Shoes for Ankle Instability and Frequent Ankle Rolling

If your ankle gives way on flat ground, on a kerb or on tiles, the cause is often chronic ankle instability. After one or two sprains the ligaments hold the joint less firmly, and the foot easily rolls onto its outer edge. Shoes do not repair ligaments, but they can remove what provokes a roll: a narrow heel, a soft heel counter, a tall sole and a pair in which the heel moves around.

This article is for general information. The workshop does not diagnose or replace a doctor: diagnosis, treatment and any correction are decided by a medical specialist. Bespoke shoes are made to follow a doctor’s recommendations.

What ankle instability is

The ankle is held by ligaments, the lower leg muscles and the sense of where the joint is. After a sprain of the outer ligaments some people recover completely, while others are left with a feeling that the ankle “gives way”.

The roll almost always goes inwards: the sole turns towards the other foot, weight moves onto the outer edge, and the ligaments stretch again. Each new episode makes the next one more likely.

There is mechanical instability, when the ligaments are lengthened or torn, and functional instability, when the joint is intact but the muscles and balance react late. Which one you have is established by a trauma or orthopaedic specialist through examination, tests and imaging.

See a doctor first

If the ankle keeps rolling, swells, hurts after walking or clicks, see a doctor first. They will assess the ligaments, rule out damage to the cartilage and the peroneal tendons and prescribe treatment: balance exercises, taping, a brace or surgery.

Shoes play a supporting role in this plan. They do not replace exercises or a prescribed brace, but they can make walking calmer and remove some everyday risks. The workshop builds the doctor’s recommendations into the construction of the pair.

Which shoe details provoke a roll

A narrow, tall heel. The contact area is small, the centre of gravity is high, and the smallest stone under the edge of the heel tips the foot over.

A soft heel counter. The heel shifts inside it, and the foot starts to tip before the muscles can react.

A thick soft sole. A tall cushioned platform lifts the foot and compresses when you step on its edge, creating a tilt.

A sole narrow at the outer edge. If the sole is narrower than the foot, the outer edge overhangs with nothing underneath.

A loose fit. If the foot slides inside the pair, the shoe does not hold it at all, however sturdy it is.

Shaft height: what the research says

A high shaft covering the ankle seems the obvious answer. The research shows a more complicated picture.

In an experiment with a sudden 35-degree tilt of a platform in twenty men, high-top boots reduced the angle of inversion by 4.5 degrees and slowed it down. The authors write that under some loads a high shaft may help avoid some sprains.

In another study, landing on a tilted surface showed no difference in maximum inversion angle between high-top and low-top trainers, and some of the lower leg muscles switched on later in the high shoes.

A third study compared walking in shoes and barefoot in twenty-one people with chronic ankle instability. In shoes, some of the biomechanical deviations linked with instability were less pronounced than barefoot.

For everyday shoes the practical conclusion is simple: a high shaft helps if it fits snugly around the ankle and is laced up. A loose shaft works like an ordinary low shoe.

Heel counter and heel fit

A firm heel counter keeps the heel bone upright. The earlier the foot starts to tip, the easier it is to stop, and the counter takes out the first degrees of tilt.

In a bespoke pair the counter is moulded to the heel, so it sits with no gap. In a ready-made pair the heel is often smaller than the counter, and the space between them lets the foot shift.

With instability the counter can be extended higher than usual on the outer side, almost to the ankle bone. From outside it looks like an ordinary boot; inside it works as a lateral support.

Heel and sole width

For frequent rolling the heel is made wide, with a large contact area. For an everyday pair that usually means two to three centimetres. A tall thin heel with ankle instability is almost always kept for special occasions and short outings.

The sole is made a few millimetres wider than the foot along the outer edge. This projection, a lateral flare, catches the foot at the start of a roll and returns it.

If the doctor has prescribed a lateral wedge, a slight raise of the sole or insole along the outer edge, it is built into the construction and the last.

Lacing and fixation

Laces hold the foot in the pair. With ankle instability, boots and shoes laced up to the instep and higher work best. Slip-ons and moccasins barely hold the foot.

The lacing is made with hooks in the upper part so it can be pulled tighter at the ankle than over the toes. The top then holds the joint while the toe stays free.

A side zip makes it easier to put on but does not hold the foot by itself. It is added together with laces when you need to get your shoes on quickly.

Which styles work

Lace-up boots with a high shaft: the most common choice for the city and walking.

Derbies and low shoes with a firm counter: for the office, when a high shaft under trousers is out of place.

Chelsea boots work less well with instability, because elastic does not hold the ankle the way laces do. If you want the style, it is made with a firm counter and a shaft fitted to the ankle.

For women: lace-up ankle boots on a stable heel and loafers with a firm counter. Stilettos and backless mules do not suit frequent rolling.

