What is the "Floppy Ankle" and why is it clinically important for chiropractors?

The 'Floppy Ankle' refers to chronic ankle instability resulting from repeated lateral sprains that damage the lateral ligamentous complex, producing pathological laxity and altered neuromuscular control. It is clinically important because chronically unstable ankles are a significant source of recurrent injury, gait dysfunction, and kinetic chain disruption affecting the knee, hip, and spine — all areas chiropractors routinely manage.

What does the ortho/neuro perspective mean in the context of this course?

This course examines chronic ankle instability through both an orthopedic lens (ligamentous anatomy, mechanical stability, injury mechanisms) and a neurologic lens (proprioceptive deficits, neuromuscular control, and the neurological basis of chronic instability). Dr. Hall integrates both perspectives to help practitioners develop more complete and effective management plans.

What topics are covered in Orthopedics 218?

The course covers the clinical anatomy of the ankle joint complex including osseous articulations, ligamentous arrangements, and longitudinal arches; the mechanism of injury and best practices for common ankle sprains; orthopedic and neurologic perspectives on ankle stability and the resting attitude of the foot; and comprehensive rehabilitative strategies for various chronic ankle injuries.

Orthopedics

Orthopedics 218: "The Floppy Ankle" — Ortho/Neuro Perspective on Chronic Ankle Injuries | CCEDseminars

Q: Is Orthopedics 218 approved for CE credit in my state?

CCEDseminars is a PACE-approved provider through the Federation of Chiropractic Licensing Boards (FCLB Provider #34015544). Orthopedics 218 is approved in numerous U.S. states, Canadian provinces, and international regions. Please review the State Approvals section on the course page or contact us to confirm acceptance in your jurisdiction.

Online Chiropractic CE Course Description & Course Details

ONLINE | RECORDED

Course	Orthopedics 218: “The Floppy Ankle” — An Ortho/Neuro Perspective on Chronic Ankle Injuries
Instructor	Michael Hall, DC, FIACN
CE Hours	2 Hours
Format	Online — Self-Paced, Available On Demand
Price	$40.00
PACE Provider	#34015544

Chronic ankle instability is one of the most underappreciated drivers of recurrent lower extremity injury and kinetic chain dysfunction in chiropractic patients. In Orthopedics 218: “The Floppy Ankle” — An Ortho/Neuro Perspective on Chronic Ankle Injuries, Dr. Michael Hall, DC, FIACN delivers a uniquely integrated 2-hour online CE course that examines chronic ankle instability through both an orthopedic and neurologic framework. You will deepen your understanding of ankle joint anatomy, refine your assessment of mechanical vs. functional instability, and build a clinical toolkit for evidence-based rehabilitation — giving your patients a genuine path to lasting stability and return to full activity.

Michael Hall, DC, FIACN

Fellow, International Academy of Chiropractic Neurology

Dr. Michael Hall is a chiropractic educator and clinician with advanced training in chiropractic neurology. As a Fellow of the International Academy of Chiropractic Neurology (FIACN), Dr. Hall brings a neurology-informed, evidence-based lens to orthopedic examination and conservative management. He is one of CCEDseminars' most prolific instructors, with courses spanning orthopedics, neurology, documentation, ethics, and clinical compliance.

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— Rob Rosenbaum, DC

Course Description

The chronically unstable ankle — the “floppy ankle” — is far more than a mechanical problem. Repeated lateral ankle sprains do not simply stretch or tear ligaments; they disrupt the rich network of mechanoreceptors embedded in those structures, producing proprioceptive deficits, altered neuromuscular firing patterns, and a compromised ability to sense and respond to joint position changes in real time. Left unaddressed, these neurological impairments perpetuate the cycle of re-injury and can contribute to chronic pain, functional instability, and progressive degeneration of the ankle joint complex.

In Orthopedics 218: “The Floppy Ankle”, Dr. Michael Hall, DC, FIACN brings together orthopedic and neurologic expertise to provide a clinically comprehensive approach to this condition. The course opens with a detailed review of ankle joint anatomy — the osseous articulations of the talocrural and subtalar joints, the ligamentous architecture of the lateral, medial, and syndesmotic complexes, and the role of the longitudinal arches in load distribution and dynamic stability.

From there, Dr. Hall walks through the common ankle sprain in depth — mechanism of injury, grading of ligamentous disruption, acute versus chronic presentations, and current best practices in both immediate and long-term management. The ortho/neuro perspective is then applied: how mechanical instability and neurological impairment interact, why the resting attitude of the foot is a key clinical indicator, and how to design rehabilitation programs that restore not just strength and range of motion, but sensorimotor function and dynamic joint stability.

This course equips chiropractors with the knowledge to move beyond simple taping and stretching protocols toward truly integrative, outcomes-focused care for the chronically unstable ankle.

