Understanding lateral ankle instability and preventing it with exercises using FLEXVIT® bands

Guest article by NeuroXtrain

Lateral ankle instability (LAI) is a complex condition that is sometimes difficult for general medical professionals to diagnose and treat. The assessment and treatment of chronically unstable ankles is due to the complexity of the unstable ankle. It consists of three joints: the talocrural joint, the tibiofibular syndesmosis and the subtalar joint. All three joints function synchronously to enable the complex movement of the ankle joint. The main factors responsible for the stability of the ankle joint are the joint surfaces, the ligament complex and the muscles that enable the dynamic stabilisation of the joints.

The lateral ankle joint consists of the anterior talofibular ligament (ATFL), the posterior talofibular ligament (PTFL) and the calcaneofibular ligament (CFL).

Parts of the lateral ankle joint:

• Anterior talofibular ligament (ATFL)
• Posterior talofibular ligament (PTFL)
• Calcaneofibular ligament (CFL)

The ATFL originates at the lateral malleolus and attaches to the lateral talar articular facet. The primary function of the ATFL is to resist inversion into plantar flexion. The ligamentum fibulare calcanei originates at the anterior edge of the fibula and attaches to the calcaneus. The CFL crosses both the subtalar joint and the ankle joint.

The primary tasks of the CFL are to resist inversion in neutral and dorsally flexed positions. It also restricts subtalar inversion, which limits talar slope. Finally, the posterior talofibular ligament is the most robust of the lateral ligaments, but only plays a complementary role in ankle stability. The PTFL originates at the posterior edge of the fibula and attaches to the talus. Of the three ligaments, PTFL and ATFL are intracapsular and only the CFL ligament is extracapsular to the ankle joint.

Why does a chronically unstable ankle occur?

Lateral ligament instability can occur in two ways: through functional or mechanical instability.

Mechanical ankle instability

Functional ankle instability

Functional instability is the sensation of ankle instability or recurrent, symptomatic ankle sprains due to proprioceptive loss. Lateral ankle instability can also be caused by hereditary ligament laxity associated with Marfan syndrome, Ehlers-Danlos syndrome and Turner syndrome.

Epidemiology

Medical history and physical examination

A detailed history can point the doctor in the right direction when diagnosing a patient with unstable ankles or ankle pain. Patients will regularly report repeated episodes of the ankle “giving way” on unsteady terrain or feeling loose. They may pay particular attention to certain activities where they are aware of potential harm. Ankle pain can also be a problem, although it is generally not the main complaint.

Hypermobility should also be an issue in the initial assessment of patients as laxity can lead to additional injury. Range of motion and strength are also critical for a complete examination, especially when compared to the contralateral limb (unaffected side).

Ankle sprains are classified into 3 grades, from the mildest to the most severe injury.

Functional classification of ankle sprains

Grade I – the patient can put full weight on the foot and walk.

Grade II – the patient walks with a distinct limp.

Grade III – the patient can no longer walk.

Anatomical classification

Treatment and management

Conservative treatment of lateral ankle instability consists of early functional rehabilitation, including protection of the chronically unstable ankle as well as:

Even with adequate functional rehabilitation, 10 to 40 % of patients develop a chronically unstable ankle after an acute ankle sprain. Several studies have been published that show the advantages of conservative therapy on the one hand. On the other hand, they also outline surgical treatment for cases that do not respond adequately to conservative treatment.

Let’s look at some exercises that can be done with elastic fitness bands (FLEXVIT ®). This can prevent ankle sprains and strengthen the muscle that surrounds the ankle joint.

Fitnessband Exercises

Exercise 2: Isolated ankle eversion

The peroneus muscles.

Exercise 3: Proprioception + ankle dorsiflexion training

Bestellen Sie jetzt das passende Fitnessband von FLEXVIT:

Sources:

Gibboney MD, Dreyer MA. Lateral Ankle Instability. [Updated 2020 Jul 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan.

Distributed under the terms of the Creative Commons Attribution 4.0 International License.

About the Authors

Practical content such as videos on specific rehabilitation/prevention/strengthening exercises and much more:

DISCLAIMER: This content (the description, images and videos) does not constitute medical advice or a treatment plan and is intended for general educational and demonstration purposes only. This content should not be used for self-diagnosis or self-treatment of any health, medical or physical condition. This content cannot replace professional advice or a visit to a doctor. Before using exercises against specific complaints, a doctor or physiotherapist should always be consulted to be on the safe side.