Ankle instability happens when the ligament fails to properly stabilise the ankle. As a result, the ankle feels like it is “giving way” or is about to. This feeling can occur together with repeated sprains caused by mundane activities such as going down stairs. This condition can make it painful to walk on uneven ground.

Pathologie de l’instabilité de la cheville

Ankle instability is often caused by a sprain which may have been ignored instead of being recuperated. The ligament is not able to heal as it has been poorly tended to or not tended to at all. Very occasionally, people with hypermobility (people who have particularly stretchy ligaments) can suffer from ankle instability without ever having sprained their ankle.

Ankle instability may be suspected if you have a history of ankle sprains in the same ankle. It is diagnosed by examining and manipulating the ankle joint to check for abnormal movements. X-rays taken while recreating these abnormal movements can also help confirm the diagnosis.

How to recover from an ankle instability

Once the diagnosis has been confirmed, treatment can start. This essentially consists of long-term rehabilitation of the ankle. This involves improving the stability of the joint by strengthening other parts of the ankle over several weeks. Following this, sports activities can be resumed gradually with those that involve pivoting being reintroduced last.

The results of this type of treatment satisfy most patients. That said, what is considered “successful” rehabilitation is very subjective and depends on the severity of the instability and the expectations of each patient; for example, the same results might satisfy an occasional walker but disappoint a professional handballer.

Second-line treatment: Surgery

If the rehabilitation results are unsatisfactory, surgery should be performed to either repair or reconstruct the ligament. Repairing the ligament is the simplest option but requires the ligament’s structure to be in good condition in order to ensure that the stitches have a solid attachment. Reconstruction surgery has the advantage of not relying on tissue quality but does involve taking part of a tendon to reconstruct the ligament and tends to cause stiffness in the ankle.

The choice of surgery is made between the patient and the surgeon based on their findings.