Chronic Ankle Instability: When Repeated Sprains Become a Serious Problem

Chronic ankle instability causes repeated sprains, pain, and ankle weakness. Learn how ligament repair surgery restores stability and alignment.

Ankle sprains are one of the most common orthopedic injuries. Almost everyone has experienced one at some point—whether as a child playing sports or as an adult stepping awkwardly off a curb.

But when does a simple ankle sprain become something more serious?

What Is Chronic Ankle Instability?

Chronic ankle instability develops when the ankle repeatedly “gives out,” especially on uneven surfaces. Patients often report:

* Recurrent ankle sprains

* Persistent swelling

* Daily ankle pain

* A feeling of looseness or weakness

* Difficulty walking on uneven ground

Over time, repeated injuries can stretch or tear the supporting ligaments of the ankle, preventing proper healing and stability.

Understanding the Anatomy

The ankle joint is made up of three primary bones:

* The **tibia** (shin bone)

* The **fibula** (outer leg bone)

* The **talus** (ankle bone that sits between them)

On the outer (fibular) side of the ankle are key stabilizing ligaments. When these ligaments are torn—especially multiple ligaments—the ankle can become mechanically unstable.

Diagnosing the Problem

Diagnosis typically includes:

* Physical examination

* Stress testing of the ankle

* MRI imaging to evaluate ligament tears

During a stress test, the ankle is gently inverted and pulled to assess looseness. In cases of instability, imaging may show the talus tilting within the tibia, indicating ligament failure.

Surgical Treatment: Ligament Repair

When conservative treatments such as bracing and physical therapy fail, surgical repair may be recommended.

During surgery:

1. The ankle is stress-tested under anesthesia to confirm instability.

2. Torn ligaments on the fibular side are repaired.

3. The ankle is tested again to confirm restored stability.

After repair, imaging typically shows the talus sitting parallel within the tibia—indicating proper alignment and improved joint stability.

Modern techniques allow this procedure to be performed through a minimal incision, often leading to faster recovery and less postoperative discomfort.

Recovery and Outcomes

Most patients experience:

* Improved ankle stability

* Reduced pain

* Greater confidence walking on uneven surfaces

* Return to normal activities after rehabilitation

Early diagnosis and proper treatment can prevent long-term joint damage and arthritis.

When to See a Specialist

If you experience:

* Repeated ankle sprains

* Ongoing ankle pain

* Instability when walking

* Difficulty on uneven ground

It may be time for a professional evaluation. Chronic ankle instability is treatable, and surgical repair can dramatically restore function when indicated.