Dr. Vaishali Suri (P.T.)
Chronic Ankle Instability: When Sprains Keep Recurring
Chronic ankle instability (CAI) is defined as a history of repeated lateral ankle sprains (3 or more) with persistent feelings of giving way and functional instability. It affects 30-40% of patients following acute lateral ankle sprains -- most commonly because the initial sprain was inadequately rehabilitated, leaving proprioceptive deficits that allow recurrent sprains to occur on minimal provocation.
What Perpetuates CAI
After an ankle sprain, the ATFL (anterior talofibular ligament) and sometimes CFL (calcaneofibular ligament) are damaged along with their incorporated mechanoreceptors. Without specific rehabilitation, the ankle develops: decreased joint position sense, delayed peroneal muscle reaction time (peroneal muscles protect the ankle from sprains), decreased dorsiflexion range (tight calf), and an altered movement pattern avoiding full weight-bearing on the unstable ankle. All of these perpetuate the instability.
Physiotherapy Programme for CAI
Balance and Proprioception Training
Systematic single-leg balance training progressing from flat surface to foam pad to BOSU ball. Eyes-open progression to eyes-closed. Static progression to dynamic (reaching in multiple directions, ball catching). This is the most evidence-based intervention for CAI.
Peroneal Muscle Strengthening
Eversion strengthening with elastic resistance, single-leg hopping with peroneal focus, reactive balance training that challenges the peroneal reflex response.
Dorsiflexion Restoration
Calf stretching (both gastrocnemius and soleus) and ankle joint mobilisation to restore full dorsiflexion range -- critical for normal gait biomechanics and ankle stability.
CAI Treatment in Faridabad
At Realign Rehab Clinic, NIT-5, Faridabad, we break the ankle sprain recurrence cycle. Book your chronic ankle assessment today.