Dr Alan Cheung
Senior Consultant Orthopaedic Surgeon in Singapore
MBBS (London), MRCS (England), FRCS (Trauma and Orthopaedics, England), Diploma in Sport and Exercise Medicine (UK), Fellow of the European Board of Orthopaedics and Traumatology, American Academy of Orthopaedic Surgeons (AAOS)
Ankle sprains are often treated as temporary injuries, especially once the pain and swelling begin to settle. Yet some people find that the ankle still feels unreliable when they return to their usual activities, leaving them unsure whether it has fully recovered.
Chronic ankle instability may develop when the ankle remains unstable or repeatedly gives way after the initial injury. Pain that lasts longer does not, on its own, indicate this problem. The concern is an ongoing or recurring loss of stability, which may warrant assessment of how the ankle has healed and what is contributing to the instability.
What Does Ongoing Ankle Instability Feel Like?
Ongoing instability may become noticeable as you resume everyday activities. It can involve sudden episodes of giving way or a lingering feeling that the ankle is not secure.
The Ankle Gives Way During Movement
The ankle may unexpectedly buckle or roll when walking on uneven ground or changing direction during sport. If this happens repeatedly, it can suggest that stability and movement control have not fully returned.
You may find yourself slowing down on uneven paths or avoiding quick turns because you are worried the ankle will give way again.
A Lingering Sense That the Ankle Is Not Secure
Some people describe the ankle as feeling loose or unreliable even when it does not actually give way. This sensation may become more noticeable during activities that place greater demands on ankle stability.
Why Do Some Ankle Sprains Lead to Chronic Instability?
Not everyone who sprains an ankle develops a long-term problem. The initial injury and the course of recovery can both influence whether instability persists.
The Extent of the Original Ligament Injury
A relatively minor sprain may overstretch a ligament, while a more severe injury can partially or completely tear its fibres. The extent of the damage and which ligaments are affected can influence how well the ankle heals and the support it regains.
Incomplete Recovery Before Returning to Activity
Pain can settle before the ankle is ready for the demands of running or sport. The supporting muscles may still struggle to keep the ankle steady when landing or changing direction.
Proprioception, which is the body’s ability to sense the ankle’s position, may also remain impaired. This can make it harder to adjust quickly when the foot lands awkwardly or encounters uneven ground, leaving the ankle more vulnerable to another sprain.
The Effect of Repeated Ankle Sprains
Repeated sprains may indicate an ongoing stability problem rather than a series of separate injuries. An unstable ankle is more vulnerable to another sprain, and each new injury can further damage the supporting ligaments, making recovery more difficult.
How Is Chronic Ankle Instability Assessed and Managed?
Assessment helps establish whether instability is related to reduced muscle support and movement control, persistent ligament problems or a combination of these factors. This helps guide treatment.
Assessing the Source of the Instability
The doctor may ask how the original injury happened, when the ankle gives way and what treatment or rehabilitation you have already tried.
A physical examination checks for ligament looseness and assesses ankle movement and muscle strength. Balance tasks, such as standing on one leg, may also help show how well you control the ankle when bearing weight.
Imaging may be used when more information is needed about the ligaments or other structures within the joint. The results are considered alongside your symptoms and examination findings when deciding on treatment.
Rehabilitation for Ongoing Ankle Instability
Rehabilitation works on the difficulties identified during assessment. Weakness may be addressed through exercises that strengthen the muscles supporting the ankle, while balance training helps improve control as your weight shifts. Restricted ankle movement may also need attention.
As control improves, rehabilitation can progress towards movements required for your usual activities, such as landing or changing direction during sport. Progression depends on how securely the ankle handles these tasks, rather than on time alone.
When Surgical Stabilisation May Be Considered
Surgical stabilisation may be considered when clinically significant instability persists despite appropriate rehabilitation, particularly where structural ligament damage is contributing to the problem. The decision also takes into account how much the instability affects everyday activity or sport.
Assess Why Your Ankle Still Feels Unstable After a Sprain With Dr Alan Cheung
An ankle may remain unstable because injured ligaments no longer provide enough support, or because strength and movement control have not fully recovered. These problems can also occur together, so assessment can help determine what is contributing to the ongoing instability.
At International Orthopaedic Clinic, patients can seek assessment for persistent ankle instability after a sprain. Dr Alan Cheung draws on his experience in managing sports injuries and ankle conditions to review how the ankle has recovered and what may still be affecting its stability.
If your ankle continues to give way or feels unreliable, book an appointment to assess why stability has not returned and whether further rehabilitation or other treatment may be appropriate.
