Chronic Ankle Instability

Overview

what it is and why it matters

Labeled anatomy of the foot showing tarsal bones (calcaneus, talus, cuneiforms, cuboid, navicular), metatarsals, and phalanges. — **Foot and ankle anatomy.** The foot contains 26 bones: seven tarsals in the back half (including the talus and the heel bone), five metatarsals forming the arch, and fourteen phalanges in the toes. The ankle joint sits between the talus and the two leg bones — tibia and fibula.

Chronic ankle instability (CAI) develops in roughly 40% of patients after an acute lateral ankle sprain and is defined by persistent feelings of giving-way, recurrent sprains, and subjective instability. The underlying problem is a combination of mechanical laxity (from incompletely healed ligaments) and functional instability (proprioceptive deficits, peroneal weakness). Left untreated, CAI can lead to progressive osteochondral damage and ankle arthritis.

Diagnosis

exam first, imaging second

Clinical history of recurrent sprains and giving-way. Positive anterior drawer and talar tilt tests with increased laxity compared to the contralateral ankle. MRI identifies ligament integrity, osteochondral lesions, and associated pathology. Stress X-rays under fluoroscopy quantify talar tilt and anterior translation objectively.

Treatment Path

how care progresses at OSI

Neuromuscular rehabilitation

Peroneal strengthening, proprioception training, and sport-specific balance retraining. The mainstay of treatment and effective in many patients.

Functional bracing

Lace-up ankle brace for sports to prevent further sprains while rehabilitation progresses.

Surgical Options at OSI

if non-operative care isn't enough

Surgery is recommended after 3–6 months of structured rehabilitation fails to resolve instability symptoms.

Overview

Diagnosis

Treatment Path

Neuromuscular rehabilitation

Functional bracing

Surgical Options at OSI

Further Reading

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