Treatment of ankle sprains

NewsBot · Jul 9, 2025

Cost-Effectiveness Analysis of Adding Telerehabilitation to Standard Care for Ankle Sprains Compared with Standard Care Alone
Juan Figueroa-García et al
Telemed Rep. 2025 Apr 11;6(1):120-127.

Background: Ankle sprain (AS) is a common musculoskeletal injury. While telerehabilitation is an effective treatment for various musculoskeletal conditions, evidence on its cost-effectiveness for AS is lacking.

Methods: A cost-effectiveness study was conducted through a 4-week randomized controlled trial in individuals with AS. The control group (n = 41) received standard care, while the intervention group (n = 41) received standard care plus asynchronous telerehabilitation. Effectiveness was measured using the Foot and Ankle Ability Measure (FAAM) with subscales for daily living (FAAM-ADL) and sports activities (FAAM-sports). The economic evaluation used the Mexican health system's official price list, including work incapacity costs, updated to 2024 (U.S. dollars). A one-way sensitivity analysis was also performed.

Results: At 4 weeks, the intervention group showed a gain of 78 points in functionality for FAAM-ADL and 80.2 points for FAAM-sports, while the control group scored 69.1 and 61.6, respectively. When the costs of work incapacity were considered, the incremental cost-effectiveness ratio (ICER) of adding telerehabilitation per point gained in FAAM-ADL functionality was US$ -14.4 and US$ -8.5 for FAAM-sports. When work incapacity costs were excluded, the ICER was US$ -0.7 and US$ -0.4, respectively.

Conclusions: Adding telerehabilitation to standard care for AS was cost-saving, achieving greater effectiveness at a lower cost. This is more evident when direct costs are considered together with the costs of work incapacity.
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NewsBot · Jul 26, 2025

Optimizing Ankle Sprain Management in Primary Care: A Randomized Trial of Telerehabilitation Added to Usual Care
Juan Figueroa-García et al
Cureus. 2025 Jun 24;17(6):e86664.

Background: Ankle sprains (AS) are among the most common musculoskeletal injuries, with physical rehabilitation being a cornerstone of treatment. Telerehabilitation has emerged as an effective alternative for managing various musculoskeletal conditions; however, evidence supporting its use specifically for AS remains limited. This study aimed to evaluate whether the addition of structured telerehabilitation to usual care (UC) improves functional recovery in patients with grade I-II AS more effectively than UC alone in a primary care setting.

Methods: Eighty-two participants were randomized into two groups (41 each): 1) Intervention group (IG): UC (standard primary care management) plus a four-week telerehabilitation program (30-minute daily exercises, five days/week) delivered via a digital platform with pre-recorded videos; Control group (CG): UC only. The primary outcome was ankle functionality measured using the Foot and Ankle Ability Measure (FAAM), including subscales for activities of daily living (FAAM-ADL) and sports (FAAM-Sports). Secondary outcomes included pain perception and work disability days.

Results: At four weeks, the IG demonstrated superior outcomes; at functionality, mean between-group differences favored the IG (FAAM-ADL: +8.3 points [95% CI 3.8-12.7]; FAAM-Sports: +13.4 points (6.7-20)). Pain: Significant reduction in VAS scores for grade II AS only (-0.9 points (-1.5 to -0.4)). Subgroup analysis: Clinically meaningful improvements in functionality were observed for both grades, but pain reduction was significant only in grade II AS. Grade I AS showed improvement limited to FAAM-Sports.

Conclusions: Telerehabilitation, as an adjunct to UC, significantly enhances functional recovery in AS, with particularly pronounced effects in grade II (moderate) sprains. However, pain reduction exhibits grade-dependent variability. These findings support incorporating telerehabilitation into primary care management protocols for AS.
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NewsBot · Jul 27, 2025

Talus Position Correlates With Dorsiflexion Range of Motion Following a Lateral Ankle Sprain: A Cross‐Sectional Study
Takeshi Toyooka et al
Health Sci Rep. 2025 Mar 10;8(3):e70550

