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If you find yourself twisting your ankle on even slightly uneven paths or repeatedly experience your ankle giving way on flat ground, it may not simply be that your ankles are weak. While many people dismiss this by saying, "I’ve always been prone to spraining my ankles," it is highly likely a clear medical condition known as Chronic Ankle Instability.

Chronic Ankle Instability is a condition where the ligaments, having failed to heal properly after repeated sprains, remain stretched or weakened. If you return to daily life without receiving appropriate treatment or before full recovery is achieved after an initial sprain, the mechanical stability of the ligaments and neuromuscular control decrease, leading to recurrent instability. This is not a mere bad habit, but a foot disorder that requires medical treatment.

The hallmark of Chronic Ankle Instability is the recurrence of specific symptoms. You may frequently twist your ankle on flat ground or slight inclines, and a persistent feeling of the ankle being "shaky" or unstable continues. Chronic pain or swelling on the outer side of the ankle persists, and the ankle becomes easily fatigued after exercise or walking. If your ankle never feels fully recovered after a sprain and symptoms repeat, you must suspect Chronic Ankle Instability.

Dr. Hong-Joon Choi, Director of Seoul Gunwoo Orthopedic Clinic (located near Gangil Station in Gangdong-gu, Seoul), emphasizes: "Frequent ankle sprains are not a simple habit, but a signal that your ligaments are failing to function correctly. If left untreated, the ankle cartilage can be repeatedly damaged, eventually leading to early-onset ankle arthritis. Therefore, an accurate diagnosis and appropriate treatment are essential."

Once ankle ligaments are stretched or torn, it is difficult for them to fully regain their original elasticity and strength. In particular, returning to daily activities after an initial sprain without sufficient treatment and rehabilitation leaves the ligaments in an incompletely healed state. As repeated injuries accumulate in this condition, the ligaments grow weaker, and the stability of the ankle joint continuously degrades.

A greater problem is that Chronic Ankle Instability is not just an issue with the ligaments. Due to repeated injuries, the neuromuscular control and proprioception around the ankle are also damaged. This diminishes the body's ability to react instantly in dangerous situations, creating a vicious cycle of re-injury.

To determine the treatment direction for Chronic Ankle Instability, the degree and scope of ligament damage, the presence of accompanying cartilage injury, and the alignment of the ankle must be precisely evaluated. Seoul Gunwoo Orthopedic Clinic utilizes ultrasound and MRI to closely examine the status of the ligaments and cartilage. It is our principle at Seoul Gunwoo Orthopedic Clinic to review the results with the patient and provide a thorough explanation, ensuring they fully understand their condition before deciding on a treatment plan together.

Chronic Ankle Instability does not always require surgery from the outset. If the degree of ligament damage is not severe and no cartilage injury is present, non-surgical treatments are prioritized. We approach treatment by restoring ligament stability and the function of the muscles around the ankle through rehabilitation (including ankle strengthening and balance training), wearing ankle braces, and extracorporeal shockwave therapy.

Dr. Choi explains, "In many cases, Chronic Ankle Instability can be sufficiently improved through proper rehabilitation alone. However, if symptoms persist despite non-surgical treatment or if the ligament damage is severe, surgical treatment must be considered."

If symptoms do not improve with conservative treatment, if the ligaments are severely damaged, or if repeated injuries have led to cartilage damage, surgical treatment is required. Seoul Gunwoo Orthopedic Clinic performs Arthroscopic Ligament Repair to minimize the burden of pain and scarring, tailored to the patient's condition.

Arthroscopic Ligament Repair is a procedure that helps restore the functional stability of the ankle by inserting an arthroscope through tiny incisions to suture the area from the anterior talofibular ligament to the calcaneofibular ligament connection. The surgery typically takes 20 to 30 minutes, and the hospitalization period is approximately 1 to 3 days. By minimizing the incision range, damage to surrounding healthy tissue is reduced, the risk of scars and complications is low, and a swift return to daily life can be expected.

In particular, a major advantage is the ability to directly check for internal inflammation and cartilage damage, allowing for simultaneous treatment if issues are found. Dr. Choi notes, "In patients with Chronic Ankle Instability, cartilage damage is often found as an accompanying issue. Using an arthroscope allows us to identify and treat both ligament and cartilage problems at once, reducing the burden on the patient."

In the treatment of Chronic Ankle Instability, rehabilitation is just as vital as the surgery itself. Following surgery, a step-by-step rehabilitation program is essential to restore ankle strength and proprioception and to normalize walking functions. If rehabilitation is insufficient, instability may recur even after surgery. Seoul Gunwoo Orthopedic Clinic manages the entire process to ensure patients safely return to their daily lives through a systematic rehabilitation program.

Dr. Hong-Joon Choi, Director of Seoul Gunwoo Orthopedic Clinic, is a foot and ankle specialist who holds a Ph.D. from Korea University and served as a Research Fellow at the Massachusetts General Hospital (MGH), Harvard Medical School. He is a co-author of the revised medical textbook Foot and Ankle, published by the Korean Foot and Ankle Society, and brings a wealth of clinical experience, having treated over 80,000 patients and performed approximately 9,000 surgeries.

Dedicated to the diagnosis and treatment of all foot and ankle conditions—including hallux valgus, ligament and cartilage injuries, plantar fasciitis, Achilles tendinitis, and ankle arthritis—Seoul Gunwoo Orthopedic Clinic strives for the foot health of patients in Gangdong-gu, Hanam, and the Misa area.

If your ankle is repeatedly unstable, please do not dismiss it as a habit and seek an accurate diagnosis.

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