Ankle Sprain: Getting Back to Action Faster!

Recovery that falls short can lead to other and even more severe leg injuries in both the short and long term. With an annual incidence of 10 ankle sprains per 1,000 people, ankle sprains prove relatively common.¹ The general public either believes the healthcare profession has little to offer or tends to regard the injuries as self-limiting and benign, resulting in a pattern of patients seeking medical care for roughly half of these injuries. Worse yet, only a small percentage of people receive supervised rehabilitation for these injuries.²

Immobilization

Immobilization of ankle sprains is somewhat controversial. In the recent past, research suggested that healthcare providers should be doing less of it. On the other hand, there is now Grade A evidence supporting the conclusion that immobilization of severe (grade 3) ankle sprains followed by functional treatment provides better functional outcomes compared to functional treatment alone.³ Nevertheless, immobilization is associated with worse range of motion in early treatment and delayed return to play. If an ankle is to be immobilized, how can we mitigate these effects and speed the process.

Isometric Exercise During Immobilization Improves Range of Motion and Speeds Recovery

Researchers from Japan measured the effects of isometric exercise during immobilization. The journal Physical Therapy in Sport published their results last November.⁴ Isometric exercise is a form of activity in which a person contracts muscles but without moving the joint appreciably. Eighty-two patients with lateral ankle sprain received a short-leg cast. Half participated in isometric exercises, and half did not. When the cast came off, the isometric exercise group had 55% better range of motion. They returned to play 29% faster (46 versus 65 days). A physiotherapist can help develop and train people in safe, effective exercise plans for ankle sprains.  

More Resources

• Risk of ACL Injury Soars Five Times Higher after an Ankle Sprain
• Acute Ankle Sprain: Supervised Physiotherapy Superior to Written Instructions
• CHECK OUT OUR FREE E-BOOK: GUIDE TO ANKLE INJURIES

References

1. Kramer LC, Denegar CR, Buckley WE, Hertel J. Factors associated with anterior cruciate ligament injury: history in female athletes. Journal of Sports Medicine and Physical Fitness. 2007 Dec 1;47(4):446. (500% higher risk)
2. Terada M, Pietrosimone B, Gribble PA. Individuals with chronic ankle instability exhibit altered landing knee kinematics: potential link with the mechanism of loading for the anterior cruciate ligament. Clinical Biomechanics. 2014 Dec 1;29(10):1125-30.
3. Warren A, Davis A, Kraszkiewicz T. Short-term Immobilization versus Functional Treatment of Severe Ankle Sprains: A Critically Appraised Topic. Oklahoma State Medical Proceedings. 2020 Dec 7;4(3).
4. Toyoshima Y, Akagi R, Nabeshima K. Isometric exercise during immobilization reduces the time to return to play after lateral ankle sprain. Physical Therapy in Sport. 2021 Nov 1;52:168-72.