Background and Aims

Following an ankle sprain, clinical examination often reveals ankle dorsiflexion pain, which has been implicated as a risk factor for recurrent ankle sprains; however, the mechanism of ankle dorsiflexion pain has not been explored. Using magnetic resonance imaging (MRI), we evaluated the relationship between the limited dorsiflexion range of motion due to pain and the position of the talus. We investigated whether an anterior talofibular ligament (ATFL) tear affected ankle dorsiflexion.
Methods

We reviewed 36 medical records and MRI images of outpatients diagnosed with a lateral ankle sprain. The data recorded were weight‐bearing lunge test (WBLT), talus alignment, and ATFL tear. Weight‐bearing lunge test differences (WBLTD) between the affected and unaffected sides were calculated. Talus alignment was defined on MRI as the extent of anterior displacement from the posterior lip of the tibia to the nearest articular surface of the talus (distance). Spearman's rank correlation coefficient was used to analyze the relationships between WBLTD and distance. Next, we divided the patients into two groups based on the ATFL tear and compared the WBLTD and distance using the Mann–Whitney U test.
Results

The mean and standard deviation for distance and WBLTD were 0.9 ± 0.9 and 3.5 ± 2.8, respectively. Spearman's rank correlation coefficient between distance and WBLTD was 0.48 (p = 0.003). There was no significant difference between tear or no‐tear of the ATFL with WBLTD and distance, respectively.
Conclusion

Anterior deviation of the talus positively correlated with dorsiflexion range of motion. Our study highlighted that the talus might have an anterior deviation in the unstressed position. However, the ATFL tear's effects on talar displacement and dorsiflexion angle were unknown.
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NewsBot · Aug 22, 2025

Functional and Neuromuscular Effects of Rehabilitation in Acute Ankle Sprain and Chronic Ankle Instability
Andrea De Fazio et al
Source

Background
Lateral ankle sprains (LAS) are common injuries that may progress to chronic ankle instability (CAI), characterized by recurrent sprains, proprioceptive deficits, and neuromuscular impairments.
Purpose
This study evaluated the impact of rehabilitation on functional outcomes and electromyographic (EMG) parameters in patients with acute LAS and CAI.
Study Design
Prospective observational cohort study
Methods
Between August 2022 and September 2023, 119 patients (73 with acute LAS, 46 with CAI) were assessed at baseline (T0) and after a three-months rehabilitation program (T1). Assessments included range of motion (ROM), muscle strength, surface EMG, balance tests (Y-Balance, Foot Lift, Side Hop, 6-m Hop), and the FAAM questionnaire. Rehabilitation consisted of individualized protocols integrating gym-based exercises and hydrotherapy, targeting ROM restoration, proprioceptive training, and muscle strengthening.
Results
LAS patients demonstrated significant baseline impairments in plantarflexion ROM (49.32 ± 13.37 vs. 61.76 ± 17.67; p = 0.01) and Foot Lift Test performance (168 ± 191.28 vs. 18.52 ± 58.38; p = 0.01). Post-rehabilitation, both groups showed improvements in ROM, strength, and functional scores. CAI patients achieved greater proprioceptive gains (Y-Balance, Side Hop), while LAS patients exhibited superior recovery in plantarflexion strength. However, EMG analysis revealed persistent neuromuscular deficits in both groups.
Conclusion
Despite clinical improvements, persistent EMG deficits, especially in CAI, indicate incomplete neuromuscular recovery. These findings highlight the limitations of standard rehabilitation protocols and underscore the need for personalized neuromuscular interventions and objective return-to-sport criteria. Future research should aim to refine diagnostic tools, standardize protocols, and incorporate technology-assisted rehabilitation to improve long-term outcomes.
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NewsBot · Sep 17, 2025

Impact of systematic ultrasonography on lateral ankle sprain management
Aubin Arcade et al
Foot Ankle Surg. 2025 Sep 11:S1268-7731(25)00204-8.

Background: Lateral ankle sprain (LAS) is the most common traumatic injury, yet its diagnosis and management remain suboptimal. This contributes to a high prevalence of residual symptoms, negatively impacting patient quality of life and increasing healthcare costs. We hypothesized that routine ultrasonography (US) following LAS could significantly modify the treatment strategy established by a specialist. Additionally, we hypothesized that US is an efficient tool for identifying osseous injuries and associated ligamentous injuries.

