What are the treatment options for ankle sprains?

Updated: Jan 14, 2019
  • Author: Craig C Young, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

Pain reduction is essential, but improvement of any loss of motion, strength, and/or proprioception is equally important. [10, 11, 12] A meta-analysis found that neuromuscular rehabilitation results in more rapid improvements in function. [48] For recurrent lateral ankle sprains, treatment should begin with a trial of conservative therapy for approximately 2-3 months.

It is generally accepted that for most patients, operative repair of third-degree ATFL tears and medial ankle ligament tears does not contribute to an improved outcome. One of the few absolute indications for surgery in patients with sprained ankles is a distal talofibular ligament third-degree sprain that causes widening of the ankle mortise. A second indication is a deltoid sprain with the deltoid ligament caught intra-articularly and with widening of the medial ankle mortise.

Physical therapy during the recovery phase is aimed at the patient regaining full ROM, strength, and proprioceptive abilities. While a formal physical therapy program is particularly important for athletes and other patients who need a quicker recovery, most low demand patients will do well with a basic home exercise program. [49]  A randomized controlled trial of 503 participants found no significant difference between those patients who participated in a formal physical therapy program and those who did not. [50]


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