Shoes for an ankle brace

If the doctor has prescribed a brace or support, it takes up room in the shoe. An ordinary pair will not go over it or presses, and people take the brace off to get their shoes on.

In that case the last is built with the brace on the foot. The volume at the ankle and instep is set for its thickness, and the shaft opens wider so the braced foot slides in easily.

Bring the brace to the measuring appointment, together with the insole if you have one. Without them the last would have to be remade.

After ligament surgery

After lateral ligament reconstruction the surgeon gives a plan: how long to walk in a boot brace, when to move to ordinary shoes and what loads are allowed.

The first pair after the brace is usually a boot with a high shaft, a firm counter and a wide sole. The leg may swell during this period, so measurements are taken once the swelling has settled, with some extra volume left around the ankle.

The timing of the move to ordinary shoes is decided by the surgeon. The pair can be made in advance, but the fitting is scheduled for when the leg is back to its working volume.

Different feet and rolling

Usually one ankle rolls more often. If one side is unstable, the lasts are built separately, and on that side the counter and lateral support are made stronger.

A high-arched, cavus foot tends to roll: its heel often tilts inwards, in the same direction as the roll. In that case the lateral support and wedge are discussed with the orthopaedist in particular detail.

If a leg length difference comes on top of the rolling, the compensation is built into the same pair so the tilt does not load the joint.

Sport and walking

Running, games and training need sports shoes and the protection prescribed by your doctor: tape or a brace. Bespoke shoes cover everyday life, the city and travel.

For walking on uneven ground and in the mountains we make boots with a high shaft, a firm counter and a wide patterned rubber sole. The sole is kept low so the foot stays close to the ground.

A slippery sole also provokes rolling: the leg slides sideways and the foot has to catch its balance. For winter the sole is chosen with ice in mind.

Home, country house and stairs

Many rolls happen at home: in slippers, flip-flops, on porch steps. Backless indoor shoes do not hold the heel at all.

If the ankle rolls often, doctors usually advise wearing shoes with a heel counter at home too. For the house and garden we make light low shoes or sandals with a closed heel and a strap over the instep.

On stairs, place the whole foot on the step. A sole with a crisp edge and slip-resistant rubber helps you not slide off the nosing.

Season and weather

In winter the risk of rolling grows because of ice and ruts in the snow. A winter boot for ankle instability has a high shaft, a firm counter and a wide rubber sole that keeps its grip in the cold.

Fur inside must not get in the way of fixation. Its thickness is built into the last so the laces can be pulled snug at the ankle and the heel does not slide in the fur.

In summer, sandals with a firm heel, an ankle strap and a wide sole work for instability. Flip-flops and backless clogs are for the beach and short outings.

Weight and flexibility of the pair

A heavy boot tires the lower leg muscles by evening, and tired muscles are slower to catch a roll. So a pair for instability is stable but carries no extra weight: stiffness comes from the counter and the shank, and the sole thickness stays moderate.

The sole should bend at the toes and stay stiff under the arch and heel. If a boot bends in the middle or twists in your hands, it will not hold the foot at the moment of a roll.

This is easy to check: hold the pair by the toe and heel and try to twist it. In a suitable shoe you feel the resistance straight away.

How to tell the pair fits

At the fitting, stand on one leg for half a minute. In a suitable pair the heel does not shift and the outer edge of the sole does not compress.

Walk across an uneven floor or a step. If the foot goes sideways sooner than in your usual shoes, the counter or sole is adjusted on the trial shoe.

Why clients come after other workshops

Clients with unstable ankles often come after a pair with a soft counter and a sole narrower than the foot. Such shoes look sturdy but do not hold at the moment of a roll.

Sergey Grechushkin builds the lasts himself from measurements of both feet and does the pattern cutting himself. The firmness of the counter, the sole width and the heel fit are checked on a demo pair, a trial shoe, before the main pair is made.

How the work is done

Both feet are measured standing and sitting, the ankle bones are marked, and old shoes are examined: wear on the outer edge of the heel shows clearly how the foot tips.

Making the lasts takes about six weeks, after which the trial shoe is made. A pair starts from 100,000 ₽, and once the last is ready, a pair takes from four weeks.

Bring the doctor’s report, the insole and the brace to the measuring appointment if they have been prescribed. The workshop is on Shelaputinsky Lane 6/3 near Taganskaya metro in Moscow, 10:00–20:00 by appointment only.

Wear and care

Break the new pair in at home and on flat surfaces before going out onto cobbles and stairs.

Check the heel tip and the outer edge of the heel once a month. A worn, slanted heel tip tilts the foot by itself, so it is replaced while the slant is still small.

The counter softens with time. If the heel starts to move, bring the pair to the workshop: the counter can be restored.