Chronic Ankle Instability
Ankle inversion injuries, commonly known as a rolled ankle, are prevalent in court sports such as basketball, netball and tennis and field sports including AFL football and soccer. They affect the lateral ligament complex, which is important for stabilising the ankle joint.
The lateral ligament complex consists of the anterior talofibular (ATFL), calcaneofibular (CFL) and posterior talofibular ligaments (PTFL). The most commonly affected ligament is the ATFL. In more severe injuries, the CFL and PTFL are affected.
Common mechanisms of injury include landing, stepping on another play’s foot or change of direction.
Although acute ankle injuries are initially managed with ice, compression, rest and taping, many people suffer from ongoing issues such as ongoing pain, swelling, joint instability and recurrent sprains which impact on sport performance. Risk factors for recurrent ankle issues include a previous sprain, insufficient rehabilitation and earlier than recommended return to sport.
Chronic ankle instability (CAI) describes the ongoing limitations following an acute ankle sprain, including ankle instability during load bearing activities and perceptions of your ankle giving way.
In a systematic review by Doherty et al 2013, they found that upto 40% of intial ankle sprains will develop chronic instability within the 12 months following an injury.
Treatment and Prevention
Firstly, its important to identify any risk factors including muscle strength deficiencies, static and dynamic balance deficits or any structural issues. This is performed using functional assessments which consist of a number of ankle specific tasks including balance and various hopping drills to asses the extent of instability.
Following assessment, the implementation of an appropriate rehabilitation program addressing any identified deficits in balance and muscle strength with the aim of progressing to sport specific movements to ensure a safe return to sport. Once returned to sport, performing maintenance strengthening exercises will assist with reducing the risk of re-injury. Taping has also shown to be beneficial in reducing the risk of re-injury, with effectiveness increased with a concurrent preventitive exercise program.
If you are having persistent ankle pain or stability issues during sport or daily life, book in with us for a thorough assessment and plan.
References
1. Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. SPORTS MED [internet]. 2013[cited 2020 Nov 10];44(1):123-140. doi:10.1007/s40279-013-0102-5.