Ankle Sprains: Combination of Manual Therapy and Supervised
Exercise Leads to Better Recovery
Ankle sprains often occur when running, walking on uneven ground, or jumping. Sprains are more common in sports activities. Usually, people are told to rest, elevate the foot, apply ice, and use an elastic wrap to reduce swelling. This treatment is typically followed by exercises that can be performed at home. Although the pain and swelling usually improve quickly, more than 70% of people who sprain their ankles continue to have problems with them. In fact, up to 80% will sprain their ankles again. This suggests that it is important to better care for ankle sprains. One option is manual therapy, where the therapist moves the ankle and surrounding joints to help restore normal joint movement. A research report published in the July 2013 issue of JOSPT examines and compares the outcomes of a home exercise program with a more involved treatment program that includes manual therapy and supervised exercises.
NEW INSIGHTS
In this study, researchers treated 74 patients. Half of these patients received a typical home exercise program. The other patients received a combined manual therapy and supervised exercise program. The patients who received the manual therapy and supervised exercise program experienced about a 70% reduction in pain at 4 weeks and more than a 92% reduction in pain at 6 months. By contrast, patients who received the home exercise program only had a 39% reduction in pain at 4 weeks and an 80% reduction at 6 months. For those in the manual therapy and supervised exercise program, the ability to perform daily activities improved from 66% at the initial exam to 87% at 4 weeks and 97% at 6 months (100% is full function). Meanwhile, those doing just the home exercise program only saw improved function to 73% at 4 weeks and 88% at 6 months. The researchers concluded that the combination of manual therapy and a supervised exercise program was superior to a home exercise program alone in the treatment of ankle sprains, because the combined program provided better pain relief and improved function.
PRACTICAL ADVICE
Patients who have sprained their ankles may benefit from a physical therapy program that includes manual therapy and a supervised exercise program. Potential benefits are less pain and improved ability to perform daily activities and return to sport. Your physical therapist can perform a thorough evaluation to help determine if you are a good candidate for this treatment as part of a program designed to help get you back to full activity after an ankle sprain. For more information on the treatment of ankle sprains, contact your physical therapist specializing in musculoskeletal disorders.