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Lateral Ankle Instability: Understanding and Effective Treatment Options

Jun 21, 2023 | Ankle Conditions, Lateral Ankle Instability

Lateral ankle instability is a common condition characterized by a recurring giving-way or spraining of the ankle. It often occurs as a result of previous ankle sprains that have not healed properly or were not adequately rehabilitated. This summary aims to provide an overview of lateral ankle instability, including its causes, symptoms, diagnosis, and effective treatment options.

I. Understanding Lateral Ankle Instability

Lateral ankle instability typically arises from damage to the ligaments on the outside of the ankle, namely the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). These ligaments provide stability to the ankle joint, allowing for proper movement and preventing excessive inward rolling or inversion of the ankle. When these ligaments become stretched, torn, or weakened, the result is instability and an increased risk of ankle sprains.

II. Symptoms and Diagnosis

The primary symptom of lateral ankle instability is a recurrent feeling of the ankle giving way or rolling inward, particularly during physical activities or walking on uneven surfaces. Other common symptoms include pain, swelling, tenderness, and difficulty with balance. To diagnose lateral ankle instability, healthcare professionals typically perform a physical examination, assess the patient’s medical history, and may order imaging tests such as X-rays or MRIs to evaluate the severity of ligament damage and rule out other potential causes of ankle instability.

III. Non-Surgical Treatment Options

  • Physical Therapy and Rehabilitation: One of the primary approaches to managing lateral ankle instability is through a structured physical therapy program. Physical therapists can develop a personalized rehabilitation plan to improve ankle strength, stability, and range of motion. Exercises may include balance training, proprioceptive exercises, ankle strengthening exercises, and functional activities to restore ankle function and prevent future sprains.
  • Bracing or Taping: External support in the form of ankle braces or taping can be beneficial in providing stability and preventing excessive ankle inversion. These measures can be especially useful during physical activities or when returning to sports after an ankle injury. Ankle braces and taping techniques help restrict excessive ankle motion and protect the ligaments, reducing the risk of reinjury.
  • Medications and Modalities: Non-steroidal anti-inflammatory drugs (NSAIDs) may be recommended to manage pain and reduce inflammation. Additionally, modalities such as ice therapy, ultrasound, and electrical stimulation can help alleviate pain and promote healing.
  • Lastly, Orthotics are definitely recommended if a patient’s foot type (i.e. high arches) requires stability to prevent from predisposing a patient to lateral ankle sprains from ankle instability.

IV. Surgical Treatment Options

  • Ankle Stabilization Surgery: In cases where non-surgical treatments fail to provide adequate relief, surgical intervention may be considered. Ankle stabilization surgery aims to repair or reconstruct the damaged ligaments. The specific surgical technique depends on the severity of ligament damage and the patient’s individual circumstances. Common procedures include ligament repair, augmentation, or reconstruction using autografts (patient’s tissue) or allografts (donor tissue). Surgical treatment is typically followed by a comprehensive rehabilitation program to optimize recovery and restore full ankle function.
  • Arthroscopic Procedures: In some cases, minimally invasive arthroscopic techniques may be utilized to address any associated joint pathology, such as cartilage damage or loose bodies. Arthroscopy allows the surgeon to visualize and treat these issues through small incisions, reducing surgical trauma and potentially expediting recovery.
  • Rehabilitation and Post-Surgical Care: Following surgery, a structured rehabilitation program is crucial to restore strength, range of motion, and stability to the ankle joint. Physical therapy will focus on improving ankle proprioception, muscle strength, flexibility, and functional activities. The rehabilitation process may include exercises to strengthen the ankle muscles, balance training, proprioceptive exercises, and gradually reintroducing functional activities and sports-specific movements. The duration of the rehabilitation program may vary depending on the surgical technique performed and individual patient factors. It is essential to follow the guidance of the healthcare professionals and complete the prescribed rehabilitation program to achieve optimal outcomes.

V. Prevention and Long-Term Management

Prevention and long-term management strategies play a crucial role in reducing the risk of recurrent lateral ankle instability. Here are some key aspects to consider:

  • Ankle Strengthening and Proprioception Exercises: Regularly performing exercises that focus on ankle strength, stability, and proprioception can help maintain ankle integrity and reduce the risk of future sprains.
  • Proper Footwear and Supportive Devices: Wearing appropriate footwear that provides adequate ankle support, cushioning, and stability is essential, particularly during physical activities or sports. Additional supportive devices such as ankle braces or taping may be beneficial in certain situations.
  • Gradual Return to Physical Activity: When returning to physical activity or sports after a lateral ankle sprain or surgery, it is crucial to follow a gradual progression plan. Gradually increasing intensity, duration, and complexity of activities allows the ankle to adapt and build strength and stability over time.
  • Regular Monitoring and Follow-up: Regular check-ups with healthcare professionals can help monitor ankle health, address any concerns, and make necessary adjustments to the treatment plan as needed.


Lateral ankle instability can significantly impact an individual’s quality of life and physical activity participation. However, with proper understanding, accurate diagnosis, and effective treatment strategies, individuals can find relief and regain stability in their ankle joint. Non-surgical treatments, such as physical therapy, bracing, and rehabilitation, are often successful in managing lateral ankle instability. In cases where conservative approaches are insufficient, surgical interventions may be considered to repair or reconstruct the damaged ligaments. The key to long-term success lies in comprehensive rehabilitation, consistent preventive measures, and maintaining ankle strength and stability through targeted exercises. By adopting a multifaceted approach to treatment and focusing on prevention, individuals with lateral ankle instability can regain confidence in their ankle function and enjoy an active and pain-free lifestyle.

Note: This summary provides general information on lateral ankle instability and its treatment options. It is important to consult with a qualified healthcare professional for an accurate diagnosis and personalized treatment plan based on individual circumstances.

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About Dr. Salvatore Meleca, DPM

Salvatore Meleca, DPM is a highly respected foot and ankle surgeon with extensive training and experience in podiatric medicine. He completed his residency at Mount Sinai Medical Center in Miami Beach, Florida, where he was mentored by Dr. Ettore Vulcano, a world-renowned orthopedic foot and ankle surgeon. Under the directorship of Dr. Jacob Silverstone, Dr. Meleca completed a 3 year surgical residency, performing and participating in various specialty surgeries such as orthopedics, plastics, vascular and more. His greatest qualities that are brought to his foot and ankle care are his sophisticated approach to conservative treatments, his careful surgical procedural selection, and his capabilities in performing minimally invasive technique surgeries.

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