Lateral ankle sprains: a comprehensive review - Part 2: treatment and rehabilitation with an emphasis on the athlete

This is the second part of a two-part comprehensive review of lateral ankle sprains. In the first part of our review, we discussed the etiology, natur al history, pathoanatomy, mechanism of injury, histopathogenesis of healing , and diagnostic approach to acute and chronic lateral ligamentous ankle in juries. Conservative intervention and treatment of grade I-III and chronic, recurrent sprains of the lateral ankle Ligaments and appropriate rehabilit ation guidelines are the topics of this article. We review the use and bene fit of different modalities and external supports and outline our five-phas e intervention program of rehabilitation based on the histopathogenesis of ligament healing. We discuss the expected timing of recovery of the acute i njury as well as the management of chronic, recurrent ankle sprains. Treatm ent of acute ankle sprains depends on the severity of the injury. Conservat ive therapy has been found to be uniformly effective in treating grade I an d II ankle sprains. Some controversy exists regarding the appropriate treat ment of grade III injuries, particularly in high-level athletes. Our belief is that the majority of these patients may also be treated well with conse rvative management. Other options for the management of grade III sprains w ill be briefly discussed at the end of this article.