Ankle Supports – Help For Chronic Instability
Chronic ankle instability (CAI), is a condition of the foot that often persists after an initial ankle sprain. Many turn to ankle supports for help. The condition is described as self reported disability, recurrent ankle injury, reduced activity levels, and sensorimotor deficits or integration of the sensory and motor systems.
The causes can be varied, including altered gait mechanics after the initial sprain. Patients with instability have a more inverted foot position and decreased foot to floor clearance during walking and jogging, with a more lateral or outside foot positioning and loading pattern during barefoot running, center of pressure during side shifting.
The inconsistency of foot positioning and faulty gait patterns may increase the risk of further ankle injury. It only takes only an instant for an unstable ankle joint to exceed its safe ligament and tendon functional limits to be re-injured. Ankle supports to increase stability may help.
Higher injury rates and severity have been seen toward the end of soccer practices and games indicating increased fatigue of the neuromuscular-control system. Nearly half of all ankle sprains in soccer happened during the last third of each half of matches. Fatigue during sustained athletic activity is considered an important risk factor for ankle sprain.[1]
Dynamic postural control is disrupted in patients with chronic ankle instability and is amplified by fatigue.[2] Variation in movement during a stop/jump maneuver shows greater variation of ankle motion in the frontal plane movement more than those who had sprained their ankles only once showing greater unstable restraint.[3]
There is less consistent positioning of the foot in the frontal plane and if it is unable to be controlled or too much, it may exceed the limits of safe movement patterns, leading to further injury and instability.
Solutions With Ankle Supports
Supports should be part of the solution. Strengthening appropriate muscles and proper healing during the initial stage of injury are important in prevention. Also, checking the knee as the next part in the kinetic chain because interconnected joints and muscles work together in motion, as the body acts as a series of linked segments.
Elastic ankle supports reduce the range unwanted sagittal plane ankle motion during running with chronic ankle instability. This may reduce the risk for recurrent ankle sprains.[4] Ankle braces are used for minor injuries as well. Instability can be mechanical and usually is related to ligament laxity and and also functional – related to posture defects or tendons and muscles.
Biomechanics of the ankle are complex and not reduced to simple up and down movements. There is a combination of the particular joint surfaces and a multi-axis ligament system, as well as arthritis.
Injury is the main mechanism responsible for ligament lesions, and the most frequent is inversion or a typical ankle strain. In chronic instability, there can be nerve, bone, cartilage and tendon pathology, which can play a role in the instability syndrome. To help with instability, minor or chronic, ankle braces can help provide relief.
Ligament lesions determine laxity or loosening, which is characteristic of mechanical instability. Functional instability goes along with proprioceptive deficiency. This is stimulation produced and perceived within the ankle, particularly those connected with position and movement.
Assessment and treatment adapted to the instability which considers these factors are crucial. To assist in stabilizing, ankle braces are often employed along with rest and ice. Stabilization braces are crucial after surgery. Joint motion problems often result from structure and organization of joint surfaces and a the ligament system.
Balance impairments and decreased balance confidence are associated with symptomatic radiographic ankle osteoarthritis and balance deficits may be related to symptoms, rather than radiographic evidence of disease.[5] Ankle pain with and without foot pain is associated with increased odds of symptomatic knee osteoarthritis and frequent knee pain more so than foot pain alone.[6]
To Conclude:
Chronic ankle instability can cause decreased postural control, altered gait mechanics, impaired proprioception, and can be challenged with complex neuro-physiological changes.[7] Supports are part of the solution along with exercise and professional evaluation.
References:
1. Br J Sports Med. 2003 Jun;37(3):233-8
2. J Athl Train. 2004 Dec;39(4):321-329
3. Clin Biomech (Bristol). 2009 Nov;24(9):762-8
4. Gait Posture. 2021 Jun:87:149-155
5. Gait Posture. 2021 Oct:90:61-66
6. Osteoarthr Cartil Open. 2021 Dec;3(4):100210
7. Gait Posture. 2023 Sep:106:28-33