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.

"I went from being almost totally debilitated by a pelvic fracture to being able to negotiate 6 flights of stairs. Therapy was intense, therapist are knowledgeable, helpful,encouraging and respectful. I highly recommend this facility."

Stephanie R.

“The treatment and tips on how to get around on my prosthetic leg has made all aspects of daily life possible.”

John

“I loved being a patient at your facility because your therapist went by my and the doctors needs. I was there not only at the old location in somerset but also I went to the new location to in North Brunswick, which I loved it was bigger and better. All of the therapist are so friendly and nice and treated you with respect. I was treated by not only Melvie but also Nick and both are so professional and gentle of the way they did my treatments. If I ever need to have physical therapy in the future I will definitely come back to your facility for you are very professional and well organized. I have been to other places but your facility beats them all.”

Christine

"The employees are a wonderful bunch of people to be around. They're friendly & give the place a hometown feel. All the therapists are really nice. RosaAnna is my PT girl. Her TLC of my muscle/injury issues has made my life much better."

Valerie I.

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