How effective is physiotherapy for chronic ankle instability?

Chronic ankle instability often follows repeated sprains and may cause a feeling that the ankle gives way on uneven ground, stairs or during sport. Physiotherapy examines ankle movement, calf and foot strength, balance, walking and the confidence to load the leg. Treatment commonly progresses from controlled range-of-motion work to calf and ankle strengthening, single-leg balance, landing or change-of-direction practice, and sport-specific tasks. A brace or tape may provide short-term support while control develops, but it does not replace rehabilitation.

Complete balance and strengthening exercises regularly, using a stable surface first and progressing only when you can control the movement. Wear suitable footwear and use a brace for activities recommended by your clinician. Practise uneven-surface and direction-change tasks under supervision before returning to demanding sport. If an exercise causes swelling, sharp pain or repeated giving-way, reduce the challenge and tell the physiotherapist. Previous sprains may also need attention to calf flexibility and foot mechanics.

Seek prompt assessment after a new injury if you cannot bear weight, the ankle looks deformed, swelling is marked, or pain is directly over a bone. Arrange review for persistent swelling, locking, numbness or repeated giving-way despite rehabilitation. Urgent care is needed if the foot becomes cold, pale or unusually numb.

Is a ligament injury or another ankle problem contributing to the instability? When can I progress from balance work to running? Should I use a brace for sport? What signs would justify imaging or a surgical opinion?