Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
Related Conditions
Quick Answer
Chronic Ankle Instability 2026: Treatment in Michigan DPM relates to foot pain — typically caused by overuse, footwear, or biomechanics. Most patients improve in 6-12 weeks with conservative care. Appointments in Howell + Bloomfield Township: (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Township, MI. Last updated April 2026.
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Chronic Ankle Instability Treatment Michigan
Chronic ankle instability (CAI) is a condition in which the ankle repeatedly gives way during activity or even with routine walking — typically as a result of incompletely healed lateral ankle ligaments after one or more ankle sprains. It affects an estimated 20–40% of people following acute ankle sprains and is one of the most common reasons active adults and athletes seek podiatric care. Dr. Tom Biernacki DPM at Balance Foot & Ankle treats chronic ankle instability in Michigan at our Howell, Brighton, and Bloomfield Township locations.
Why Does Ankle Instability Become Chronic?
After an acute lateral ankle sprain, the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) may heal in a lengthened or attenuated position, leaving permanent laxity. Proprioception (joint position sense) is also disrupted — damaged mechanoreceptors in the ligaments fail to provide accurate feedback to the neuromuscular system. Without rehabilitation, these deficits compound with each subsequent sprain, creating a cycle of instability, re-sprains, and progressive lateral ankle cartilage damage.
Symptoms
- Recurrent ankle sprains — especially on uneven surfaces
- Sensation of the ankle “giving way” during activity
- Persistent lateral ankle pain and swelling
- Apprehension about activities requiring lateral movement
- Weakness of the peroneal muscles
Diagnosis
Dr. Biernacki performs the anterior drawer test and talar tilt test to assess ATFL and CFL laxity. Stress X-rays under fluoroscopy quantify talar tilt and anterior drawer displacement compared to the contralateral side. MRI evaluates ligament integrity, osteochondral lesions of the talus (which commonly co-exist with CAI), peroneal tendon tears, and sinus tarsi syndrome — all of which can contribute to ongoing symptoms and must be addressed at surgery if present.
Treatment
Physical therapy is first-line treatment for CAI. Targeted programs improve peroneal muscle strength, proprioception, and neuromuscular coordination. Supervised rehabilitation using balance boards, perturbation training, and sport-specific exercises can resolve CAI in 60–70% of patients.
Ankle bracing with a lace-up or hinged brace reduces re-sprain risk during sports and activity. Bracing is used as a bridge during rehabilitation and long-term for patients who prefer non-surgical management.
Brostrom-Gould ligament reconstruction is the gold standard surgical procedure for CAI that has failed conservative care. Dr. Biernacki imbrications and tightens the ATFL and CFL back to anatomic length through a small lateral ankle incision, reinforced with the inferior extensor retinaculum (Gould modification). Outcomes are excellent — over 85% of patients return to full athletic activity. Arthroscopy prior to open reconstruction allows simultaneous treatment of osteochondral lesions and removal of loose bodies.
Frequently Asked Questions
How many ankle sprains does it take to develop chronic instability?
CAI can develop after a single severe sprain that is inadequately rehabilitated, or after multiple less severe sprains. The key risk factor is incomplete rehabilitation — returning to activity before proprioception and strength are fully restored.
What is the recovery from Brostrom ankle reconstruction?
Patients are non-weight-bearing in a splint for 2 weeks, followed by a CAM boot for 4 weeks with progressive weight-bearing. Physical therapy begins at 6 weeks. Return to sport typically occurs at 4–6 months.
Schedule your ankle instability evaluation at Balance Foot & Ankle in Howell, Brighton, or Bloomfield Township, Michigan. Dr. Biernacki offers online booking 24/7.
Dr. Tom’s Recommended Products for Ankle Pain & Injuries
📍 Located in Michigan?
Our board-certified podiatrists treat this condition at two convenient locations. Book online 24/7 at either office.
These are products I personally use and recommend to my patients at Balance Foot & Ankle.
- ASO Ankle Stabilizing Orthosis — Figure-8 straps with bilateral stability columns — the gold standard lace-up ankle brace for return to sport
- McDavid 195 Ankle Brace — Hinged design allows dorsiflexion/plantarflexion while blocking inversion — best for chronic lateral instability
- Doctor Hoy’s Natural Pain Relief Gel 3oz — Menthol-based cryotherapy — penetrates soft tissue to reduce ankle sprain inflammation and acute pain
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we trust for our own patients.
Dr. Tom’s Recommended: Natural Topical Pain Relief
This is what I actually use in our clinic at Balance Foot & Ankle.
- Doctor Hoy’s Natural Pain Relief Gel — Natural topical pain relief I use in our clinic. Arnica + camphor formula. Apply directly to the painful area 3-4x daily for fast-acting relief without NSAIDs.
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we trust for our own patients.
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- Aircast Air-Stirrup — Gold Standard Ankle Brace
- Zamst A2-DX — Maximum Support for Athletes
- McDavid Lace-Up Ankle Brace — Everyday Stability
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Insurance Accepted
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Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Township Office
43494 Woodward Ave, #208
Bloomfield Township, MI 48302
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In-Office Treatment at Balance Foot & Ankle
When conservative care isn’t enough, Dr. Tom Biernacki and the team at Balance Foot & Ankle offer advanced treatment options — including Ankle Sprain & Instability Treatment in Michigan at our Howell and Bloomfield Township clinics.
Book online 24/7. Call (810) 206-1402 or book online.
Pros & Cons of Conservative Care for foot care
Advantages
- ✓ Conservative care first
- ✓ Book online 24/7
- ✓ Multiple insurance accepted
Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
Dr. Tom’s Recommended Products for foot care
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
Footnanny Heel Cream Dr. Tom’s Pick
Best for: Daily moisturizer for cracked heels
Ready to Get Back on Your Feet?
Appointments in Howell + Bloomfield Township. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
Call Now: (810) 206-1402
In-Office Treatment at Balance Foot & Ankle
If home treatment isn’t providing relief for your ankle conditions, our podiatry team at Balance Foot & Ankle can help with expert evaluations and advanced in-office care.
Book online 24/7. (810) 206-1402
Ready for Expert Care?
Appointments in Howell & Bloomfield Township, MI.
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Or call: (810) 206-1402
