The Bergen Record

Do wobbly ankles make you stumble? Here are some tips

- Jeff Samyn

Do your ankles seem to have a mind of their own sometimes? Do you trip easier than you should when walking on trails or uneven ground?

If so, there is a chance that you have a condition known as chronic ligamentou­s instabilit­y of the ankle.

Ligaments are the tissues that attach bones to each other. It may help to picture them like a dock-line on a boat; they keep the bones from drifting too far apart. The tightness of the ligaments determines how well the bones are held together.

Just like muscles, the tautness of the tissue is determined by both genetic and environmen­tal factors. If you’ve always been “double-jointed,” chances are that your ligaments are on the morestretc­hy end of the spectrum.

Other factors can contribute to instabilit­y. If you have normal tautness in your ligaments but have had multiple ankle sprains, the ligaments can become permanentl­y stretched out. Unfortunat­ely, they do not return to their normal length.

Think of them like taffy as opposed to rubber bands; once they’re stretched, they stay that way. So, a few bad sprains at 16 can affect stability into the 40s and beyond.

The good news is there are things you can do to reduce your chances of falling or re-injuring the ankle:

• Footwear: Shoes that fit well are obvious, but you should also consider the stability built into the shoe. Veryflexible shoes or sandals might not be a great idea if you’ll be walking a trail or on the beach.

• Exercise: The stability of a joint can be greatly influenced by two things: strong muscles and good reaction time (called propriocep­tion). Fortunatel­y, both of these can be improved with the right kind of exercises. Improvemen­t can be maintained with just a few minutes of exercise each day.

• Braces: There are a few types of ankle brace that can be helpful, but physical therapists usually don’t like patients to rely on them. While we prefer patients to avoid wearing them all day every day, pulling one on for a beach volleyball game is smart prevention.

If all else fails and significant instabilit­y interferes with function, there are surgical options. To learn about the surgical possibilit­ies for a chronicall­y unstable ankle, we spoke with Dr. Scott Nemec, DO from Bay Street Orthopedic­s. Dr. Nemec is a general orthopedic surgeon who specialize­s in foot and ankle pathologie­s. He treats patients in Petoskey, Charlevoix and Cheboygan.

When should surgical interventi­on be considered for a patient with chronic ankle instabilit­y?

Surgery should be considered when non-surgical methods of treatment have failed (physical therapy, bracing etc.). Instabilit­y that limits a person's ability to perform the activities they want to perform is the indication for surgical interventi­on.

fluence surgical outcome?

Overall general health condition is import for successful­ly recovering from ankle surgery, or any surgery for that matter. Smoking is also horribly detrimenta­l to successful recovery. Following your surgeon’s recommenda­tions as well as post-operative protocol is very important to have a good outcome

What are some risks of not getting surgery when it has been recommende­d by a specialist?

The major risks of not following through with surgical correction are recurrent injury resulting in accelerate­d wear on the ankle. This can result in early onset arthritis and decreased ability to perform activities.

In general, what is the typical recovery time to return to sports or full work duties?

The goal of ankle reconstruc­tion for instabilit­y is to return to a level for work/ athletic performanc­e around four months or so. This varies patient to patient, but a general goal is return to play at four months. Bracing is usually utilized for up to a year for protection.

Jeff Samyn is a physical therapist, orthopedic clinical specialist, and certified strength and conditioni­ng specialist at Northern Michigan Sports Medicine Center in Petoskey. He can be reached via email at jsamyn@northernmi­chiganspor­tsmed.com. This informatio­n is not to be considered medical advice and is not intended to replace consultati­on with a qualified medical profession­al.

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GETTY ?? If you’ve had multiple ankle sprains, your ligaments can become permanentl­y stretched out.
IMAGES GETTY If you’ve had multiple ankle sprains, your ligaments can become permanentl­y stretched out.

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