Learning Objectives

Upon successful completion of this course, the participant will be able to:

Gain a thorough understanding of the clinical anatomy of the foot and ankle, including osseous articulations, ligamentous arrangements of the lateral, medial, and syndesmotic complexes, and the role of longitudinal arches in dynamic stability.
Critically evaluate current practices in managing chronic ankle injuries, integrating orthopedic and neurologic assessment frameworks to differentiate mechanical from functional instability.
Develop comprehensive rehabilitative strategies for various ankle injuries, incorporating sensorimotor retraining, progressive loading protocols, and evidence-based approaches to restoring dynamic joint stability.

Course Outline

I. Ankle Joint Complex — Clinical Anatomy

Osseous articulations — talocrural joint, subtalar joint, midtarsal complex
Ligamentous arrangements — lateral complex (ATFL, CFL, PTFL), deltoid ligament, syndesmotic complex
Longitudinal arches — medial and lateral arch structure and load distribution
Intrinsic and extrinsic musculature contributions to dynamic stability
Mechanoreceptor distribution and proprioceptive function in the ankle ligaments

II. The Common Ankle Sprain — Mechanism and Management

Mechanism of injury — inversion, plantarflexion, and supination patterns
Grading of lateral ligamentous disruption (Grade I–III)
Acute vs. chronic presentation — distinguishing features
Current best practices — PEACE & LOVE framework, early protected mobilization
Why ankle sprains recur — proprioceptive and neuromuscular deficits

III. The Ortho/Neuro Perspective on Ankle Stability

Mechanical instability vs. functional instability — clinical differentiation
Resting attitude of the foot — clinical significance and assessment
Neurological contributors to chronic instability — proprioceptive loss, altered reflex arcs
Kinetic chain implications — ankle instability and knee, hip, lumbar spine involvement
Orthopedic special tests — anterior drawer, talar tilt, external rotation stress test

IV. Comprehensive Rehabilitative Strategies

Phase I — acute management, swelling control, protected weight-bearing
Phase II — range of motion restoration and early proprioceptive training
Phase III — progressive strengthening — peroneals, tibialis anterior and posterior, intrinsics
Phase IV — sensorimotor retraining — balance board, single-leg stability progressions
Phase V — sport-specific and functional return-to-activity programming
Bracing, taping, and orthotics — evidence and clinical decision-making
When to refer — surgical consultation criteria for chronic mechanical instability

Course Technology & Access

How to Join: The course title in your account is the access link. No software installation is required. The course is accessible through any modern browser on desktop, tablet, or mobile devices.

This is a self-paced online course available on demand. Once registered, you can access the course content at any time from your CCEDseminars account.

A CE certificate is issued upon successful completion of the course evaluation. Please retain your certificate for state licensing board submission.

State Approvals & Accreditation

CCEDseminars is a PACE-approved provider through the Federation of Chiropractic Licensing Boards (FCLB). PACE Provider #: 34015544.

Questions about your state's approved credit hours? Contact us at info@ccedseminars.com.

Frequently Asked Questions

What is the “Floppy Ankle”?

The “Floppy Ankle” refers to chronic ankle instability — pathological laxity and neuromuscular dysfunction resulting from repeated lateral ankle sprains. It produces ongoing instability, proprioceptive deficits, and a high risk of recurrent injury if not properly rehabilitated.

What topics are covered in this course?

The course covers clinical anatomy of the ankle joint complex, the mechanism and management of common ankle sprains, orthopedic and neurologic perspectives on ankle stability, and comprehensive phased rehabilitation strategies for chronic ankle injuries.

How many CE hours does this course provide?

Orthopedics 218 provides 2 continuing education (CE) hours for licensed chiropractors.

How do I access this course after registering?

The course title in your account is the access link. No software installation is required. The course is accessible through any modern browser on desktop, tablet, or mobile devices.

What is the cost?

Orthopedics 218: “The Floppy Ankle” is available for $40.00.

Is this course approved in my state?

CCEDseminars is a PACE-approved provider (FCLB Provider #34015544). Orthopedics 218 is approved in numerous U.S. states, Canadian provinces, and international regions. Please check the State Approvals section below on this page or contact us for your jurisdiction.

Ready to master chronic ankle instability from both sides of the clinical equation?

2 CE Hours | Online | $40.00 | PACE Approved #34015544

References

Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train. 2002;37(4):364–375. PMC164373
Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med. 2014;44(1):123–140. doi:10.1007/s40279-013-0102-5. PubMed
Hiller CE, Kilbreath SL, Refshauge KM. Chronic ankle instability: evolution of the model. J Athl Train. 2011;46(2):133–141. doi:10.4085/1062-6050-46.2.133. PubMed
Vuurberg G, Hoorntje A, Wink LM, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018;52(15):956. doi:10.1136/bjsports-2017-098106. PubMed

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