Ankle sprains are one of the most common injuries encountered by Physical Therapists working in sports medicine practices. Prior research has shown 85% of these injuries will involve the ligaments on the outside of the ankle. The severity of the sprain is graded on a 3 point scale which describes the degree of ligamentous injury. In previous blogs we have described research documenting Physical Therapy interventions, including manual therapy and exercise, are superior to R.I.C.E. as well as Physical Therapy exercises without manual therapy. New research also demonstrates the effectiveness of manual therapy. including joint manipulation and mobilization, when combined with high level exercise in the treatment of chronic ankle instability.

A review of the available evidence was completed recently in the Journal of Sports Rehabilitation to determine the effectiveness of manual therapy and exercise vs. exercise alone in the treatment of chronic ankle instability (Walsh et al. 2020). Authors reviewed 3 randomized controlled trials on the topic and reported improved patient outcomes of pain and function when manual therapy was utilized with exercise compared to exercise alone in this patient population. This review supports the utilization of manual therapy in this patient population to restore normal joint mobility to the injured ankle. High level exercise is then prescribed to normalize muscle strength, balance (proprioception), and sport specific movements.

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