What helps against chronic ankle instability?

There are various treatment options for chronic ankle instability. Conservative treatment is tried first. This involves doing physical therapy (physiotherapy) to strengthen the joint, and possibly wearing a removable ankle brace or splint to stabilize it.

Common forms of physical therapy include neuromuscular training and proprioceptive training. The two kinds of training are similar. They are both designed to improve strength, stability, balance and coordination in the ankle joint. The exercises include, for example, foot movements, standing on one leg, weight shifts, and strength training. Research has shown that neuromuscular training can actually improve the stability and the movement of the ankle in the first few weeks. Experts recommend doing the exercises three of four times a week for about 20 to 30 minutes – for a period of at least 4 to 6 weeks. This can also reduce the risk of spraining the ankle again.

If the joint remains unstable despite this training because the ligaments are too loose, surgery may be considered. One option is to shorten and tighten the ankle ligaments. Another option is to take a tendon out of the lower leg and use it as an outer ligament on the ankle. Tendons and ligaments are made from similar tissue.

This instability often affects muscle coordination. For this reason, exercises are always an important part of rehabilitation after surgery. Wearing an ankle brace during this time also helps. It provides external support for the joint. The pressure it puts on the joint can help you to regain a good sense of muscle coordination too.

People probably benefit from starting movement, strength and coordination exercises two to three weeks after surgery at the latest. These exercises can also be learned as part of a medically prescribed physical therapy program. Studies suggest that people who do this become active again sooner than those keep their foot still for six weeks and don't do any exercises during that time. The study participants who had started doing exercises and strength training earlier were able to go back to work about one to two weeks sooner. They were also able to do sports again about three weeks sooner. But there were no advantages after about two years: The stability and flexibility of participants' ankle joints was the same in both groups.