Similar numbers of ankle sprain patients who participated in a recent study achieved “excellent recovery” at 6 months—whether they received physical therapy or not. Researchers suggest these results may raise doubt as to the usefulness of physical therapy postinjury.
The study, conducted in Canada and published in BMJ, included 503 people, ages 16 to 79, who had experienced either a mild or moderate ankle sprain. Half of the participants received the usual care—painkillers, rest, ice, compression, and elevation of the ankle—and the other half received the usual care plus up to seven 30-minute sessions of physical therapy.
Six months postinjury, 57% of patients in the physical therapy group and 62% of the patients in the usual care group achieved “excellent recovery,” according to a media release from MedlinePlus.
“There was not a clinically important effect with the standardized physiotherapy regimen provided to our participants,” concludes the research team—led by Brenda Brouwer from the School of Rehabilitation Therapy at Queen’s University in Kingston, Canada—in the release.
However, Dr Aleksey Lazarev, an an orthopedic surgeon and sports medicine clinician at Lenox Hill Hospital in New York City, notes in the release that it’s premature to draw final conclusions from this research.
“In my opinion, not every ankle sprain is the same, and a lot depends on age, mechanism of injury, activity level, history of prior ankle sprains and [ankle] instability, and presence of any additional injuries,” he explains. “Physical therapy can still play an important role in a patient’s recovery and prevention.”
Elizabeth Anastasio, a senior physical therapist at Staten Island University Hospital in New York City, agrees with Lazarev.
“In mild and moderate strains, the lateral ankle tendons and ligaments [of the ankle] have been overstretched and/or micro-tearing may have occurred. For this kind of injury, rest and compression from offending activities will allow the involved structures to heal and scar back down to their bony attachments.”
“However,” she adds, “the patient should seek further and more skilled physical therapy intervention if symptoms do not resolve or improve within 1 week. In the case of more severe sprains, physical therapy is advised as [ligament] support and joint integrity are most likely compromised.”