Why does my ankle keep giving way?
Because two things that a sprain damages were probably never fully restored. One is the ligament (mechanical) side, but the bigger factor in most people is the functional side – the ankle”s sense of position and the split-second muscle reactions that stop a roll. If those are not retrained after a sprain, the ankle stays unreliable and re-sprains easily. That is the cycle, and it is very treatable once the real cause is addressed.
Do I need surgery to fix an unstable ankle?
Usually not. The great majority of chronic ankle instability comes from incomplete rehabilitation, not from ligaments that need surgical repair – and it responds very well to a structured balance-and-strength programme. Surgery (ligament repair) is genuinely useful, but only for the minority with true mechanical laxity that has failed a proper rehab effort. So we start by fixing what was missed, and reserve surgery for those who really need it.
What does the rehabilitation actually involve?
Its heart is balance and proprioception training – progressively challenging the ankle”s control system to react correctly – which is the best-evidenced treatment and measurably reduces recurrent sprains. Alongside it, we strengthen the peroneal and lower-leg muscles that actively guard the ankle, and retrain sport-specific cutting, landing and agility before return. It is active, progressive, and it works because the ankle re-learns control through practice.
I just wear a brace – is that enough?
A brace or tape is genuinely useful for high-risk activity while you rebuild, and reduces the chance of a sprain in the moment. But on its own it does not fix the underlying deficits – the ankle stays functionally unreliable without it. The durable solution is the balance and strength work; the brace is a helpful support during that process, not a substitute for it.
Could there be something else wrong in there?
Sometimes, and we check. A chronically painful, swollen, catching or clicking ankle that is not responding to good rehab can hide another injury – a cartilage (osteochondral) lesion, a peroneal tendon tear, or a subtle bony injury from the original sprain. If your ankle is not behaving like simple instability, we investigate (usually MRI) rather than just pushing on – because treating the wrong problem will not work.
When is surgery indicated?
When there is genuine mechanical instability – demonstrable ligament laxity – that continues to cause giving-way despite a real, completed balance-and-strength programme, or when a hidden structural injury (cartilage or tendon) needs addressing. Ligament repair has good outcomes in the right candidate. But because most instability is functional and rehab-responsive, surgery is the exception, not the starting point – and even after surgery, the same balance rehabilitation is essential.
