Are Ankle Sprains the "Common Cold" of Musculoskeletal Injuries?

The inversion ankle sprain is one of the most common musculoskeletal injuries, with an incidence of 7.2/1000 people age 15 to 19.¹ People participating in basketball, football, and soccer are at particularly high risk for an ankle sprain. The ankle sprain has been reported to account for up to 34% of all sport-related injuries.²

Ankle Instability

Likely due to the common nature of these injuries, the common vernacular in response to this injury is, "you're fine; just walk it off." Because of the common laissez-faire attitude related to lateral ankle sprains, they have been likened to the common cold which is the most prominent example of a self-limiting medical condition. Despite this popular belief, ankle sprains can potentially lead to serious long-term disability and dysfunction. Chronic ankle instability and injury are common sequelae following just one sprain.

In fact, people who do not perform ankle proprioceptive/balance exercises after a sprain are more likely to develop ankle instability.³ The reinjury rate following the first-time sprain ranges from 17-73%.³ High-risk sports like basketball report the highest rates of reinjury. Up to 33% of patients have pain or instability at oneyear and 25% still experiencing problems at three years post sprain.⁴

Effective Interventions

As therapists, we have an opportunity to make sure this population receives the care they need to maximize return to prior activity/sport and prevent long-term disability and instability.

Clinicians should address impairments in strength, joint mobility, and proprioception to reduce chronic instability. Specifically, balance/proprioceptive training with sport-specific activity training should be a focus in order to limit recurrence of ankle sprains. Therapists should recognize that patients who fail to use external lace-up supports (especially in high-risk sports) are at higher risk for a lateral ankle sprain.^5,6Therapists should maximize optimal dorsiflexion to decrease ankle sprain and chronic instability.³

Here's an example of a dynamic proprioceptive activity from the Medbridge Home Exercise library:[iframe id="https://www.youtube.com/embed/pAiu4ZXwAz8" align="center" mode="normal" maxwidth="600" grow="no"]

And, here is an example of aself talocruralmobilization to increase dorsiflexion:

[iframe id="https://www.youtube.com/embed/NrZ4NuSlJ88" align="center" mode="normal" maxwidth="600" grow="no"]

Advocates for Proper Care

Therapists are positioned to change the perception that lateral ankle sprainsare a self-limiting condition. With tools like Medbridge's 40+ evidence-based courses on foot and ankle issues and over 270 video-based exercises on foot and ankle rehab, it should be easy to advocate for proper intervention like balance/proprioception training to limit recurrence and disability.