Physiotherapy may not help ankle sprains: study

Physiotherapy may not be helpful for certain types of sprained ankle injuries, a new study has found.

Published in The BMJ, the research found that physiotherapy for simple ankle sprains has no “clinically important improvements” when compared to self care at home.

“More than 40 per cent of patients fail to recover because of persistent pain, recurrent injury and instability,” the paper reads. “These symptoms, which are characteristic of chronic ankle instability, result in long term constraints to levels of physical activity and could be a key mediator for post-traumatic osteoarthritis.”

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The study looked at 503 patients between the ages of 16 to 79 who visited emergency departments with mild or moderate ankle sprains between 2009 and 2013.

Patients were split into two groups: the first received physiotherapy and home care, and the second received home care with basic instructions on managing the injury themselves (which included protection, rest, ice, the use of a compression bandage, elevation and painkillers).

They followed the patients’ progress at one, three and six months.

After analyzing their findings, researchers found that 43 per cent of patients in the physiotherapy group and 38 per cent in the home care group had not reached “excellent recovery” by the study’s end.

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A finding the researchers found interesting was that just under 60 per cent of participants reported having a previous ankle injury at the time of the study. They say this further highlights the tendency for poor recovery after an ankle sprain, as well as the high occurrence.

They also believe that recurrent injury is a common symptom of chronic ankle instability, which is an important thing to know when undergoing therapeutic exercise.

According to researchers, lateral ankle sprains are the most commons musculoskeletal injuries for those who are physically active. Incidents rates for the general population are also high as it’s estimated that five to seven injuries per 1,000 people per year suffer from a sprained ankle.

How to treat a sprain ankle

If you’re treating a ankle sprain at home, the Mayo Clinic outlines four steps you should take known as R.I.C.E.

R: Rest. Avoid any movement that causes pain, swelling and/or discomfort.

I: Ice. Keep ice on the area for 15 to 20 minutes and repeat every two to three hours while you’re awake.

C: Compression. Wrap your ankle in a compression bandage until the swelling subsides. Do not wrap it too tightly as it can cut off circulation. Begin wrapping at the end farthest from you heart.

E: Elevation. Elevate your ankle above the level of your heart to reduce swelling. It helps to drain excess fluid.