Biomechanics, pathomechanics, diagnosis, treatment, and return to play criterias of lateral ankle sprains: an evidence-based clinical guideline

Abstract

Lateral ankle sprain (LAS), which is common in recreational and professional athletes, recurs and becomes chronic if left untreated. Since the number of mechanoreceptors it contains is high, LAS should not be considered only as a musculoskeletal disorder. A detailed clinical evaluation is recommended. Clinically, the patient presents with limitation of dorsiflexion range of motion (ROM), muscle atrophy and unequal strength between the muscles, deterioration in walking, running and jumping, and proprioceptive losses. The patient should be approached from a biopsychosocial perspective both in the evaluation and treatment phases. The treatment of the patient is carried out in 3 phases and the transition between phases should be based on mentioned criterias. In the acute phase of rehabilitation, emphasis should be placed on eliminating pain and edema, and preventing loss of ROM and muscle strength. In the subacute and chronic stages, emphasis should be placed on increasing the proprioceptive sense and muscle strength, improving the biomechanics of daily life and sports-specific movements such as walking, running, jumping. If the patient is an athlete, return to sports should be planned after the criterias met.