking, running, cutting
  • Establish baseline strength and power
  • Improve proprioception of the ankle joint
  • Practice tasks that are important to your need
    • Cutting
    • Agility
    • Deceleration
    • Landing/jumping mechanics

 

Thomas Divilly

M.I.S.C.P., C.S.C.S.


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