Research Articles – Ankle

Most patients with common foot injury don’t
seek out physical therapy services

Plantar fasciitis is a very common foot injury, with about one million individuals seeking out treatment for it every year. Patients with plantar fasciitis typically experience a stabbing pain in the bottom of the foot near the heel, which is usually the worst with the first few steps after awakening. Recommended treatments for plantar fasciitis include a variety of stretching and strengthening exercises, bracing and hands-on therapy called manual therapy, which is usually administered by a physical therapist. There is strong evidence showing that physical therapy-based treatments like manual therapy and exercises are effective for this injury, but it’s not completely clear if patients are actually taking advantage and seeking out this type of care. For this reason, a study was conducted to investigate how many patients with plantar fasciitis are referred to physical therapy. Of the more than 800,000 patients in the database, only 7.1% were actually evaluated by a physical therapist within 30 days of their diagnosis. Patients who were treated with manual therapy were found to have shorter lengths of care and paid less overall for their care than those who did not. These findings show that although physical therapy is strongly supported by evidence as a beneficial treatment for plantar fasciitis, the vast majority of patients with the injury do not seek out this type of care.

Large-scale review shows that exercise therapy is one
of the most effective treatments for ankle sprains

Ankle sprains are the most common injury in athletes and those who are physically active. After spraining an ankle, up to 40% of patients will go on to develop a condition called chronic ankle instability, which increases the chances of another ankle sprain occurring in the future. Many treatments are available to reduce the chances of this condition developing, but there is so much research out there that it is difficult to determine which is most effective. For this reason, a large-scale review was conducted of these studies to summarize them and figure out which treatments are best. Results showed that exercise therapy was capable of reducing pain, swelling and function in patients with ankle sprains, and was helpful for preventing future ankle sprains from occurring.

A treatment program that includes specific exercises and hands-on therapy
is helpful for patients with repeated ankle sprains

Ankle sprains are the most common injury in athletes and those who are physically active. In addition to the initial pain and disability that these injuries cause, up to 40% of patients who sprain their ankle once will go on to develop a condition called chronic ankle instability. Those who experience chronic ankle instability deal with continual pain and soreness, and are more likely to sprain their ankle again in the future. Two strategies used by physical therapists for treating these patients are manual therapy and exercise therapy. Both have been found to lead to benefits, but it’s not completely clear what effect they have when used together. Therefore, a powerful study called a randomized-controlled trial (RCT) was conducted. Results showed that the combination of manual therapy and exercise therapy led to lower levels of pain, better ankle stability and greater flexibility overall. Patients with chronic ankle instability should therefore seek out these services from a physical therapist to reduce their chance of future ankle sprains.

Training program effective for reducing the rate of ankle sprains in athletes

Ankle sprains are the most common injury in sports, especially those that require lots of jumping, pivoting and/or changing direction. In addition to experiencing pain and disability, athletes that sprain their ankles once are more likely to sustain another sprain in the future, which makes it important to reduce the chances of this occurring. Measures like taping and bracing may be effective, but they have some disadvantages, and it’s been suggested that prevention exercise programs are better and avoid these disadvantages. A study followed up on this to determine if specific exercises could reduce the rate of ankle sprains, and results showed that athletes with a history of ankle sprain could benefit substantially from such a program and cut their chances of experiencing another sprain in the future.

Balance training program helps reduce the likelihood of repeated ankle injuries

One ankle sprain is usually bad enough for the person who experiences it, but for some, if the proper moves aren’t made, it could mean the start of an ongoing and bothersome condition known as chronic ankle instability (CAI). CAI is the tendency towards repeated ankle sprains and recurrent symptoms (pain, weakness, giving way), and occurs in about 40-70% of patients who suffer from an initial lateral ankle sprain. One suggested method to prevent CAI from occurring is by improving balance and proprioception (the sense of your joint’s position in your body) after the first ankle sprain. To investigate this theory, a study evaluated the effect of a balance training on study subjects and found it to significantly improve balance and proprioception, meaning such a program has the potential to reduce the occurrence of CAI if administered after the initial injury is sustained.

Ankle sprain prevention program dramatically saves money for health-care system

Acute ankle injuries are far and away the most common musculoskeletal injuries throughout the world, with lateral ankle sprains occurring more often than any other. To combat this issue, a number of preventative intervention programs have emerged as of late, and many of them have proven to be effective in reducing ankle sprain recurrence. The only thing lacking is a full-scale analysis on the cost-effectiveness of such a program on the health-care system. Therefore, researchers tested a particular program and calculated the savings of a reduction in ankle sprains, finding it to beneficial and economically advantageous to those who implement it.

Surgical vs. non-surgical treatment for Achilles tendon rupture

The course of treatment for Achilles tendon rupture is one that continues to change on a regular basis, and a general consensus on the best way to approach it is yet to be reached. While re-rupture rates are slightly lower with surgery compared to rehab, the complications and costs associated with surgical intervention are much higher, and some meet it with caution. The recent development of a functional brace that allows movement, however, has given more credence to the possibility of a non-surgical intervention. To determine the effectiveness of this new brace, a study compared it to patients who underwent surgery, and found only minimal differences in re-rupture rates, boosting the stock of rehab over surgery.