Chronic Ankle Instability and Pain: Diagnosis and Treatment

Essential Insights and Treatment Options

Ankle sprains represent the most common presenting orthopedic problem to emergency rooms.  Furthermore, since a sprained ankle is so common, it is often mistreated or treated at home without proper care resulting in chronic ankle instability and associated secondary ankle problems.

Common Presenting Findings of Chronic Ankle Instability:

  • Looseness with giving way or giving out
  • Catching of the ankle
  • Locking
  • Pain along the arch tendon (posterior tibial tendon)
  • Pain along the outside tendon (peroneal tendon)
  • Swelling
  • Abnormal rotation of the foot over time

These findings are due to the ankle being loose and subsequent instability of the ankle causing secondary problems such as ankle tendon tears, cartilage damage or bone spurs.  These secondary pain sources are more often the presenting complaint as the patient has gotten used to the loose ankle as a primary source of pain.

Diagnostic testing for chronic ankle instability includes physical exam, x-rays, MRI and possible CT scan.  Each test has specific pluses.  Physical exam is used to check looseness, tendon pain and joint palpation for loose bodies and bone spurs and capsule inflammation.

An MRI offers the best information.  The ankle ligaments, tendons, cartilage and bone can be check.  The information in an MRI is invaluable in checking the ankle and also for planning surgical procedures.

In rare cases a CT scan is used for additional information if a fracture or cyst in the bone is suspected.

Following examination and testing, a game plan for treatment is considered.  We often will try conservative care such as bracing, injection therapy and physical therapy for mild cases, but in a majority of cases, there is a surgical problem that needs to be corrected.

Common SUrgical Treatment Associated with Chronic Ankle Instability:

 

In most cases, the triad of common injury and the source of greatest pain and problems is a combination of scar tissue formation, instability and peroneal tendon tear. This triad has been reviewed and multiple papers have been published on the topic by University Foot and Ankle Institute.

The underlying cause of this triad is initial ankle sprain resulting in ligament tear that is not well treated.  Over time the ankle forms scar tissue due to the body trying to stabilize the loose ankle. The ligament tear and laxity of the ankle make the peroneal tendon work to hard trying to stabilize the ankle resulting in a tear of the tendon on the back of the ankle.  Over time the patient develops chronic pain and weakness as the ligaments and tendons do not work as a whole

With proper work-up and testing and sound surgical planning, chronic ankle instability can be well treated with excellent outcomes.  The recovery is about 6 weeks in a cast and about 3 weeks of physical therapy after the cast is removed.  Patients are most often able to return to full activity with no restrictions and have full recovery to pre-injury level. We can help you recover from your ankle ligament tear injury.

Call 877-989-9110 for a consultation at one of  University Foot and Ankle Institute’s nine advanced care centers in Southern California.

Follow me

Leave a Reply

Your email address will not be published.

12,299 Total 1st Party Reviews / 4.9 out of 5 Stars
  • Google
    I've been very impressed by the service at The Foot Specialists. Dr. Kelman is the best. He's professional and he also has a w...
    Theresa A.
  • GatherUp
    Fine
    Richard K.
  • GatherUp
    Excellent Dr Kelman and Merci are the best!!!
    Lisa S.
  • Google
    Best overall experience I have had with any medical specialist in a long time. Nice to see professionals who care about their p...
    4Nocturne
  • Facebook
    I asked how to access my account and was ignored. The doctor seemed to have a personal vendetta against Skechers rather than go...
    Kyle C.
  • GatherUp
    Great Doctor and great staff. No waiting, in and out.
    Mohammad K.
  • GatherUp
    Overall good experience. I didn't necessarily need the boot given my condition so should have waited until after all tests were...
    Sylvia M.
  • GatherUp
    Good
    Miguel S.
  • GatherUp
    Excellent
    Stacy G.
  • GatherUp
    Nice office Doctor was great!
    Tracey T.
  • GatherUp
    Great the doctor was very helpful in explaining the many options I had for treating my foot
    Megan K.
  • GatherUp
    great practice...nice people!
    Lisa S.
Same Day Appointments
Now Available!

Or call 877-989-9110

24 hours a day, 7 days a week