journal of orthopaedic and sports physical therapy

ankleAt Apex Orthopedic Rehabilitation in Paramus, NJ I have evaluated many patients who are concerned about the recurrent ankle sprains they have suffered. Most are inversion sprains in which the ankle rolls outward and the foot turns inward, resulting in the stretching and tearing of ligaments on the outside of the ankle. Often the patient’s previous “rehabilitation” consisted of a  few exercises to be done at home with little or no hands on care (i.e. massage, joint mobilizatons, stretching) from a physical therapist.

A recent study in Journal of Orthopaedic and Sports Physical Therapy, July 2013 edition, compared two treatment methods for inversion ankle sprains.

Home Exercise Group (HEP) was exercise based approach comprising of range of motion, strengthening and balance with instructions on progression for 4 sessions guided by a physical therapist

Manual Therapy and Exercise Group (MTEX) used the same exercises as in the HEP group but with the addition of 8 sessions of extensive manual treatments aimed at the foot and ankle complex of joint mobilizations.

 

The MTEX group showed significant improvements compared to the HEP group in pain levels and overall function. This study supports my recommendation that, especially for patients experiencing chronic ankle sprains, manual therapy interventions reduce the chance of future ankle sprains. MTEX shows positive results both short and long term.

 

I have never read a report of negative effects of hands-on therapy, though some earlier studies do not find that it improves outcomes for people who perform their exercises exactly as prescribed. However,  since most people find their training and exercise regimen interrupted by other commitments, additional time spent in hands-on therapy is well spent to minimize recurrent injury.

In the current healthcare environment many clinics do not offer this “manual,” hands-on care to their patients partly because this care requires skilled physical therapists and can’t be delegated to ancillary staff.  Be sure to ask prior to scheduling if your physical therapy clinic offers these services.   You will benefit from both the care itself and from more interaction with  and education from your physical therapist. Interaction allows your therapist to continually reassess your condition and improve outcomes.

Apex Orthopedic Rehabilitation in Paramus, NJ provides orthopedic and sports physical therapy services for the greater Paramus, Ridgewood, and Bergen County region.  This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your physician before engaging in a physical therapy or rehabilitative regimen.