Condition · Foot and ankle
Chronic ankle instability
After recurrent sprains, the lateral ligaments may remain stretched and neuromuscular control may deteriorate. The ankle may roll easily or give way, especially on uneven ground and during changes of direction.
Clinical context
What you should know
Instability may be mechanical because of ligament laxity, functional because of poor muscular control and proprioception, or a combination of both. A tight Achilles tendon, cavovarus alignment, peroneal tendon problems and osteochondral lesions may perpetuate symptoms.
Recurrent sprains can damage the cartilage. Treatment therefore addresses both stability and associated injuries.
First step
Consultation and assessment
The examination compares laxity, alignment, strength and balance. Weight-bearing radiographs look for deformity and osteoarthritis; MRI or CT is selected to assess tendons, cartilage or surgical planning.
The clinical diagnosis must explain the symptoms. Laxity on testing without functional giving-way episodes does not automatically indicate surgery.
Stepwise treatment
Options are chosen according to the diagnosis and treatment goal
Conservative treatment
- a progressive programme for strength, balance and proprioception
- a brace or functional taping for higher-risk activities in suitable cases
- improving ankle movement and control of the entire limb
- footwear modification and treatment of alignment factors where possible
Medication, injections and devices each have their own indications and contraindications. They are not recommended automatically and do not replace a diagnosis or monitoring of the response.
When surgery is considered
Ligament reconstruction is considered when appropriate rehabilitation does not control instability. Arthroscopy may be added when symptomatic impingement, loose bodies or osteochondral lesions are present.
Do not delay
Signs that require prompt assessment
- inability to bear weight, deformity or bone tenderness after a new sprain
- a cold, pale or numb foot, or neurological weakness
- marked calf swelling or shortness of breath
In an emergency or if symptoms are severe, call 112 or go to the nearest emergency department.
Frequently asked questions
Concise answers, without blanket promises
Why does the ankle give way even if the ligaments appear stable?
Functional instability may result from weakness, impaired proprioception, pain or restricted movement. The examination distinguishes between these components.
How long should rehabilitation be tried?
There is no single duration for everyone. The quality of the programme, objective progress and persistence of episodes during relevant activities all matter.
Editorial responsibility
Medically reviewed content
Dr. Răzvan Anițaș
Consultant orthopaedic and trauma surgeon; PhD in medical sciences
Last editorial update: 22 August 2026
Medical reference sources
First step
Consultation, diagnosis and a clearly explained plan
This content is educational and does not replace medical assessment. Similar symptoms can have different causes and require different treatments.