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Lateral Ankle Instability

Overview


Lateral ankle instability is a complex condition that can, at times, prove difficult to evaluate and treat for general practitioners. The difficulty in evaluation and treatment is due in part to the ankle complex is composed of three joints: talocrural, subtalar, and tibiofibular syndesmosis.



What are the symptoms of ankle instability?


1.Pain or tenderness in the ankle.

2.Discomfort or swelling.

3.A repeated “giving way” of the ankle on the outer, or lateral, side.

4.A general feeling of instability or wobbliness in the ankle, particularly when walking, running or when on uneven surfaces.



Treatment 

Conservative treatment of lateral ankle instability consists of early functional rehabilitation; including rest, ice, elevation, compression, initial range of motion, progressive weight-bearing guided by symptom tolerance, and physical therapy. Even with proper functional rehabilitation 10 to 40% of patients will go on to develop chronic ankle instability following acute ankle sprains. Multiple studies have been published which show both the benefits of conservative therapy as well as surgical treatment for cases that do not adequately respond to conservative treatment.

There have been more than 70 different operative techniques described in the literature for correcting ankle instability, and can be divided into three main categories; anatomic, non-anatomic, and anatomic augmented tenodesis reconstruction.



Lateral ankle instability exercises

Single leg stance – Stand up and hold on to something for balance. Put all your weight on your injured ankle for 15 seconds. Standing calf raises – Again with a balancing aid, put all your weight on your injured ankle and raise yourself up on it by extending it. Hold for 15 seconds.



What causes lateral ankle instability?

Ankle instability is caused by injury to the lateral [outside] ankle ligaments. This usually causes strain or stretch, and in more severe forms, causes a sprain or tear in the ligaments.


How do I strengthen my lateral ankle?


Put the heel of your good foot on top of the toes of your injured foot. Gently pull your toes and ankle towards your face on the injured ankle and the good foot can provide resistance on top. Hold for 5 seconds. Repeat 10 times.


How can you prevent ankle injuries at work?

Wearing the right footwear for the job protects you from stress- related injury to the ankles, knees, hips and spine. Wear activity- specific, well-fitting shoes, use sports strapping tape or an ankle brace to provide good ankle joint support (see your physiotherapist for advice on the correct support).


What is the most common risk factor for lateral ankle sprains?

Factors that increase your risk of a sprained ankle include: Sports participation. Ankle sprains are a common sports injury, particularly in sports that require jumping, cutting action, or rolling or twisting of the foot such as basketball, tennis, football, soccer and trail running. Uneven surfaces.


How do you check lateral ankle ligaments?



Procedure: The patient is positioned similar to the Inversion stress test. The examiner everts and abducts the heel while stabilizing the distal tibia. The test is performed on both the sides. An increased laxity and pain on the injured side in comparison to the uninjured side would indicate a positive test.










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