Understanding Chronic Ankle Instability (CAI)
Chronic ankle instability (CAI) is more than just a sore ankle. It’s an uncomfortable condition in which the outer (lateral) side of your ankle feels like it might “give way” when you walk, move or even stand.
If, in fact, it does “give way” with a turn or sprain, the result is lingering tenderness, discomfort and swelling.
Around 10% of people who experience an ankle sprain develop CAI.
The Problem with Untreated CAI
When CAI goes untreated, it tends to get worse. Every new sprain increases your chances of future sprains, leading to more damage.
Over time, this instability can cause other ankle problems, like arthritis.
In this article we’ll discuss:
- What causes Chronic Ankle Instability
- Treatment options for CAI
- The role of physical therapy in treating CAI
What Causes CAI?
A root cause of CAI is the abnormal lengthening of one or both ligaments on the ankle’s outer side, usually caused by an initial ankle sprain that did not heal completely.
CAI usually starts with an ankle sprain that doesn’t heal completely. This can cause one or both ligaments on the outer side of the ankle to stretch abnormally.
These ligaments are responsible for stabilizing your ankle, so when they’re weakened, your ankle becomes more vulnerable to further injury.
Who’s Most at Risk?
Certain groups of people are more likely to develop CAI, particularly those who put repeated stress on their ankles.
This includes:
- Athletes: Whether you play basketball, soccer, tennis, or any other sport that involves quick movements, your ankles are constantly under pressure. Sprains are common, and without proper recovery, these sprains can lead to CAI.
- Dancers: Ballet dancers, in particular, place significant strain on their ankles due to the demanding nature of their movements. A sprained ankle that doesn’t heal fully can quickly turn into CAI, making it harder to perform at their best.
- Active Individuals: Runners, hikers, and people who engage in regular physical activity also face a higher risk. Their ankles take repeated impacts, and if a sprain is not given the proper time and care to heal, instability can develop.
- Anyone with a History of Ankle Sprains: If you’ve had multiple ankle sprains, even minor ones, your risk of CAI increases. Over time, the ligaments may not bounce back to their original strength and tightness, leaving your ankle more prone to future injuries.
Why An Incomplete Healing Sets the Stage for CAI
Even if your initial sprain feels like it has healed, stretched ligaments can leave your ankle unstable.
- You might notice your ankle feels weak or wobbly.
- This instability makes it easier for your ankle to twist or roll again, often leading to another sprain.
- And with each sprain, the likelihood of developing CAI grows.
If left untreated, this cycle can continue, leading to ongoing ankle instability, pain, and discomfort. That’s why it’s essential to address ankle sprains properly, ensuring they heal completely before returning to your regular activities.
Treatment Options for CAI
If you’re dealing with chronic ankle instability (CAI), the good news is that there are several effective treatment options.
Depending on the severity of your condition, your treatment plan may include:
1) Bracing and Support
- Ankle Brace: Wearing an ankle brace can offer external support, reducing the risk of re-injury and giving you confidence as you move.
- Taping: Applying athletic tape can provide additional support and stabilization during activities that might put stress on the ankle.
2) Activity Modification
- Reducing High-Risk Activities: Temporary adjustments to your exercise routine may help, such as avoiding sports or activities that put too much strain on your ankle until stability improves.
- Gradual Return to Activity: Slowly reintroducing activities as your ankle becomes stronger and more stable, under the guidance of a therapist.
3) Medications
- Anti-Inflammatory Medications: Over-the-counter medications like ibuprofen can help manage pain and reduce swelling, especially after a new injury.
4) Physical Therapy: Your First Line of Defense
In many cases, physical therapy can successfully treat CAI.
Here’s how it works:
- Strengthening Exercises: We’ll target specific muscles in your ankle to help strengthen specific ankle muscles to provide some of the stability the ligament once did.
- Balance and Range-of-Motion Exercises: These exercises will help lessen the feeling that your ankle is about to “give way,” restore your balance, and improve the way your ankle moves. You’ll feel more confident in your step, with less fear of instability.
- Ankle Support: We might suggest taping your ankle or wearing a brace. Taping your ankle or wearing an ankle brace for exterior support lessens the chance of future sprains occurring and make you feel more secure and comfortable.
5) Surgical Options
If physical therapy doesn’t completely resolve your CAI, surgery might be an option.
- Ligament Repair: In cases of severe instability where physical therapy is not enough, surgery can repair or tighten the damaged ligaments.
- Ligament Reconstruction: If the ligament is too damaged to repair, the surgeon may replace it with a graft from another tendon.
If a comprehensive physical therapy plan cannot counter CAI, surgical options to repair or replace the stretched ligament(s) are usually quite successful.
But remember that physical therapy is a crucial part of post-surgery rehabilitation.
6) Post-Surgical Physical Therapy
- Rehabilitation Exercises: After surgery, physical therapy plays a critical role in regaining strength, flexibility, and stability in your ankle.
- Gradual Recovery Plan: A structured therapy plan helps you transition back to your normal activities safely and effectively.
Each of these treatment options can be tailored to your needs, with the ultimate goal of restoring ankle stability, reducing pain, and preventing future injuries.
Moving Forward: A Custom PT Plan for You
No matter what treatment you receive for your CAI, we can create a regimen of exercises to make your ankle feel more stable and relieve pain and tenderness. Thus, you will feel more comfortable when you resume your normal daily activities.
Our goal is to help your ankle feel more stable and relieve the pain and tenderness that’s holding you back.
The sooner we start working on it, the sooner you’ll feel more comfortable and confident returning to your normal activities.
Did you know you have Direct Access* to Physical Therapy? No referral, no problem!
Why Wait? Start Taking Care of Your Ankle Today
Living with CAI can be frustrating, but the good news is you don’t have to face it alone.
With the right treatment plan, you can regain stability, reduce pain, and get back to doing the things you love—without worrying that your ankle will give out.
So, take the first step toward feeling better. We’re here to help you move forward, one stable step at a time.
The Jackson Clinics serves 18 locations throughout Northern Virginia.
Find one near you: https://thejacksonclinics.com/locations/