Massage therapy · Kitchener–WaterlooChronic Ankle Instability

Chronic ankle instability is characterised by the ankle giving way on a recurring basis. The condition often develops after someone suffers repeated ankle sprains (Zhang et al., 2026). Most of the time, the giving way occurs when walking or doing other activities, but it can happen even when standing still. A number of athletes suffer from the condition. People who have chronic ankle instability often complain about:

• An ankle that repeatedly turns, especially on an uneven surface or when playing sports
• Ongoing swelling and discomfort
• Tenderness or pain, usually along the outside of the ankle
• An unstable or wobbly feeling in the ankle
• Difficulty balancing on one leg

Chronic Ankle Instability Anatomy

How to Treat Chronic Ankle Instability

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Ankle instability can make it difficult to run, play sports, walk and stand comfortably, so it is worth treating properly.
• Most of the time, the instability is due to recurring sprains that happen because the ligaments have not had time to heal fully (American Academy of Orthopaedic Surgeons, n.d.).
• Balance exercises are key! Poor balance often leads to repeat sprains and ankle instability (American Academy of Orthopaedic Surgeons, n.d.). Work hard on the ankle exercises and be persistent – it takes time.
• The majority of safety measures are common sense, such as wearing shoes that give your foot and ankle enough support (American Academy of Orthopaedic Surgeons, n.d.).
• By neglecting a minor injury, it can turn into a bigger problem down the line. If you're unsure, ask me and I'll take a look.

An ankle that keeps giving way usually needs more than time: it needs the strength, balance and control that repeated sprains can leave behind. My aim is to rebuild those step by step, so your ankle feels steady on uneven ground and copes with your sport again.

I start by assessing how your ankle moves, testing the ligaments, the strength of your ankle, calf and hip, and your balance on each leg. I also look at how you walk and ask when it gives way.

Settling It Down

• Hands-on work for the calf and the muscles along the outside of the shin, which often stay guarded after repeated sprains
• Cross-fibre work across the old ligament injury once it isn't freshly sprained
• Gentle joint mobilisation if the ankle has become stiff, without stretching the loose ligaments
• Warm or cool applications in the clinic, and I'll show you how to use ice at home if it swells after activity

Strength and Balance

• Pain-free holds pushing the foot outward, then resistance-band work for the outer shin muscles
• Balance work from supported to unsupported, then reaching, then a cushion or balance board
• Calf raises, single-leg work and hip and thigh strength, so the whole leg helps control the ankle
• Later, gym-based progressions, hopping, cutting and sport-specific drills for a graded return to sport
• A home programme between visits

Support

1. Zhang, J., Chen, C., Hong, J. et al. (2026) '2025 Chinese clinical practice consensus and guideline on chronic lateral ankle instability', International Journal of Surgery, 112(4), pp. 8995–9001. doi: 10.1097/JS9.0000000000004337
2. American Academy of Orthopaedic Surgeons (n.d.) Sprained ankle. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/sprained-ankle/ (Accessed: 7 October 2026).
3. NHS (2024) Sprains and strains. Available at: https://www.nhs.uk/conditions/sprains-and-strains/ (Accessed: 7 October 2026).