Chronic Ankle Instability: Why Repeated Sprains Shouldn’t Be Ignored

Understanding Ankle Sprains

An ankle sprain occurs when the ligaments that support the ankle are stretched or torn, usually from rolling or twisting the foot in an awkward position. These ligaments act like strong bands that prevent the ankle from moving too far in any direction.

When sprains happen repeatedly-or when a single severe sprain is not treated properly-the ligaments may not heal completely. This leaves the ankle weaker, less stable, and more prone to future injury.

What Is Chronic Ankle Instability?

Chronic ankle instability is a condition where the ankle frequently “gives way,” especially during physical activity or when walking on uneven ground. Patients often describe:

• Repeated ankle sprains
• A constant feeling of looseness or weakness in the ankle
• Ongoing pain, swelling, or tenderness
• Difficulty with balance and stability

This cycle of instability and reinjury can significantly affect athletic performance and daily life.

Degrees of Ankle Sprains

Ankle sprains are categorized into three grades, based on severity:

• Grade 1 (Mild): Ligaments are stretched with microscopic tears. Pain and swelling are usually mild, and weight-bearing is often possible.
• Grade 2 (Moderate): Partial ligament tear with more significant pain, swelling, and bruising. Walking becomes difficult.
• Grade 3 (Severe): Complete ligament rupture. Pain, swelling, and bruising are severe, and the ankle is unstable with little ability to bear weight.

Chronic instability can develop from any grade of sprain if recovery is incomplete.

Diagnosing Chronic Ankle Instability

A proper diagnosis begins with a detailed history of your injuries and a physical exam. Our specialists may also use imaging, such as X-rays or MRI, to evaluate ligament damage and rule out fractures or cartilage injuries.

Treatment Options

At Princeton Sports and Family Medicine, we use a comprehensive, stepwise approach to restore ankle strength and stability:

1. Conservative Care

• RICE Method (Rest, Ice, Compression, Elevation): For acute sprains.
• Bracing or Taping: Supports the joint and reduces risk of reinjury.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and swelling.
• Injections: Corticosteroid or regenerative options in select cases.

2. Physical Therapy

Rehabilitation is essential for recovery. Therapy focuses on:

• Strengthening the muscles of the foot and lower leg
• Improving balance and proprioception
• Restoring range of motion
• Re-training movement patterns to reduce future risk

3. Surgical Intervention (for severe cases)

If conservative treatment fails and instability persists, surgery may be considered to repair or reconstruct damaged ligaments.

Prevention and Long-Term Outlook

The best way to prevent chronic ankle instability is to fully rehabilitate every sprain before returning to high-level activity. Even mild sprains benefit from medical evaluation and guided recovery. With proper care, most patients regain stability and return to sports or daily activities without limitation.

Take the Next Step

If you’ve experienced multiple ankle sprains or feel ongoing weakness in your ankle, don’t ignore it. Early treatment can prevent long-term problems.

Physical therapy is one of the most important steps in regaining ankle stability. Each program is customized to a patient’s needs, but the focus is always on rebuilding strength in the muscles of the foot and lower leg, improving balance, and retraining movement patterns to prevent reinjury. Learn more about our physical therapy services.

In addition, pain and inflammation can often be managed with over-the-counter NSAIDs or targeted therapeutic injections such as corticosteroids. These options may be recommended alongside therapy and bracing, depending on the severity of your symptoms. To take the next step in your recovery, schedule a consultation with our team. Visit our appointment page or call today to book your follow-up.