Methods: Fifty-one ankles with lateral instability diagnosed in the emergency department (ED) were retrospectively included. A second evaluation by an orthopedic surgeon was conducted within the first ten days to establish the "initial treatment". All patients underwent US and MRI within the first three weeks after the initial ED assessment and were reevaluated to establish the "post-US treatment". We determined concordance between initial and post-US treatment. Additionally, we assessed the diagnostic accuracy of US for identifying osseous and associated ligament injuries, including the anteroinferior talofibular ligament (AITFL), deltoid ligament, spring ligament, calcaneocuboid ligament (CCL), dorsal talonavicular ligament (DTNL), and bifurcate ligament, MRI serving as the reference standard for assessing ligamentous and osseous injuries.

Results: Treatment for LAS was modified for 16 ankles (31.3 %) following US examination (W=97, p < 0.05). US demonstrated excellent sensitivity (0.73) and specificity (0.95) for identifying osseous injuries. Additionally, US detected injuries to the AITFL in 6 ankles (11.8 %), deltoid ligament in 16 (31.3 %), spring ligament in 1 (2 %), CCL in 1 (2 %), DTNL in 1 (2 %), and bifurcate ligament in 2 (3.9 %).

Conclusion: US examination following LAS was significantly associated with treatment modifications. It also proved high accuracy for detecting osseous injuries missed by plain X-rays and diagnosing associated ligament injuries. Given these findings, it appears relevant to update the current diagnostic algorithm for LAS, including US.
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NewsBot · Sep 25, 2025

The effects of kinesiology taping on joint stability during descending stairs in patients with acute ankle injuries
Ye Wei, Datao Xu, Zhifeng Zhou, Xiuye Qu, Julien S. Baker, Liangliang Xiang & Yaodong Gu
BMC Sports Science, Medicine and Rehabilitation volume 17, Article number: 271 (2025)

Background

Acute ankle injuries are common in sports and daily activities. Kinesiology taping enhances lower limb motion patterns, joint stability, and balance during descending stair activity in such patients. The objective of this study was to conduct a comparative analysis of the biomechanical impacts exerted by a KT group and an ST group on the lower limbs of patients with acute ankle injuries while descending stairs.
Methods

The study included 27 participants with acute ankle injuries, who underwent biomechanical assessment under both KT and ST conditions. An integrated Vicon motion capture system, AMTI force platform, and electromyography (EMG) sensors were utilized to comprehensively evaluate biomechanical performance. Participants completed 20 descending stair trials under each condition, with joint stiffness, center of mass (COM), and bone displacement identified as key metrics for assessing stability. Statistical analyses, including paired t-tests and statistical parametric mapping (SPM1D), were employed to identify significant biomechanical differences between the two conditions.
Results

The study revealed that compared to ST, kinesiology taping significantly reduced inversion and eversion angles (p < 0.001). Electromyography (EMG) analysis of the KT group revealed a remarkable enhancement in the activation levels of the calf muscle group (p < 0.001). In stark contrast to the ST group, the KT group demonstrated a substantial increase in ankle joint stiffness. Moreover, the KT group also achieved elevation in the activation of the hip muscles, with all these differences being highly significant (p < 0.001).
Conclusion

Research shows that individuals with acute ankle joint injuries face issues such as significant inversion and eversion angles, reduced ankle joint stiffness, and persistent joint instability when descending stairs. Kinesiology taping can address these issues by reducing joint angles, increasing stiffness, and balancing moments. KT also stabilizes the center of mass and diminishes fall risks. This demonstrates that kinesiology taping effectively enhances stability during descending stairs and helps prevent recurrent injures. It is recommended as a protective measure following acute ankle injuries.
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NewsBot · Jan 9, 2026

Clinical assessment of lateral ankle sprains among Swedish physiotherapists: a nationwide survey comparing practice to international and locally modified frameworks
BMC Sports Science, Medicine and Rehabilitation

