Why Do My Ankles Feel So Weak?

Posted 5 Jun '23

Been noticing that your ankles tend to feel weak when you’re out and about? You might feel like they’re a lot more prone to suddenly rolling in or out than they used to be, especially when you’re not wearing supportive shoes that offer firm stability around the ankle. You may feel like your ankle can just ‘give way’ at any time - a concerning thought for many. You may be getting bouts of tenderness, discomfort or swelling around your ankle, which can make it more tiresome to keep lifting your foot up at the ankle, as you go throughout your day.

While this can be immediately concerning in children and younger adults, for older adults, these symptoms may be taken for granted and written off as just a “normal part of ageing”. The truth is that it’s anything but normal - it’s (most likely) a medical condition called chronic ankle instability, with or without some muscle weakness of the ‘dorsiflexors’ at the front of the lower leg and foot. Here’s a look into why chronic ankle instability has been an incredibly common problem for our Brisbane podiatrists to see and treat, what exactly is going on when you’re feeling ankle weakness and instability, and how you can restore the strength and stability in your ankles - in some cases, almost instantly.

Chronic Ankle Instability: The Basics

Chronic ankle instability is a condition where your ankles have developed a level of weakness and instability to the point that they are prone to giving way during walking and everyday activities (and often even more so during sports and physical activity), leading to recurrent ankle sprains, pain and ongoing discomfort.

The cause of ankle instability is one that is surprising for most people - you know all the ankle sprains many have had in their earlier years that were simply ‘walked off’ instead of taking the right rehabilitative steps to care for and re-strengthen your ankle? Yep - it’s this repeated damage from the ankle sprains that leads to the ankle-supporting ligaments growing weaker and less stable over time. And here’s where the ‘vicious cycle’ begins - a weakened ankle means more risk of ankle sprains, which leads to further ankle weakening (if the right rehab isn’t taken). With several ankle sprains over many years, this eventually leads to the weak and unstable feelings on a daily basis. 

To add to the matter, whenever any inflammation occurs around the ankle, whether that’s following a sprain or just from the stress on the ankle, the problem of chronic ankle instability can also worsen because of the effect that prolonged inflammation can have on tissues.

Foot Drop Ankle Weakness

It’s worthwhile mentioning that another common cause of a weak feeling in the ankle, whether that occurs together with chronic ankle instability or separately, is a condition called foot drop. Foot drop occurs when an underlying problem with one of the nerves in your lower leg means that it can no longer effectively innervate the muscles that are responsible for allowing you to seamlessly lift your foot up relative to your ankle. In some cases, this can occur at the same time as an ankle sprain - such as when you roll your ankle during a sprain and fracture your fibula at the same time due to impact from the fall. 

You may also experience muscle weakness in the same muscle group for a range of other reasons - such as after a period of immobilisation, like in a cast or brace, where you haven’t been using the muscles for a prolonged period. If you have an element of this muscle weakness or foot drop you may struggle to lift your forefoot up, and you may notice your toes hitting the ground when you walk, making you more prone to tripping and falling.

Regardless of whether you’re dealing with just chronic ankle instability, or there is an additional element of muscle weakness involved - our podiatrists have a range of effective treatment solutions that can help you feel more confident and stable on your feet at any age.

How To Get Moving With Confidence And Stability

Our podiatry team has a very strong focus on chronic ankle instability and effective ankle sprain recovery - because we understand the ongoing effects it can have on a person’s life and not only their physical but their social and emotional well-being, too. Depending on your level of injury and the severity of your ankle instability and weakness, we’ll develop a unique treatment plan for you, which may involve:

• EXO-L Brace for ankle instability: EXO-L is a leading slimline ankle brace that is proven to prevent up to 95% of ankle sprains, while allowing your ankle to move freely and comfortably. Think of it like a seatbelt, kicking in when you need it most - the moment just before you roll your ankle and sprain your ligaments. This is a custom device made from a 3D scan of your ankle and a comprehensive assessment with your podiatrist. It cups the back of your ankle and uses the side of your shoes as an anchor point.
  
