Ankle sprain: pathophysiology, predisposing factors, and management strategies

Abstract

Abstract:With the high percentage (up to 75%) of initial lateral ankle sprains (LAS) leading to repetitive sprains and chronic symptoms, it is imperative to better understand how best to treat and rehabilitate LAS events. The purpose of this paper is to review LAS pathophysiology, predisposing factors, and the current evidence regarding therapeutic modalities and exercises used in the treatment of LAS. Functional rehabilitation, early mobilization with support, is the current standard of care for LAS. However, the high percentage of reinjury occurrence and development of chronic symptoms (up to 75%) after a LAS, suggests the current standard of care may not be effective. Recent evidence has shown the need for more stringent immobilization to facilitate ligament healing and restoration of joint stability and function after a LAS. Additionally, the importance of adding adjunctive therapies, specifically joint mobilizations and balance training have been shown to improve function and decrease the incidence of reinjury after a LAS. Modifying current rehabilitation protocols to include protecting the ankle joint with stringent immobilization, and including joint mobilizations and balance training may be the first step to decreasing the incidence of short and long term ankle joint dysfunction.

Semi-Rigid Cast versus Elastic Bandage in Grade II Lateral Ankle Sprain Treatment

“…Not only CAI limit physical activity, but CAI also leads to articular degeneration of the talus, and an increased risk of osteoarthritis. (10,23) Authors of recent review determined that lateral ankle sprains contributed to 13% to 22% of all osteoarthritis cases involving the ankle and 80% of posttraumatic osteoarthritic cases (2,24). In this study, there was no significant difference between ankle instability occurrences between groups.…”

“…Treatment options for these injuries continue to evolve as advances are made in terms of techniques and materials, but the optimum management is still open to debate. In most emergency departments, patients are given an elastic support bandage, but in some departments, a wool and crepe wrap round bandage is used (9,10). Recent evidence has shown the need for more stringent immobilization to facilitate ligament healing and restoration of joint stability and function (10).…”

Effect of Four Weeks of Home-Based Balance Training on the Performance in Individuals with Functional Ankle Instability: A Remote Online Study

“…In more than 70% of people who suffered from lateral ankle sprain, the residual effects remained for up to 18 months after the initial injury [7,8]. Recent studies found a significant association between ankle injury, recurrence and subjective feeling of giving away [9,10].…”

The Effect of Balance and Combined Exercises on Pain and Functional Characteristics of Female Athletes With Chronic Ankle Instability

“…n ankle joint is among the joints with the most sports injuries [1,2]. A lateral ankle sprain is one of the most common inju-A ries that occur during exercise and performing daily living activities [3,4]. These injuries occur more frequently in football, futsal, basketball, volleyball, and sports requiring quick body direction change [1].…”

“…These injuries occur more frequently in football, futsal, basketball, volleyball, and sports requiring quick body direction change [1]. Studies have suggested that muscle weakness, followed by increased ankle joint laxity and sensory-motor deficits as a result of a sprain, is associated with deficits in balance, postural control, and function [3]. Balance training, Pilates, core body stabilization, as well as aquatic and preoperative exercises, are recommended to improve the performance of individuals with chronic ankle instability.…”