Explanation of Diagnosis

Ankle instability is a chronic condition where the ankle repeatedly gives way due to weakened ligaments and muscles, often following repeated sprains or inadequate rehabilitation. Symptoms include frequent ankle rolling, pain, swelling, and a feeling of unsteadiness on uneven surfaces or during activity.

Specific Work Modifications

• Avoid prolonged standing or walking on uneven surfaces.
• Wear supportive shoes with ankle stabilization (high-top sneakers or ankle brace).
• Use anti-fatigue mats if standing for long periods.
• Modify tasks to allow sitting breaks and reduce stress on the ankle.
• Avoid carrying heavy loads that could increase fall risk.

Specific Activity Modifications

• Avoid high-impact activities (running, jumping, hiking on uneven terrain) until stability improves.
• Modify workouts by switching to low-impact exercises like swimming, cycling, or elliptical training.
• Use an ankle brace or tape when returning to sports.
• Perform ankle-strengthening and balance exercises daily to prevent re-injury.

Recommended Supplements

• Collagen peptides (10 g daily) – Supports ligament and tendon strength.
• Vitamin C (500 mg daily) – Aids in collagen synthesis and tissue healing.
• Magnesium (300-400 mg daily) – Helps with muscle relaxation and recovery.
• Omega-3 fatty acids (1000 mg daily) – Reduces inflammation.
• Turmeric (500 mg twice daily) – Supports joint and ligament health.

Recommended Nutrition and Hydration

Diet Recommendations:

• Anti-inflammatory foods: Fatty fish (salmon, sardines), turmeric, berries, nuts, and leafy greens.
• Collagen-boosting foods: Bone broth, citrus fruits, and bell peppers.
• Protein-rich foods: Chicken, eggs, lentils, and dairy to support ligament repair.
• Limit processed foods, sugar, and alcohol, which can worsen inflammation.

Hydration Tips:

• Drink at least 2–3 liters of water daily to support muscle and joint health.
• Limit caffeine and alcohol, which can dehydrate tissues and slow recovery.

Home Exercise Prescription

Perform 2-3 times daily to strengthen the ankle and improve stability:

Phase 1: Strengthening (Weeks 1-4, Rebuild Ligament Support)

1. Towel Scrunches (Arch Strengthening)

1. • Place a towel under your foot and scrunch it toward you using your toes.
   • 10 reps, 2 times daily.

2. Resistance Band Ankle Strengthening

1. • Use a resistance band to strengthen ankle movements (up, down, inward, outward).
   • 10 reps per direction, 2 times daily.

3. Heel Raises

1. • Stand and slowly raise onto your toes, then lower.
   • 10 reps, 2 times daily.

Phase 2: Balance & Proprioception (Weeks 4+, Prevent Future Injuries)

4. Single-Leg Balance Exercise

1. • Stand on the affected foot for 15-30 seconds, increasing time as tolerated.
   • Repeat 2-3 times per leg.

5. Balance Board or Bosu Ball Training

1. • Stand on a wobble board or Bosu ball to challenge stability.
   • 1-2 minutes, 1-2 times daily.

6. Heel-to-Toe Walk (Tightrope Walking)

1. • Walk in a straight line, placing one foot directly in front of the other.
   • 20 steps, 2 times daily.

⚠ Avoid uneven terrain, running, or cutting movements until stability improves.

Helpful Books

1. "Rehab Science: How to Overcome Pain and Heal from Injury" – Tom Walters, DPT
2. "The Athlete’s Guide to Ankle & Foot Injuries" – Brian Shiple, DO

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.