Ankle instability is characterized by a lack of stability in the joint. It generally appears following a sprain (simple or recurrent) in 70% of cases, or following poor healing of the anterior calcaneofibular and talofibular bundles of the ankle ligament.
Symptoms of ankle instability
The feeling of instability in the joint remains the primary symptom of this disorder. It can be felt by the patient, particularly when walking on uneven terrain. In addition to the physical factor, ankle instability can also induce apprehension, which may lead the patient to reduce their participation in sports activities involving the affected joint (football, basketball, tennis, etc.). It should also be noted that while pain is not always a noticeable symptom of ankle instability, it can sometimes occur.
How to diagnose ankle instability?
The diagnosis of ankle instability is primarily clinical. The healthcare professional can therefore compare the patient's account with an examination of the joint. Simultaneously, they can also try to determine if the joint presents any factors that could contribute to the development of ankle instability. This is particularly relevant if the joint has any damage or if the ligaments are not sufficiently strong.
What are the different ankle pathologies that can cause instability?
Ankle instability can have two distinct origins: mechanical or functional.
- Instabilities of mechanical origin are linked to anatomical abnormalities, such as ligament laxity, for example;
- Functional instabilities, on the other hand, are linked to a problem of posture or neuro-motor control.
Ankle sprain: the most common injury
The external ankle sprain This is the most frequently encountered traumatic injury resulting from the development of ankle instability. It often progresses to a recurrence (between 40 and 70% of cases, according to studies), or even to chronic ankle instability. After a year, it is not uncommon for the patient to again suffer from a painful, unstable ankle, with loss of mobility and muscle weakness.
The most frequent cause of this chronic condition is a loss of ankle responsiveness, and therefore proprioception. A secondary cause is a loss of strength, particularly in the peroneal muscles. These muscles in the outer compartment of the leg are the primary muscles responsible for ensuring lateral ankle stability.
Ankle instability: what treatments are available?
The management of ankle instability relies on various treatments:
- preventive treatment;
- medical treatment;
- surgical treatment.
Preventive treatment of ankle instability
Preventive treatment relies on the complete treatment of the ankle sprain to limit the risk of developing instability. In the most severe cases, this involves immobilizing the joint with a removable brace for six weeks.
Subsequently, physiotherapy sessions will need to be prescribed in order to strengthen the muscles and improve the patient's neuro-motor control, particularly on unstable terrain.
Medical treatment
In cases of proven instability, the joint should be stabilized using orthopedic devices. However, these solutions are only temporary and often require further intervention. ankle rehabilitation to strengthen the muscles responsible for stabilizing the ankle, or even surgical treatment to effectively treat this type of disorder.
Surgical treatment of ankle instability
The goal of surgical treatment is to stabilize the joint by adjusting the tension and/or reattaching the ligaments to their insertions. In some cases, this single step is sufficient to treat ankle instability. However, if the problem is more severe, a tendon graft, using the peroneus brevis tendon, is then considered.
Following this type of surgery, the patient's ankle must be immobilized for 21 days in a cast. Rehabilitation can then begin 45 days after the operation, focusing on restoring range of motion and strengthening the muscles.
However, it is important to keep in mind that this type of surgical procedure can sometimes cause side effects. These include:
- complications during the operation;
- healing defects;
- infections;
- chronic pain;
- ankle stiffness.
Managing ankle instability with the Allyane method
Allyane's neuromotor reprogramming method allows intervention at several levels:
- in the rehabilitation phase of an external ankle sprain: it helps to accelerate the patient's care, by helping them quickly regain optimal contraction of the peroneal muscles and by correcting dysfunctional motor patterns;
- In the rehabilitation phase: it allows intervention on the optimization of functional movements (jumping, running), but also of sporting movements.
The Allyane method is especially an ideal solution for managing chronic ankle instabilities that fail to progress after a year, particularly by allowing work on centrally originating motor inhibitions.