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Published on November 30, 2018

illustration of weak ankle

What To Do When Your Ankles Give Way

One bad ankle sprain can linger in your life and lead to pain and the unnerving feeling that your ankle is about to give way. One-third of people who suffer an ankle sprain may experience chronic instability of the ankle.

Many people assume it’s just part of getting older, or another spot where arthritis is taking its toll on the body. But ankle instability is its own condition, and it’s one that can be addressed.

“The feeling that comes with ankle instability is unsettling, and often painful. But many people just assume they have to endure it,” said Garrett Wobst, DPM, a surgeon with Avera Orthopedics Aberdeen. “Many people try some self-treatment approaches, such as an over-the-counter brace or physical therapy. In many cases, it has little effect.”

Understanding What It Is – And Is Not

Ankles provide the day-in, day-out support for activities from walking to sports to heavy labor.

“Arthritic ankle pain is not the same as instability. That pain will be dull and chronic, more like a recurring ache,” said Wobst. “Pain from instability will present quickly, especially when you’re walking on uneven surfaces or climbing stairs, or engaging in side-to-side movements.”

Arthritis is a condition itself, and can arise from infection, traumatic injury, underlying disease or wear on a joint. Instability often comes to a person’s life because of injury – think a bad ankle sprain.

“There’s really no way to predict who heals quickly and is fine after a sprain and who doesn’t,” Wobst said. “We have had older people who recovery 100 percent and then had someone in high school who developed ankle instability – they had one bad sprain and the ankle was never right after that.”

Getting Relief

Instability of the ankle can last a lifetime – and treatment approaches can be straightforward. Physical therapy and braces for the ankle – whether custom-made or not – often are the recommendations a primary-care doctor or specialist like Wobst would recommend as first steps.

“Some people will try steroid injections in the hopes they will develop the necessary response and reduce the frequency of the occurrence,” he said. “The next step would be MRI, or in some cases a stress radiography imaging sequence, to identify the issues in the ankle.”

Relieving It Once And For All

Imaging usually will lead to surgery. The instability is most often caused by torn ligaments in the ankle that never properly heal. With a procedure, these important ankle connections can be rebuilt and alleviate the underlying issue.

“What happens in a patient with instability of the ankle is that the muscles in the area are doing the work the damaged ligaments no longer can do,” Wobst said. “That’s why the pain and issues of feeling it ‘go out’ occur more often when you’re tired or after a longer day. It doesn’t tend to loosen up or feel better with activity like an arthritic ankle might.”

With an arthroscopic procedure and repair of the ligaments, the ankle can be stabilized. The symptoms will diminish.

“Many people face ankle instability, but unfortunately, most just tend to live with it,” said Wobst. “We can repair the tears and have it repaired for good, so that unnerving feeling of giving way is a thing of the past.”

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