Evidence-Based Physical Therapy Management for Chronic Ankle Instability in Young Females: A Systematic Review

Chronic ankle instability (CAI) is a prevalent and debilitating musculoskeletal condition, particularly among young active females, resulting from recurrent lateral ankle sprains and subsequent neuromuscular deficits. Despite its high incidence in this demographic, evidence-based physiotherapy protocols tailored specifically to young female populations remain understudied. The primary aim of this review was to analyze evidence-based physical therapy interventions for CAI in young females, synthesize current findings on therapeutic efficacy, and identify gaps that warrant further investigation. A thorough online search for papers published between 2014 and 2026 was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 methodology across PubMed, Google Scholar, Scopus, Excerpta Medica Database (EMBASE), and the Cochrane Library. Thirteen studies satisfied the requirements for inclusion. The Risk of Bias-2 (RoB-2) tool for randomized controlled trials (RCTs) and the AXIS tool (appraisal tool for cross-sectional studies) were used to evaluate methodological quality. The selected research frequently indicated that structured physiotherapy encompassing balance training, neuromuscular re-education, peroneal strengthening, whole-body vibration, joint mobilization, proprioceptive neuromuscular facilitation (PNF) stretching, core stabilization, and multimodal rehabilitation significantly improves dynamic balance, proprioception, functional performance, and self-reported function in young females with CAI. Multimodal physiotherapy targeting neuromuscular and sensorimotor deficits is highly effective for CAI management in young females. Early identification, individualized programming, and integration of core and proximal strengthening into rehabilitation protocols are essential for optimizing outcomes and reducing reinjury risk.