Ankle Sprain Management: Best Practices Based on Last Ten Years of Evidence

It is so helpful when experts summarize the best available evidence for management of a disease. Richard Seah and Sivanadian Mani-Babu recently did this in an article in the British Medical Bulletin entitled: “Managing Ankle Sprains in Primary Care: What Is the Best Practice? A Systematic Review of the Last Ten Years of Evidence.” Here are some of their conclusions:

  • Mild-to-Moderate Sprains – functional treatment options work best. These are described as: elastic banding, soft cast, taping or orthoses with associated coordination training.
    • Lace-up supports reduce swelling more than semi-rigid ankle supports, elastic bandaging, or tape.
    • Tape can cause “dermatological complications” (presumably skin irritation).
  • Severe Ankle Sprains – A short period of immobilization in a below-knee cast or pneumatic brace hastens recovery more than compression bandages alone.
  • Semi-rigid orthoses and pneumatic braces offer beneficial support and prevent subsequent sprains during high-risk sports activities.
  • Supervised rehabilitation training combined with conventional treatment for acute lateral ankle sprains appears to be beneficial, although some study results are conflicting.

It is a little unclear how the authors assess the conventional treatment of rest, ice, compression, and elevation (RICE).

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