Chronic ankle instability
Understanding this condition
The lateral ligaments of the ankle (in particular the anterior talo-fibular ligament) stabilise the ankle and prevent sprains. When a patient has repeated sprains, this is called chronic ankle instability.
This often occurs after an initial poorly treated sprain: the ligaments heal in a poor position, the ankle remains lax, and every twisting movement triggers a new sprain. Chronic instability can also be related to a particular foot morphology (cavus foot, calcaneal varus).
Symptoms
A sensation of the ankle "giving way" on unstable surfaces, especially on uneven ground, on stairs, or during sport. Repeated sprains, sometimes from minor traumas.
A permanent apprehension develops, which alters gait. Lateral pain and chronic swelling are common.
How can it progress?
Repeated sprains progressively wear the ankle cartilage and can cause osteochondral lesions (cartilage and underlying bone damage). In the long term, the risk is early-onset ankle osteoarthritis.
Instability also limits sporting activity and increases the risk of falls, particularly in older patients.
Treatment options
First line: proprioceptive physiotherapy (balance and weight-bearing rehabilitation), strengthening of the peroneal muscles, ankle brace or orthosis during sport.
When instability persists despite well-conducted rehabilitation, surgical ligament repair or reconstruction is proposed (Broström-Gould technique). A consultation assesses the indication and appropriate technique.