Ankle Instability / Unstable Ankles

Also see our page on ankle sprains.

If you have ever sprained an ankle, you are at risk of developing a condition called “chronic ankle instability.” People with chronic ankle instability are prone to repeated sprains of their ankle. This is a very serious problem because each time you sprain your ankle you increase the chances of ankle arthritis later in life. In addition, each time you sprain your ankle it is even more likely you will sprain it again.

If you have unstable ankles, occasionally “twist your ankle” or “turn your ankle”, feel like your “ankle gives way”, are prone to falls due to a lack of control of your ankles, or have had more than one ankle sprain you should make an appointment to see us in our Seattle office right away. Chronic ankle instability can be successfully treated. There are many studies in the medical literature indicating the most effective ways to treat chronic ankle instability and we have developed successful protocol to treat unstable ankles based on these studies.1-4

The three most important aspects of treatment are:

1. Protection: Until you develop adequate strength and balance to prevent reinjuring your ankle, we will prescribe the use of ankle braces to protect your ankle. As your strength and balance improve we will let you know when you can stop using these braces.

2. Improve balance: Standard treatment of ankle sprains focuses on strengthening the ankle. Research, however, shows that it is much more important to focus on improving balance rather than strength. As part of your treatment you will be put on a program to improve balance – particularly on the injured side.1

3. Custom foot orthotics: Multiple studies have demonstrated chronic ankle instability decreases substantially with the use of custom foot orthotics. A 2002 study took two groups of people – one group had no history of ankle problems and the other group had chronic ankle instability. Each group was then asked to stand on one leg on an unstable surface without an orthotic and then with an orthotic. The amount of ankle instability was measured in each situation. The results showed that the group with no ankle problems had no change in the stability with or without an orthotic. The group WITH ankle problems, however, had a significant increase in ankle stability with the orthotic. This effect has been shown in many similar studies (studies listed below).2, 3, 4

What to Expect in Our Office
When treating patients with chronic ankle instability, our treatment program often includes the following:

• Run several tests to evaluate the extent of ankle instability
• Recommend proper protection for the ankle during the healing and rehabilitation process
• Design a therapy program with a special focus on improving balance on the injured ankle
• Prescribe specialized custom orthotics designed specifically to reduce ankle instability and prevent future ankle sprains.
• We can almost always treat chronic ankle instability with conservative treatment. Surgery is almost never necessary.

What to do prior to seeing us:
You must protect your ankle and prevent further sprains. We recommend wearing the Ossur Exoform Ankle Brace, available at this link.

We can offer help even if you have been spraining your ankle for years. Contact us today if to get started on your treatment program.

1. MUNN J, ET AL. Eccentric Muscle Strength in Functional Ankle Instability. Med Sci Spot Exercise. 35: 245. 2003.

2. ORTEZA LC, VOGELBACH WD, DENEGAR CR: The effect of molded and unmolded orthotics on balance and pain while jogging following inversion ankle sprain. J Athl Train 27: 80, 1992

3. OCHSENDORF DT, ET AL. Effect of orthotics on postural sway after fatigue of the plantar fascia and dorsiflexors. J Ath Train 35: 26. 2000.

4. GUSKIEWICZ KM, PERRIN DH: Effect of orthotics on postural sway following inversion ankle sprain. J Orthop Sports Phys Ther 23: 326, 1996.

All pages on this website © 2005-2010
Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
The material provided on this web site is for informative purposes only.
If you need specific medical advice, please contact the office for an appointment.