Ankle sprain is one of the most frequent injuries in high-performance sports and, being in a sports activity, prompt reincorporation to the sporting gesture and shortening recovery times is of utmost importance.

The ligament injury is known as a sprain, which is produced by a maximum elongation of the fibers that causes partial or total rupture of the fibers. According to the mechanism of injury, it can be classified into:

  • Grade I
  • Grade II
  • Grade III.

Physiotherapeutic treatment proposes early stimulation with tensile loads on the injured ligament to force fibroblast proliferation and regain joint function, normally the most common sprains are grade I and II.

To treat the acute stage injury, the RICE method will be used:

  • Rest
  • Ice
  • Compression
  • Elevation
  • Deep oscilation.

It has the purpose of generating a localized vasoconstriction, containing and mediating the inflammatory process and lowering the tension loads.

Phase 1. Functional rehabilitation (weeks 1-2).

  • Application of electrostimulation with interferential current modulated at 2000 HZ, spectrum from 45 to 50 HZ and wave amplitude of 90 HZ, accompanied by CHC for 15 minutes for disinflammatory and analgesic purposes.
  • Support of manual therapy with lymphatic drainage of edema and relaxation of the affected muscles with deep oscillation, completing 1 cycle of 15 minutes.
  • Kinesiotape applications.

Phase 2. Retraining (weeks 3-4).

  • Generate an acceleration in joint reeducation and the incorporation of the ranges of movement of the joint, as well as the incorporation of proprioceptive stimuli in a controlled and supervised environment for the adequate performance of therapeutic exercises.
  • It is important to consider at this stage the support of the functional bandage in order to generate a greater degree of security and joint correction for the development of patient confidence.

Phase 3. Return to sport (weeks 5-6)

One of the main objectives at this stage is strengthening and a gradual return to sport with low intensities and loads for strengthening the periarticular muscles to develop joint stability.

  • Among the exercises to be incorporated during this phase are the eccentric workloads, (this type of strengthening is the one that generates the most force)
  • Polymetry
  • Monopodal jumps.

While we are working with injured tissue, it is important to make the athlete aware of the probable sensation of pain during the execution of the therapeutic exercises, as well as the inflammation, they will be treated with physical means and manual therapy (shock waves).

Phase 4. Competitive stage (week 6 onwards)

This phase implies the return to sport, in which we will work specific exercises in a controlled manner in the area of functional strengthening and their reincorporation into the field or competition area.

Although it is important to continue the treatment that started in week 1, at this stage we must include specific exercises with a greater load and intensity of execution, changes in speed, acceleration and deceleration, as well as changes in direction.

The treatment will be complemented with the use of sports orthopedic insoles, specially designed for the patient, and for the sport they perform.

Among the main benefits of orthopedic insoles are:

  • Correct the biomechanics of the ankle in a static and dynamic way.
  • Reduce sports injuries.
  • Correct alterations in the foot and ankle.
  • Increased physical performance during sports activity.

Treatment duration 45 minutes.

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