The anterior area of the ankle is the front, or top of the ankle. The ligaments in this area include the anterior talofibular ligament and that anterior tibiotalar ligament. These ligaments can become damaged, causing subsequent instability of the ankle.

  • Weakness of the lower leg or ankle muscles and laxity of the anterior ankle ligaments are the most common cause of anterior ankle instability.
  • General ligamentous laxity may predispose an individual to instability or dislocations.
  • Repetitive strain injuries (RSI) at work, or overuse activities are common in people who participate in sport activities and individuals who have jobs that require performing activities of a repetitive nature.
  • Those participating in activities characterized by repetitive motions (jumping, running, etc.) that may aggravate the ankle, resulting in anterior ankle instability.
  • Sudden trauma or accident like a fall on the ankle
  • Tenderness of the ankle area, especially in the anterior region.
  • Discomfort with movement, especially with flexing the ankle
  • Feeling that the ankle is “dead” after repeated activity
  • A feeling that the ankle will “go out” when moving in certain positions. This is called the Apprehension Sign.
  • Significant pain of the ankle
  • Swelling, weakness, numbness and occasional bruising of the ankle area

Conservative treatment of anterior ankle instability is the first line of action. This includes physical therapy to reduce inflammation and associated pain. In addition, a regiment of exercises to improve muscle strength and ankle stability should be initiated. Bracing and the use of ankle supports may be indicated during rehabilitation and as a preventive measure. In more severe cases of instability involving other joint structures, surgical intervention may be necessary.

Physical Therapists are professionals, educated and trained to administer interventions. As stated in The Guide to Physical Therapist Practice interventions are the skilled and purposeful use of physical therapy methods and techniques to produce changes consistent with the diagnosis, prognosis, and the goals of the patient or client.

Common interventions in the treatment of anterior ankle instability include:

  • Manual Therapeutic Technique (MTT): hands on care, including soft tissue massage, and joint mobilization by a physical therapist to modulate pain and reduce any soft tissue or tendon irritation.
  • Therapeutic Exercises (TE) including strengthening exercises to improve strength of the lower leg muscles in the ankle and increase stability.
  • Neuromuscular Reeducation (NMR) to restore stability, begin retraining the lower extremity, improve joint stability and improve movement technique and mechanics (for example, jumping or running) in daily use of the involved lower extremity.
  • Modalities that can include the use of ultrasound, electrical stimulation, ice, cold laser and others to decrease pain and inflammation at the ankle and tendons.
  • Home program that includes strengthening, stretching and stabilization exercises as well as instructions to help the person perform daily tasks and advance to the next functional level.

Procedures that your physician may recommend and perform in addition to physical therapy include:

  • Initial immobilization of the instable ankle with boot or air-cast
  • REST and ICE
  • The use of NSAIDS (Non Steroidal Anti-Inflammatory Drugs)
  • Steroidal Injections to reduce inflammation
  • Pain medication to reduce the discomfort and allow the patient to perform the recommended exercises
  • Physical Therapy to include strengthening and work on balance and proprioception for ankle stability retraining
  • Surgery to correct underlying pathology and avoid instability and repeated dislocations. This may include surgical repairs or procedures to tighten the anterior ankle ligaments.

Prognosis

Most people recover full function following a course of conservative care of physical therapy to strengthen and stabilize the ankle. Those with more involved situations such as lateral ligament tears, or chronic dislocations will require surgery and intensive physical therapy afterward to restore full function.

Schedule an
Appointment!

Get back to doing what you love.

We are dedicated physical therapists that genuinely care. We strive to restore you to your former self, no matter the injury.

SCHEDULE APPOINTMENT

Real People, Real Testimonials.

The Bridgewater Location is excellent! Every single staff person is on point. From day one when I called to schedule my first appointment and throughout my treatment staff were helpful, professional, and overall a caring and compassionate team. Their professionalism and caring was evident not only in my treatment, also in the treatment of other patients. Being in a room with multiple treatment stations you cannot help but notice the care received by other patients. My ankle is 100% better and if I ever need PT again I would not hesitate to return. I was always a part of the therapy process, if I had questions they were answered. If I wanted to improve my ankle health at home I was provided clear instructions for exercises. Staff were skilled and knowledgeable. I highly recommend this location to family and friends.

Constance C.

My experience with Twin Boro after my total knee replacement has been exceptional. They made all my appointments to fit into my schedule, explained all my exercises to me and made me feel very confident that I would be taken care of.”

Patricia

“Thanks to Twin Boro I can still engage in activities and sports that I would not be able to had I not received high quality PT.”

Mitchell

"Eric was an excellent physical therapist. I made tremendous improvement during my time there. Rachel & Brittany were always smiling and creating a positive environment. Highly recommend using twinboro EHT!!!"

Ella G.

View all Testimonials

We have 23 convenient locations

We love being close to our patients. Find out which of our premier facilities is nearest you!

VIew a list of all locations