Recurrent Ankle Instability

Recurrent ankle instability occurs when the ankle repeatedly “gives way” after an initial sprain, typically on uneven ground or during sport. Ongoing laxity of the lateral ankle ligaments (usually the ATFL ± CFL) can cause repeated sprains, pain, swelling, and loss of confidence.

At The New Foscote Hospital, you can access rapid consultant foot & ankle assessment, targeted imaging, specialist physiotherapy, and, when needed, ligament repair or reconstruction to restore stability and function.

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Symptoms

• Repeated ankle sprains and episodes of giving way
• Lateral ankle pain, swelling, and tenderness
• Instability on uneven ground or when changing direction
• Reduced sport performance or fear of movement
• Stiffness or catching if there is joint irritation or scar tissue

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Causes And Risk Factors

• Inadequately rehabilitated ankle sprain
• Ligament laxity (ATFL/CFL) or general hypermobility
• Cavovarus foot posture or hindfoot malalignment
• High-demand pivoting/cutting sports
• Associated problems: peroneal tendon pathology, osteochondral lesions, impingement

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Diagnosis At The New Foscote Hospital

Your consultant will take a focused history and examination (including anterior drawer and talar tilt tests) and may arrange:

• Weight-bearing X-rays to assess alignment and exclude fractures
• Ultrasound for dynamic ligament and peroneal tendon assessment
• MRI to evaluate ligament quality and cartilage/osteochondral injuries

Orthopaedic Services
Meet Our Consultants
Imaging At Foscote (MRI)

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Treatment Options

Non-Surgical Management (first-line)

• Physiotherapy: proprioception/balance training, peroneal strengthening, gait and landing mechanics
• Ankle brace or taping for sport or uneven terrain
• Activity modification and graded return to play
• Footwear/orthotics if malalignment contributes

Many patients improve with a structured rehabilitation programme.

Surgical Options (when instability persists)

• Broström-type lateral ligament repair (ATFL ± CFL) ± internal brace augmentation
• Ligament reconstruction using grafts if the tissue quality is poor or laxity is longstanding
• Ankle arthroscopy to treat associated synovitis, scar tissue or osteochondral lesions when indicated

Your surgeon will explain the recommended approach, risks and expected recovery for your specific case.

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Recovery And Rehabilitation

• Day-case surgery is common. Short period of protection (boot/brace) followed by guided physiotherapy.
• Progressive range of motion, strength, balance and sport-specific drills.
• Return to desk work typically within weeks; return to cutting/pivoting sport is usually several months, depending on healing, rehab progress and sport demands.

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When To Seek Specialist Help

Book an assessment if you have:

• Repeated giving-way episodes despite rehab
• Ongoing pain or swelling after a sprain
• Fear of re-injury limiting activity or sport
• Concerns about long-term cartilage damage or tendon problems

Early diagnosis and targeted treatment reduce the risk of further sprains and joint wear.