At Move Clinic, home of beautiful bush walks we see our fair share of ankle sprains. They are a common injury, especially among athletes and active individuals. Despite their frequency, many people underestimate the potential long-term consequences. Chronic Ankle Instability (CAI) can significantly impact physical activity and ability to get out on exciting hikes. This week we look at CAI and best way to treat.
Why Discuss CAI?
Ankle sprains are often dismissed as minor injuries that heal quickly with minimal treatment. However, research shows that residual symptoms can persist for months or even years, leading to chronic issues. Approximately one-third of individuals experience lingering pain, re-sprains, swelling, muscular weakness, and a sense of instability after an ankle sprain. Alarmingly, up to 70% of those who suffer an acute ankle sprain may develop CAI within a short period, with 40% experiencing CAI one-year post-injury. These chronic impairments can restrict daily activities and increase the risk of early-onset post-traumatic osteoarthritis.
What is it?
CAI is characterized by persistent pain and instability following an ankle sprain. It includes both mechanical instability (ligament laxity and excessive joint motion) and functional instability (feelings of instability due to sensory deficits). A typical lateral ankle sprain can lead to long-term deficits in postural control, proprioception, muscle reaction time, and strength, contributing to CAI.
Diagnosing CAI
Several tools help confirm CAI, including:
- Cumberland Ankle Instability Tool (CAIT)
- Identification of Functional Ankle Instability (IdFAI)
- Foot and Ankle Outcome Score (FAOS)
CAI is diagnosed if there is a history of significant ankle sprain, recurrent instability, or feelings of giving way, confirmed by validated questionnaires. The best bet is to see a physio who can assess from your history and objective exam your diagnosis.
Recommended Interventions
Bracing/External Support:
Used to aid short-term rehabilitation by improving engagement in exercises. We do not recommend long term bracing but instead a solid strengthening program.
Main Rehabilitation Focus
Proprioceptive and Neuromuscular Exercises: These exercises improve dynamic postural stability and patient-perceived stability during functional activities.
Manual Therapies: Including graded joint mobilizations and manipulations.
Additional Interventions
Address Fear Avoidance Beliefs: Understand fears and limitations to enhance self-efficacy.
Education: Informing patients about the rehabilitation process and recovery expectations.
Take home message
Understanding and addressing CAI is crucial for preventing long-term disability and maintaining an active lifestyle. Through proper diagnosis, targeted interventions, and ongoing management, individuals can achieve better outcomes and regain confidence in their physical abilities. By prioritizing ankle health and seeking professional care, you can minimize the risk of chronic issues and enjoy a more active pain free life. If you have concerns about chronic ankle sprain come see us and we will help you get back on the trails.