Background

Lateral ankle sprains (LAS) are among the most common musculoskeletal injuries globally. Although international frameworks such as the Rehabilitation-Oriented Assessment Tool (ROAST) and Ankle-GO provide structured approaches for LAS assessment and return-to-sport (RTS) evaluation, their implementation in Sweden has not been investigated.
Methods

A cross-sectional online survey was distributed to registered Swedish physiotherapists managing patients with LAS. The survey assessed adherence to the original ROAST, as well as modified versions of the frameworks (ROASTmodified and Ankle-GOmodified). Additionally, physiotherapists’ self-rated confidence in their methods was assessed to explore potential discrepancies between perceived competence and framework adherence. Descriptive and inferential statistics were used to analyse associations between reported assessment practices and physiotherapists’ workplace location, educational level, and clinical experience.
Results

A total of 124 physiotherapists responded. Most (87.1%) reported using fewer than 50% of ROAST criteria, while 48.4% met at least 50% of ROASTmodified criteria. Adherence was significantly higher among those working in urban areas (p = 0.032), with no significant differences based on educational level or years of clinical experience. Regarding RTS, 36.7% of physiotherapists applied methods aligned with Ankle-GOmodified, but only 6.5% regularly used patient-reported outcome measures (PROMs) in this context. The most commonly used assessment domains were gait pattern, range of motion, and muscle strength, while PROMs and physical activity level were rarely included.
Conclusions

Adherence to international frameworks for LAS assessment was generally low among Swedish physiotherapists, but higher when modified versions were applied. Urban-based physiotherapists reported higher adherence compared to their rural counterparts, while educational level and experience had little influence. A discrepancy between perceived confidence and actual adherence suggests a gap between self-assessed competence and implementation.
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NewsBot · Jan 15, 2026

Identifying factors associated with proprioceptive impairment in individuals after lateral ankle sprain: a cross-sectional study
Takahiro Watanabe et al
Physical Therapy in Sport Volume 78, March 2026, 101885

Highlights

•
Proprioceptive deficits after lateral ankle sprain contribute to chronic ankle instability.
•
The stretch strain sensor–based circumduction reproduction test can detect shank-rearfoot and rearfoot-midfoot proprioceptive deficits in individuals with CAI.
•
Proprioceptive impairments assessed using the stretch strain sensor are influenced by subtalar instability and limited dorsiflexion.

Abstract
Objective
To investigate the validity of a stretch strain sensor–based circumduction reproduction test and identify factors associated with foot–ankle proprioceptive dysfunction in individuals with a history of lateral ankle sprain.
Design
Cross-sectional study.
Setting
University laboratory.
Participants
Seven copers and 18 patients with chronic ankle instability (CAI).
Main outcome measure
The circumduction reproduction test measured absolute error between eyes-open and eyes-closed conditions as an indicator of proprioception during ankle circumduction. Absolute errors in the sensor, shank-rearfoot and rearfoot-midfoot relative angles were measured using a three-dimensional motion analysis system. An independent t-test was used to compare errors between groups. Pearson's correlations were calculated to identify factors contributing to absolute errors, including foot joint variables, anterior displacement, subtalar joint excursion, and weight-bearing lunge test.
Results
The CAI group showed significantly greater sensor error (p = 0.025). The sensor errors significantly correlated with shank-rearfoot (r = 0.698) and rearfoot-midfoot (r = 0.760) errors. The sensor error was significantly associated with subtalar joint excursion (r = 0.667) and weight-bearing lunge test (r = −0.528).
Conclusions
The circumduction reproduction test using the stretch strain sensor enables accurate evaluation of proprioceptive impairments, with absolute errors associated with subtalar joint excursion and weight-bearing lunge test.
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NewsBot · Feb 1, 2026

Celecoxib in combination with foot and ankle orthoses for the treatment of acute ankle injuries: A study on the correlation between anti-inflammatory and analgesic mechanisms and functional recovery
Qilong Hu et al
Pak J Pharm Sci. 2026 Mar;39(3):783-791.

