Chronic ankle instability is the condition of the ankle characterised by repeated ankle sprain, giving way or sense of giving way during walking, running or even on standing. Ankle instability can be mechanical instability where ankle movement is more than the physiological limit or functional instability where there is no excessive ankle movement but sense of instability is there due to improper neuromuscular and proprioceptive function.

Following an ankle sprain in addition to ligament laxity deficit in proprioception, postural control, muscle reaction time and muscle strength also happens. So chronic ankle instability can develop if rehabilitation and healing is inadequate following an acute ankle sprain. Presence risk factors related to ankle sprain can cause higher probability of developing chronic ankle instability, like participation in sports required jumping and twisting movements, cavovarus deformity of foot, faulty footwear, inherent weakness of lateral ankle muscle and generalised laxity. Inability to perform jumping and landing activity after 2 weeks of first ankle injury or poorer dynamic postural control and lower self-reported function after 6 months of injury are the indicator of development of chronic ankle instability. OCD of talus can develop in chronic ankle instability.

Feeling of giving way while walking on uneven or bubbly surfaces, running and jumping. Multiple episodes of ankle sprain, lateral ankle pain and swelling.

If your ankle gives way or there is a sense of giving way or you often have ankle sprain, you should visit a specialist foot and ankle surgeon.

Your doctor will examine your foot to assess ankle instability and the balancing capacity of your ankle. He will also look for any foot deformity or other risk factors. He may advise you to get a special stress view for ankle x-ray and MRI.

Most of the time the treatment is conservative aiming to improve neuromuscular coordination and muscle strength. Use of ankle brace during high risk activity and sports is also recommended. Surgical treatment is required in high grade ligament instability, ankle instability with foot deformity and failure to improve following an adequate rehab program. Surgical treatment includes

• Open or arthroscopic ligament repair
• Ligament reconstruction
• Deformity correction