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Not all ankle instability is doe to recurrent injury. This patient has a varus hindfoot which puts his lateral ligaments at mechanical disadvantage.

"Giving way", weakness or instability of the ankle is a common complaint. Most often it is related to one or more injuries that have failed to resolve. Most such patients have some damage to their lateral ankle ligaments, proprioceptive abnormalities and other neuromuscular issues. However, sometimes there is an additional underlying chronic problem such a biomechanical abnormality or ankle arthritis.

In older people, it sometimes turns out that what the patient means is not that they get sudden episodes of giving way, but that their hindfoot is slowly becoming more tilted as a result of tibialis posterior tendon and deltoid/spring ligament dysfunction (adult acquired flatfoot). Therefore, it is important to ask exactly what problem the patient is having.