Inclusion Criteria:  Clinical diagnosis of lateral ankle pain and instability Beighton score ≥4 Age with 18 to 60 years  Exclusion Criteria:  Patients with an acute or subacute ankle injury (within 3 months) Injury of the deltoid ligament Alignment of lower extremity greater than 5 degrees Fractures of the lower extremity Stage III or IV osteoarthritis Patients who refused to participate in the study