With an annual incidence of 7 sprains per 1000 individuals, ankle sprains are one of the most common orthopedic injuries. 85% of all sprains are lateral ankle sprains, involving the outside of the ankle. These involve the flexed and inverted foot. Of those individuals who sustain an ankle sprain, 72 % report symptoms at 6 month follow up, authors report. The least severe injuries on a 3 point scale, Grade I and II, are most likely to reoccur. This may lead to chronic symptoms of instability.
Early protection and controlled motion following an acute ankle sprain is recommended by physical therapists. An ankle sprain can often lead to reduced hip motor function, increasing the patient’s risk to further injuries. In an effort to return the patient to their prior level of activity, PT works to correct these imbalances throughout the lower quarter. In order to reduce patients’ pain and improve function, authors recommend a multimodal treatment approach including manual therapy, exercise, early weight bearing and balance interventions.
Weight bearing, with or without assistive devices, following an ankle sprain has been proven to benefit the patient, as opposed to no weigh bearing exercises. A Physical Therapy approach of manual therapy and R.I.C.E (rest, ice, compression and exercise) is shown to be more beneficial than just the utilization of R.I.C.E. alone.
The combination of manual therapy, balance/proprioceptive training and returning to sport exercise prescription is proven to be a more effective treatment program, designed to reduce pain, disability and to prevent ankle injury recurrence.
A prospective study of 85 patients with acute ankle sprains, conducted by Whitman et al, noted that 75% of patients showed that in the first week of a manual therapy and exercise approach , patients had an immediate improvement in their symptoms and function. Patients with ankle sprains had an overall improvement in pain and motion and had a decrease in disability following manual therapy program, according to a recent review.
Patients may have an earlier return to their exercise program as a result of restoring range of motion and decreasing pain processing from joints of the lower extremity. At both 4 weeks and 6 months after their sprain, patients that underwent a formal Physical Therapy program of manual therapy and exercise, were more improved than those with a home program, reported Cleland et al.
Following an acute ankle sprain, recommendations include balance training programs, in order to reduce postural sway, to improve joint function and stability and to prevent recurrence.
Ankle Sprains – Combination of Manual Therapy and Supervised Excercise Leads to Better Recovery
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In the event of an acute ankle injury, patients should look to Physical Therapy services in order to facilitate return to sport and prevent recurrence. Patients will be treated with manual therapy, exercise and balance training and sport specific exercise interventions.
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