• Custom foot orthotics: orthotics are prescription medical devices that sit inside your shoes and can contain specifically-prescribed features, such as a raised lateral border and an increased heel cup depth, that best support the ankle, add stability during movement, and reduce the likelihood of a sprain. All of our orthotics are custom-made from a 3D scan of your foot paired with a comprehensive assessment, so we can prescribe the best features for your ankles and feet.
  
• Ankle strengthening exercises: part of your treatment will always involve a program to work on your ankle ligament strength, as well as proprioception training (balance and stability) and neuromuscular training to help retrain how your muscles activate. Completing your exercises means that over time, you’ll start experiencing noticeable differences to your ankle strength and function, and your confidence on your feet.
  
• EXO-UP brace for foot drop: if your primary issue is foot drop due to nerve damage, we may recommend the EXO-UP, the sister brace to the EXO-L listed above. This brace is slimline and versatile, connecting to your existing footwear to help keep your toes dorsiflexed (lifted) to help prevent tripping and falling. Like the EXO-L, it is also a custom-prescribed and designed brace involving a 3D scan and a comprehensive manufacturing process.
  
• Footwear assessment: your footwear can help add a great deal of stability to your daily life, which is why we always assess your footwear and give you recommendations of the best footwear to help support your ankle in light of your foot type and ankle characteristics. 
  
• Ankle surgery: given the success that we see from these conservative modalities in helping improve the quality of life of those with chronic ankle instability, we view ankle surgery as a final resort, due to the invasive nature of the procedure, the recovery time, and the risk factors.
  

Before you’re able to get in to see your podiatrist, something you can do immediately at home to help best support your ankle is switch to a supportive pair of shoes like running shoes that wrap around the ankle and support the ankle, so it cannot freely roll. If you have strapping tape at home, you can also try strapping your ankle to increase stability. If you’re experiencing pain, you may choose to use NSAIDs to help temporarily improve your comfort. If you’re not experiencing much pain and discomfort, you can also get started on some ankle instability exercises such as these.

Other treatment modalities that we offer that may be used alongside your therapy include:

• Shockwave therapy to provide pain relief, vascularisation, protein biosynthesis, cell proliferation which result in tissue regeneration.
  
• MLS deep tissue laser therapy - a painless treatment to relieve pain, reduce inflammation and promote healing and soft tissue repair.
  
• Trigger point dry needling the length and tension of muscles fibers and stimulate mechanoreceptors, increase muscle blood flow and oxygenation, reduces both central and peripheral sensitisation to pain to provide an analgesic effect. 
  
• Joint mobilisation to fire articular mechanoreceptors, reduce joint adhesions, decrease muscle guarding to provide pain relief and to treat reversible hypomobility of capsular origin. 

Final Point: Never Ignore Ankle Sprains

Ankle sprains can feel so commonplace that it may feel fine to just shrug them off, knowing that the pain will typically subside within a few days. However, according to the 2016 consensus on the long-term consequences of ankle sprains, here’s what you should know:

• If you’ve already had one ankle sprain, the chances of you having at least one other sprain is high, with factors such as your footwear, tendency to walk over uneven ground, your foot type and gait also influencing this risk.
  
• The majority of people with recurring ankle sprains are shown to develop chronic ankle instability over time.
  
• Ongoing ankle instability is associated with sensorimotor deficits, such as diminished reflexes, poorer motor control skills at the ankle, and difficulty perceiving touch, pressure, pain, and the position of the ankle at any given time.
  
• Ankle instability can lead to the early onset osteoarthritis of the ankle joint, linking back to the trauma sustained from the sprain.
  
• Both ankle sprains and chronic ankle instability are associated with decreases in physical activity levels, leading to a decrease in a person’s quality of life.
  
• The earlier that ankle sprains are treated with the help of an experienced health professional - the better the outcomes.
  
• Late treatment is always better than no treatment.

Book your appointment with our podiatry team online here or call us on (07) 3356 3579.