Acute
ankle injury, a common musculoskeletal injury, can cause
ankle sprains. Some evidence suggests that previous
injuries or limited joint flexibility may contribute to
ankle sprains. The initial assessment of an acute
ankle injury should include questions about the timing and mechanism of the injury. The Ottawa Ankle and Foot Rules provide clinical guidelines for excluding a fracture in adults and children and determining if radiography is indicated at the time of injury. Reexamination three to five days after injury, when
pain and swelling have improved, may help with the diagnosis.
Therapy for
ankle sprains focuses on controlling
pain and swelling. PRICE (Protection, Rest,
Ice, Compression, and Elevation) is a well-established protocol for the treatment of
ankle injury. There is some evidence that applying
ice and using nonsteroidal antiinflammatory drugs improves healing and speeds recovery. Functional rehabilitation (e.g., motion restoration and strengthening exercises) is preferred over immobilization. Superiority of surgical repair versus functional rehabilitation for severe lateral ligament
rupture is controversial. Treatment using semirigid supports is superior to using
elastic bandages. Support devices provide some protection against future
ankle sprains, particularly in persons with a history of recurrent
sprains. Ankle disk or
proprioceptive neuromuscular facilitation exercise regimens also may be helpful, although the literature supporting this is limited.