By Lenae Sexton, PT, DPT, OCS
The dreaded ankle sprain! Always seems to happen at the most inopportune time: a week before a race, the day before a vacation, etc. Such a nuisance! In my experience, most people consider this injury to be minor. They throw some ice on it, rest a day, and get back to it. Years ago I felt the same way. However, what I have seen in the clinic has changed my take on the matter.
We get a considerable number of patients who have not recovered from their ankle sprain 4+ weeks after the injury. They are finally referred to physical therapy after going to their orthopaedist when they didn’t bounce back like they expected. They drag themselves into our office frustrated and discouraged. And guess what – they recover with great success! BUT, the recovery often takes longer because of the delay in care. So, do all ankle sprains need physical therapy? How does one know when to head to a PT?
According to a study done by Doherty, et al…
If 2 weeks after your first sprain you are:
unable to perform jumping and landing tasks with the same quality as pre-injury
AND
you have compromised balance compared to pre-injury
THEN
you need targeted care!3
Here are some tidbits from current research to explain why:
- Comparing to a “wait-and-see” policy, a targeted training program gives better results for pain and function long term AND a decrease in recurrence of sprain.4
- After an ankle sprain, there is increased dependence on the non-injured limb which may have implications for future injury risk on both sides.2
- In individuals with chronic ankle instability (persisting instability after the acute symptoms of pain and swelling have primarily resolved), there is not only impaired movement at the ankle but also at the hip and knee which may have implications for future injury risk at each of those regions.1
In short, a solid rehab program is a good idea for both short-term and long-term health of the entire movement system after an ankle sprain.
If this info speaks to you, come and see us! If this info seems valuable for a friend or family member, forward it on to them and urge them to come see us! No need to suffer from the repercussions of ankle sprains!
1 Doherty, C., Bleakley, C., Hertel, J. et al. Dynamic balance deficits in individuals with chronic ankle instability compared to ankle sprain copers 1 year after a first-time lateral ankle sprain injury. Knee Surgery, Sports Traumatology, Arthroscopy (2016) 24: 1086.
2 Doherty, C., Bleakley, C., Hertel, J. et al. Lower extremity coordination and symmetry patterns during a drop vertical jump task following acute ankle sprain. Human Movement Science (2014) 38: 34-46.
3 Doherty, C., Bleakley, C., Hertel, J. et al. Recovery From a First-Time Lateral Ankle Sprain and the Predictors of Chronic Ankle Instability: A Prospective Cohort Analysis. The American Journal of Sports Medicine (2016) 44 (4).
4 Van Ochten, J., Van Middelkoop, M., Meuffels, D., et al. Chronic complaints after ankle sprains: a systematic review on effectiveness of treatments. Journal of Orthopaedic & Sports Physical Therapy (2014) 44 (11): 862-C23