Lateral Ankle Sprain: Therapy [Clinical Review Discussion]

"The lack of quality studies relating to the diagnosis of ankle sprains may be attributable to the fact that all ankle sprains are treated in a similar manner regardless of grade" (1). They are separated primarily by the length of time spent in the different phases of recovery. Interestingly ankle sprains are also treated similarly in all of the healing arts with only minor differences. Even the value of surgical intervention for Grade 3 sprains rather than conservative treatment is controversial (2).

A disturbing fact has been noted by 2 different authors. As with many soft tissue injuries, chronicity is present in a substantial percentage of patients years after the initial injury. Konradsen et al reported 32% of patients reported pain, swelling or recurrent sprains after 7 years. Interestingly there was no correlation between severity of the initial injury and residual disability (3). A systematic review of the clinical course of ankle sprain found only 36% to 85% of patients are asymptomatic after 3 years (4). It is imperative the physician treats ankle sprains aggressively and properly educates the patient in order to minimize long term effects.