Background: Celecoxib combined with an ankle orthosis is widely used in the treatment of acute ankle injuries. However, details of local adverse reactions such as skin lesions and tenderness related to the orthosis are unclear and the safety differences among different intervention groups are not well understood, affecting the choice of treatment regimen.

Objective: This study aimed to explore the anti-inflammatory and analgesic mechanism of celecoxib combined with an ankle orthosis in the treatment of acute ankle injuries and its correlation with functional recovery.

Method: 160 patients with moderate acute ankle injuries were randomly divided into four groups (n=40 each): the control group received routine treatment, the celecoxib group received celecoxib in addition, the orthosis group received an ankle orthosis in addition and the synergistic treatment group received both treatments. Inflammatory markers (C-reactive protein (CRP), interleukin-6(IL-6), etc.), pain markers (Visual Analogue Scale (VAS) score, etc.) and functional markers (American Academy of Foot and Ankle Surgery (AOFAS) score, etc.) were compared among the four groups. Correlation and influencing factors were analyzed and stratified analysis was performed based on the side of injury.

Results: The synergistic treatment group showed better results than the other three groups in terms of inflammation, pain and functional indicators at all time points (p<0.05); the degree of inflammation and pain relief was significantly positively correlated with functional recovery (r=0.71~0.83, p<0.001); celecoxib dosage, orthotic wear and the degree of IL-6 reduction were independent influencing factors for functional recovery (p<0.05); patients with left-sided injuries benefited more significantly from synergistic treatment (p<0.05). There was no difference in the incidence of adverse reactions among the four groups (p>0.05).

Conclusion: The synergistic treatment enhances efficacy through anti-inflammatory and biomechanical stabilization effects, with good safety profile and patients with left-sided injuries benefit more.
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NewsBot · Feb 4, 2026

Gait study of surgical treatment and conservative treatment of acute ankle sprain: a single-center cohort study
Gui Xuan You, Ming Hui Li, Lei Huang, Xin Zhou & Lei Zhang
Archives of Orthopaedic and Trauma Surgery

Objectives
Although there are different ways, the choice of treatment for grade-I–II anterior talofibular ligament (ATFL) injuries caused by acute ankle sprain is still controversial. The primary purpose of our study was to compare the efficacies of modified Broström-Gould surgery and conservative treatment in grade-I–II ATFL injuries caused by acute ankle sprain. The secondary goal was to assess the plantar pressure characteristics of ankle sprain.

Methods
Between Sep 2022 and December 2023, 63 patients diagnosed with acute ankle sprain (ATFL grade I-II injuries) were prospectively included in the arthroscopic modified Broström-Gould surgery group (n = 33) and conservative treatment group (n = 30). The main outcomes were the ankle functional rating scale, plantar pressure and gait parameters at preoperative, and 1, 3, 6, 12, 24months postoperative. One-way repeated measures analysis of variance ( ANOVA ) and Mann-Whitney U test were used to analyze the differences at different time points after treatment.

Results
There were significant differences in gait parameters between the surgical and conservative groups at one and three months post-treatment. Additionally, the American Orthopaedic Foot and Ankle Society (AOFAS) score, Maryland Foot Score, and Visual Analogue Scale (VAS) scores were significantly different between the surgical and conservative groups after 24 months of treatment (P < 0.001). Furthermore, at 24 months post-treatment, there were significant differences between the injured and normal groups in terms of foot contact area, foot load ratio, single and double support phases, and center of gravity shift (P < 0.001).

Conclusion
Surgical and conservative treatments may not fully restore ankle stability and gait in patients, yet the modified Broström-Gould procedure holds the potential to restore ankle function three months sooner.
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Treatment of ankle sprains

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Treatment of ankle sprains

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Prevention & Treatment of Ankle Sprains

Treatment of the Distal Fibular for Lateral Ankle Sprains

Cannabidiol (CBD) in the Treatment of Foot and Ankle Pathology

Walking Abilities and Impaired Ankle Dorsiflexion Function in Children After Cancer Treatment

Is it safe to give an ankle block to a patient who is under fertility treatments?

Strain counterstrain in the treatment of patients with chronic ankle instability

Reduced Ankle ROM due to Chemotherapy Treatment

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