Lateral Ankle Sprains: Injury & Treatments

Lateral Ankle Sprains: Injury & Treatments

INJURY GRADES

GRADE I (mild):

• Ligament fibre stretch, no rupture.
• Minor swelling.
• Palpatory tenderness.
• Minor functional loss.
• No increased instability.

GRADE II (moderate):

• Partial ligament tear.
• Moderate pain.
• Swelling and palpatory tenderness.
• Mild instability.
• Moderate functional disability.

GRADE III (severe):

• Complete tear of ligament and joint capsule. Severe bruising, swelling, pain.
• Significant loss of function.
• Increased instability.
• Unable to bear weight.

✅✅
TREATMENT:
Non-operative measures for Grades I–III have good to excellent outcomes.
✅
Treatment is based on the 3 phases of biological ligament healing:

• Inflammatory
• Proliferation
• Remodelling.

🔥🔥
INFLAMMATORY:
🔥
Avoid swelling and ongoing injury. 
🔥
POLICE 4-5 days:

• Protect
• Optimal loading
• Ice
• Compression
• Elevation

🔥
NSAIDs decreases pain without adverse events.
🔥
Manual therapy has minimal benefits.
🔥
No effect found from ultrasound, laser, or electrotherapy.
🔥
Short-term brace (<10 days) for Grd III, can speed recovery vs. compression bandage.
🔥
Long-term brace (> 2 weeks) leads to poorer outcomes. .
💭💭
PROLIFERATION (6-12 wks):
💭
Controlled stress promotes proper collagen orientation.
💭
Protection from prevents formation of weaker type III collagen. .
💭
External ankle brace can help, mores than tape.
💭
Exercises are essential:

• Early active range of motion
• Strengthening
• Proprioceptive
• Functional

📊📊
REMODELLING (1 yr):
📊
Simulate physical demands of sport: Jumping.

• Turning
• Twisting

📊
Supervision by a multidisciplinary team is helpful.
📊
Functional treatment is preferred over surgery.
📊
Surgical treatment may be beneficial in some elite athletes.
📊
Considering:

• Timing in the season
• Expectations
• Sports specific ankle load
• Individual history
• Stage of career
• Time to diagnosis
• Combined injury
• Access to expert imaging and treatment

Thoughts? Questions? Comments?
🧠
Comment on @physicaltherapyresearch instagram - reposted with permission

#physicaltherapyresearch #atfl # anklesprain
📚📚📚
SOURCE:
D’Hooghe, et al. 2020. Return to Play After a Lateral Ligament Ankle S

Dalton Urrutia, MSc PT

Dalton is a Physical Therapist from Oregon, currently living and running the performance physiotherapy clinic he founded in London for Grapplers and Strength & Conditioning athletes. Dalton runs the popular instagram account @physicaltherapyresearch, where he posts easy summaries of current and relevant research on health, fitness, and rehab topics. 

Want to learn more or contact him?

Reach out online:

@physicaltherapyresearch

@Grapplersperformance

www.grapplersperformance.com

Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!

Learn more online - new online discussion group included!

Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. 

• NEW - Online Discussion Group
• Live cases
• webinars
• lecture
• Live Q&A
• over 600 videos - hundreds of techniques and more! 
• Check out MMT Insiders

Keeping it Eclectic...

This article was originally posted on Modern Manual Therapy Blog

Via Wellness http://www.rssmix.com/