Rehabilitation of Lateral Ankle Sprains in Sports

Abstract

Lateral ankle sprains are one of the most common injuries in athletes. The rate of injury is as high as 70%. The most commonly involved ligament is the anterior talofibular ligament (ATFL), followed by the calcaneofibular (CFL) and posterior talofibular ligament (PTFL). The common mechanism of injury is inversion with excessive ankle supination in forced plantarflexion when the ankle joint is in its most unstable position. There are three grades of ankle sprains: Grade I, mild with an incomplete tear of ATFL; Grade II, moderate with a complete tear of ATFL with or without an incomplete tear of CFL; and Grade III, severe with complete tear of ATFL and CFL. Grades I and II respond well to functional treatment. Functional treatment includes RICE protocol, i.e., rest, ice, compression, and elevation. It also includes range of motion and strengthening exercises, proprioceptive training, and sports-specific exercises. Bracing and taping of the ankle joint help in preventing the sprains and also reduce the recurrence of the injury. Grade III ankle injury may be treated with surgery if the symptoms persist post functional treatment. The guidelines provided for the treatment of ankle sprains are of general validity, but each athlete is different with different needs. Hence, a personalized exercise protocol should be followed to achieve best results.

Effectiveness of Ultrasound-Guided Platelet-Rich Plasma Injection in Comparison with Standard Conservative Treatment on Improving Pain and Function Among the Athletes with Partial Tear of Anterior Talofibular Ligament of Ankle: A Randomized Controlled Trial

“…Exclusion criteria: MRI diagnosed other associated ligamentous injuries of ankle, any associated fracture around the ankle, patients who received corticosteroid injection within last 12 weeks, history of platelet dysfunction syndromes, malignancy, thrombocytopenia. A sample size of 48 was calculated using formula N=(Zα + Zβ) 2 (𝑆1 2 +𝑆2 2 )/(𝑚1−𝑚2) 2 According to a study conducted by Dhaundiyal S et al 17…”

“…Ankle is the most commonly affected joint in the world of sports and its injuries accounts for 10% to 30% of all injuries. 1,2,3 Among all ankle injuries, ankle sprains are the most common accounting for approximately 80% of which 77% are lateral ankle sprains. 4,5,6,7 73% of lateral ankle sprains are due to rupture or tear of the anterior talofibular ligament (ATFL) and ATFL is the weakest ligament in the lateral collateral complex of the ankle.…”

“…9 It is commonly seen in sports where there is involvement of frequent jumping, running, pivoting, sudden stopping, acceleration and lunging movement like in football, field hockey, basketball tennis, badminton, ballet/dance etc. 2,6,10 The symptoms of ATFL injury includes pain, swelling, weakness and instability of ankle joint and typically results in a temporary period of reduced functioning and disability. 5,8 It has numerous sequelae that contribute to a substantial healthcare burden from the indirect cost of follow up care, loss of productivity, time loss of activity and care of its long-term consequences.…”

“…These should include sports-specific exercises specific to the particular sport played by the athlete. 2 Although the initial line of management remains a functional rehabilitation, surgery should be considered if the symptoms persist. 2 A previous study revealed that patients who underwent acute surgical treatment took longer to return to work.…”

“…2 Although the initial line of management remains a functional rehabilitation, surgery should be considered if the symptoms persist. 2 A previous study revealed that patients who underwent acute surgical treatment took longer to return to work. Also, studies revealed that surgery was not helpful in reducing additional complications, costs and risks.…”