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A Novel Mobilization for Acute Ankle Sprains

Erson Religioso
Research shows ankle sprains respond favorably to manual therapy. But what if the sprain is so acute and sensitive that traditional techniques are not tolerated?
The case in the video on later pages was a severe ankle inversion sprain on the left and moderate on the right. The patient is a high level gymnast who injured herself tumbling during a floor routine.
The video was taken almost a week after the sprain. She had significantly decreased mobility with pain in all planes. Normally I would try a posterior glide to the lateral malleolus and ankle inversion/plantarflexion, which has worked on her in the past with great results. This time, that was too painful as was lateral malleolus contact. 
Instead, I tried slacking the irritated skin and ligaments while gradually moving the forefoot/ankle into dorsiflexion and eversion. This was pain free and after working my way to end range, her active/passive NWB range was much better and her gait was nearly pain free.
This got her started with loading and was easily replicated for an hourly home exercise program to modulate pain. Videos of various motor control drills will be posted soon!

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