Chronic instability results from damage to the supporting ligaments of the ankle after injury usually by twisting and falling on it.
It is very common for one to twist the ankle at sport, on uneven ground or just missing a step and this leads to partial or complete rupture of the lateral ligaments of the ankle.
This initially is a very incapacitating injury leading to a painful swollen and often very bruised foot and ankle. A small number of these ankle injuries result in chronic pain and instability. This can be not only very irritating but very incapacitating.
We diagnose this injury by clinical examination to feel for the stability of the joint. A plain x-ray is usually normal although very minor fractures can occur when the ligament separates from its bony attachment.
Despite the possible severity of the initial injury, the ligaments have a good capacity to heal and between 80 and 90% settle with rest ice compression and elevation (R.I.C.E.). If this problem does not respond to physiotherapy, the chronic pain responds to an arthroscopy to remove the inflamed lining of the joint or the instability can be improved by a reconstruction of the lateral ligaments. This is a very reliable way to treat this problem and mostly normal ankle function results.