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Chronic Ankle Instability

Returning to activity before sprained ligaments have fully healed may cause them to heal in a stretched position, resulting in less stability at the ankle joint. This can lead to a condition known as Chronic Ankle Instability (CAI), and an increased risk of ankle sprains.

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(Source: Wikipedia)

About Chronic Ankle Instability

People who have a sprained ankle might develop chronic (long-lasting) ankle instability. It is considered to be chronic if the ankle joint still gives way too easily six months after the first sprain, or if the ankle is sprained again within six months of the first sprain. Unstable ankle joints can easily be twisted again. About 10 to 20 out of 100 people with ankle sprains develop chronic ankle instability.

This kind of instability can develop if the ankle ligaments are overstretched or torn, and grow back together too loosely (mechanical instability). The interactions between the bones in the ankle and the surrounding ligaments and muscles may be disrupted too.

The body has an unconscious awareness of movement and spatial orientation within the body, known as proprioception. This helps to coordinate the movements of the joints by using unconscious reflexes to stabilize them and keep the body balanced. So if an ankle feels permanently unstable, this might not only be caused by overstretched ligaments, but also by a problem with proprioception or resulting problems with muscle coordination... Read more about Chronic Ankle Instability

What works? Research summarized

Evidence reviews

Chronic lateral ankle instability may be treated with or without surgery

Chronic ankle instability is common after an acute lateral ankle sprain. Initial treatment is conservative, either with bracing or neuromuscular training. However, if symptoms persist and the ligaments on the outside of the ankle are elongated or torn, surgery is usually considered.

Neuromuscular training to enhance sensorimotor and functional deficits in subjects with chronic ankle instability: a systematic review and best evidence synthesis

OBJECTIVE: To summarise the available evidence for the efficacy of neuromuscular training in enhancing sensorimotor and functional deficits in subjects with chronic ankle instability (CAI).

The effectiveness of foot orthotics on improving postural control in individuals with chronic ankle instability: a critically appraised topic

CLINICAL SCENARIO: Chronic ankle instability (CAI) is a condition commonly experienced by physically active individuals. It has been suggested that foot orthotics may increase a CAI patient's postural control.

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Summaries for consumers

Chronic lateral ankle instability may be treated with or without surgery

Chronic ankle instability is common after an acute lateral ankle sprain. Initial treatment is conservative, either with bracing or neuromuscular training. However, if symptoms persist and the ligaments on the outside of the ankle are elongated or torn, surgery is usually considered.

Ankle sprains: What helps against chronic ankle instability?

Strength and coordination exercises help in the treatment of chronic ankle instability. But surgery is sometimes a good idea too. People who already start rehabilitation exercises two to three weeks after surgery will probably become active again sooner than people who only start later on. People who have a sprained ankle might develop chronic (long-lasting) ankle instability. It is considered to be chronic if the ankle joint still gives way too easily six months after the first sprain, or if the ankle is sprained again within six months of the first sprain. Unstable ankle joints can easily be twisted again. The joint remains unstable in about 10 to 20 out of 100 people who have a severe ankle sprain. This kind of instability can develop if the ankle ligaments are overstretched, or if they are torn and grow back together too loosely (mechanical instability). The interactions between the bones in the ankle and the surrounding ligaments and muscles may be altered too. Our bodies have an awareness of their own movement and spatial orientation, known as proprioception. This also helps to coordinate the movements of the joints, stabilize them using reflexes, and keep the body balanced. So if an ankle feels permanently unstable, this might not only be caused by overstretched ligaments, but also by a problem with proprioception or resulting problems with muscle coordination.

Ankle sprains: Overview

Ankle sprains are one of the most common types of injury. When an ankle is twisted, the ligaments are overstretched. In the worst case, they might tear. Small blood vessels tear too, causing the swelling around the ankle. Read on to find out about first aid measures, the treatment options and what can help to stabilize the joint.

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More about Chronic Ankle Instability

Photo of an adult

Also called: Ankle instability, CAI

See Also: Sprained Ankle

Other terms to know:
Equilibrium (Balance), Ligaments, Proprioception

Related articles:
How the Ankle Works

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