Definition of Ankle Sprain
It is an injury of the lateral ligament complex at the ankle joint. Basically it occurs when the foot turns or twists beyond the normal range of movement, causing the ligaments that connect the bones of the leg, ankle and foot to tear or overstretch.
Intrinsic and extrinsic risk factor are out of the management of physiotherapy and increase the chances of ankle sprain. Athletes with ankle sprain histories are five times more likely to suffer the injury compared to their uninjured counterparts. Height and weight affect the possibility of suffering an ankle sprain with taller heavier athletes being more exposed. Age is another intrinsic risk with younger athletes being more prone to suffering ankle sprains. The extrinsic factors include the level of the competition with the risk heightening uniformly with the progress. The playing surface is a risk with artificial surfaces raising the risk. The type of sport is another factor with soccer having lower risks compared to basketball, volleyball and mountain climbing.
Ottawa Ankle Rules
In activities of daily living (ADL), lateral ankle injuries (LAI) exhibiting a fracture is a concern. The rules are developed to eliminated the possibilities of fractures after one has sustained an acute ankle injury. Further they purpose to the costs and numbers of radiographic procedures. It is based on a questionnaire and a research protocol upon which one may only be subject to X-ray diagnosis if they indicate pain in the middle foot combined with palpation pain at the base of metatarsal bone V, if they cannot walk at least for steps or experience palpation the navicular bone.
The presence of hematoma development and local pressure pain being experienced by the patient at palpation or an anterior drawer test is present or both are exhibited indicates that it is very likely there is a ligament fracture.
Examination of the patients 4-5 days after the trauma gives a better diagnostic result within 48 hours.
Ice and compression in the inflammatory phase of the acute phase of the ankle sprain is significant treatment when accompanied with rest and elevation.
Immobilization is also a mechanism of treatment in acute phase of the LAI. The use of plaster or rigid support ensures rapid decrease of pain and swelling.
Braces are more efficient in use during immobilization or exercise therapy compared to elastic tapes as one easily resumes their activities but the later has fewer complications.
Exercise therapy is another form of treat of LAI in its acute phase and it is significant in prevent recurrence on the long term.
It is advisable to perform functional treatment over surgical therapy in treatment of acute lateral ankle ligament.
Communication between Professionals
Referring professionals can make the communication and treatment process short and effective by providing correct information. This can be facilitated by the use of an information checklist.
Exercise therapy that involves training in balance and coordination within 12 months of the occurrence of the injury inhibits its recurrence.
Tapes or braces can be used to prevent inversion injuries when the patient is active on sports or their daily activities.
Outcome and Impairment measures
Evaluation of the treatment effectiveness ought to be made using one or more valid, reliable and sensitive to change tools. The measures should reflect the outcomes by being functional. Examples include the maximal wide hop and single leg stance test.
Impairment measures are significant for noticing change during the treatment. Using the weight bearing lunge test gives excellent results on inter and intra tester reliability.
Resumption of ADL
When it is work, having a return to work schedule and strategy is important in optimization of the reintegration process.
Among athletes, a rehabilitation process is essential to ensure they maintain among other aspects their strength, coordination and function.
Kerkhoffs, G. M., van den Bekerom, M., Elders, L. A., van Beek, P. A., Hullegie, W. A., Bloemers, G. M., … & Hoogstraten, J. W. A. P. (2012). Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline. British journal of sports medicine, 46(12), 854-860.