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Foot and Ankle

Chronic Ankle Instability

Dr. Allison Boden a fellowship-trained orthopedic foot and ankle surgeon at the University of Louisville, specializes in treating a range of foot and ankle conditions, including chronic ankle instability. This condition, often stemming from repeated ankle sprains, can significantly impact mobility and quality of life. Understanding the nature of chronic ankle instability, its symptoms, causes, and diagnostic processes is key to seeking effective treatment and regaining stability and confidence in daily activities.

Lateral ankle sprains are common among both the general population and athletes engaged in recreational or competitive activities. Approximately 15-30% of individuals who experience a lateral ankle sprain may go on to develop chronic ankle instability, as the ligaments that stabilize the joint may heal in a stretched-out position or not heal. Chronic ankle instability is marked by persistent ankle pain, reduced muscle strength, limited range of motion, and impaired balance, often leading to decreased participation in social activities and a diminished quality of life.

Chronic lateral ankle instability (CLAI) is a condition characterized by repeated episodes or perceptions of the ankle giving way, ongoing symptoms such as pain, weakness, or reduced ankle range of motion (ROM), diminished function, and/or recurrent ankle sprains that persist for more than 1 year after the initial injury.

Chronic ankle instability is a condition characterized by recurrent episodes or the perception of the ankle “giving way”. This instability commonly occurs during physical activities, particularly those that involve running, walking on uneven surfaces, or quick directional changes. However, in more severe cases, individuals may experience instability even during routine movements, such as walking on flat surfaces or standing.

The symptoms of chronic ankle instability vary in severity but commonly include the following:

  1. Recurring Ankle “Giving Way”: A feeling that the ankle is unstable or buckling, especially when walking, running, or standing on uneven ground.
  2. Chronic Swelling and Tenderness: Swelling around the ankle joint may persist even after the acute phase of an injury has passed. The area may also feel tender to the touch.
  3. Persistent Pain: Ongoing discomfort or pain, particularly on the lateral side of the ankle, is common.
  4. Difficulty with Physical Activities: Individuals with chronic ankle instability often struggle with sports or activities requiring quick changes in direction, jumping, or running.
  5. Reduced Balance and Coordination: A feeling of wobbliness or imbalance, even when performing simple movements, is another hallmark of the condition.

Symptoms can become progressively worse over time without treatment, leading to decreased mobility and an increased risk of further injury.

Chronic ankle instability typically develops after repeated ankle sprains that damage the ligaments responsible for stabilizing the ankle joint. Over time, these ligaments may fail to heal properly or regain their original strength and elasticity, leading to persistent looseness and instability. Left untreated, chronic ankle instability can result in long-term issues such as ankle joint degeneration, cartilage damage, or arthritis.

Several factors increase the likelihood of developing chronic ankle instability:

  1. Inadequate Rehabilitation Post-Sprain: Skipping physical therapy or not fully rehabilitating an ankle sprain can lead to lingering weakness or laxity in the ligaments.
  2. High-Risk Activities: Sports that involve jumping, pivoting, or rapid changes in direction, such as basketball, soccer, or tennis, can place repeated stress on the ankle.
  3. Structural or Anatomical Factors: Flat feet, high arches, or other biomechanical abnormalities may predispose an individual to ankle sprains and instability.
  4. Weakened Muscles or Poor Proprioception: Weakness in the muscles surrounding the ankle and impaired proprioception (the ability to sense joint position) can contribute to instability.

A thorough and accurate diagnosis is essential to effectively treat chronic ankle instability. Dr. Allison Boden employs a comprehensive approach to diagnosis, which includes a detailed medical history, a physical examination, and advanced imaging techniques when necessary.

Chronic ankle instability is a progressive condition that can lead to significant complications if left untreated. Persistent instability can result in repeated injuries, which may accelerate wear and tear on the ankle joint. Over time, this can lead to conditions such as osteochondral lesions, chronic pain, and early-onset arthritis.

Seeking an early diagnosis from an expert like Dr. Allison Boden is crucial to prevent further damage and restore ankle stability. Dr. Boden’s expertise in treating both sports-related injuries and degenerative conditions ensures that each patient receives a tailored treatment plan designed to address their unique needs.

References

  • Hertel J, Corbett RO. An Updated Model of Chronic Ankle Instability. J Athl Train. 2019 Jun;54(6):572-588. doi: 10.4085/1062-6050-344-18. Epub 2019 Jun 4. PMID: 31162943; PMCID: PMC6602403.
  • Wang L, Yu G, Zhang X, Wang YZ, Chen YP. Relationship between ankle pain, range of motion, strength and balance in individuals with functional ankle instability: a cross-sectional study. BMC Musculoskelet Disord. 2023 Dec 8;24(1):955. doi: 10.1186/s12891-023-07079-1. PMID: 38066472; PMCID: PMC10704625.
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