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Monna Arvinen-Barrow, Nathan Maresh and Jennifer Earl-Boehm

Lateral ankle sprains (LASs) are among the most common injuries encountered during sport and exercise participation. 1 – 3 Typically, a consequence of either extrinsic (eg, direct blow to the ankle or landing on an opponent’s foot) or intrinsic (eg, proprioception deficits, mechanical laxity, or a

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Ryan McCann, Kyle Kosik, Masafumi Terada and Phillip Gribble

Key Points • Patients with a lateral ankle sprain often sustain recurrent injuries after return to play. • Impairments and activity limitation persist beyond return to play from a lateral ankle sprain. • It remains unknown how these outcomes contribute to recurrent lateral ankle sprains. Athletic

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Gabrielle Stubblefield, Jeffrey Tilly and Kathy Liu

Key Points ▸ Changes in joint laxity across the six patients followed occurred throughout the acute and subacute stages after a no time lost (NTL) lateral ankle sprain when compared to a preinjury baseline assessment. ▸ Increased joint laxity was noted in all patients after NTL ankle sprains

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Matt Hausmann, Jacob Ober and Adam S. Lepley

ankle sprains. However, very little evidence has been produced regarding the clinical effectiveness of deep oscillation therapy, limiting its application in therapeutic rehabilitation of acute lateral ankle sprains. Clinical Question Is deep oscillation therapy effective in reducing pain and swelling in

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Robert Vallandingham, Zachary Winkelmann, Lindsey Eberman and Kenneth Games

practice recommendations for the prevention and management of ankle sprains. 6 The recommendations in the position statement gather the best evidence available for clinicians to prevent and manage a lateral ankle sprain (LAS). Due to the fact that up to 70% of patients report residual effects following a

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Jeffrey D. Simpson, Ethan M. Stewart, Anastasia M. Mosby, David M. Macias, Harish Chander and Adam C. Knight

Lateral ankle sprains (LASs), which damage the lateral ankle ligaments, are a common orthopedic injury. 1 This injury results from excessive subtalar inversion or a combination of subtalar inversion, internal rotation, and talocrural plantar flexion about an externally rotated distal tibia during

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Erik A. Wikstrom, Cole Mueller and Mary Spencer Cain

Lateral ankle sprains (LAS) are the most common injuries in sport 1 – 4 and the military 5 , 6 and are extremely common among the general public. 7 In 2010, LAS resulted in excess of $1.1 billion in health care charges from emergency departments in the United States alone. 7 Despite this volume

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Frank C. Mendel, Michael G. Dolan, Dale R. Fish, John Marzo and Gregory E. Wilding

Context:

High-voltage pulsed current (HVPC), a form of electrical stimulation, is known to curb edema formation in laboratory animals and is commonly applied for ankle sprains, but the clinical effects remain undocumented.

Objective:

To determine whether, as an adjunct to routine acute and subacute care, subsensory HVPC applied nearly continuously for the first 72 h after lateral ankle sprains affected time lost to injury.

Design:

Multicenter, randomized, double-blind, placebo-controlled trial.

Setting:

Data were collected at 9 colleges and universities and 1 professional training site.

Participants:

50 intercollegiate and professional athletes.

Interventions:

Near-continuous live or placebo HVPC for 72 h postinjury in addition to routine acute and subacute care.

Main Outcome Measure:

Time lost to injury measured from time of injury until declared fit to play.

Results:

Overall, time lost to injury was not different between treated and control groups (P = .55). However, grade of injury was a significant factor. Time lost to injury after grade I lateral ankle sprains was greater for athletes receiving live HVPC than for those receiving placebo HVPC (P = .049), but no differences were found between groups for grade II sprains (P = .079).

Conclusions:

Application of subsensory HVPC had no clinically meaningful effect on return to play after lateral ankle sprain.

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Danny Pincivero, Joe H. Gieck and Ethan N. Saliba

A treatment and rehabilitation protocol was implemented on a university football player sustaining a second-degree lateral ankle sprain. The initial treatment plan involved the application of the RICE principle (rest, ice, compression, and elevation). This particular rehabilitation protocol was aimed at restoring range of motion and function at the earliest possible time with the use of a cryokinetic technique developed by Knight and with progressive exercise. The subject in this case study returned to full participation 6 days postinjury. The results from this report indicate that a program of cryokinetics and functional progressive exercise performed within pain-free limits can greatly enhance the return of an athlete to competition.

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Maude Bastien, Hélène Moffet, Laurent Bouyer, Marc Perron, Luc J. Hébert and Jean Leblond

The Star Excursion Balance Test (SEBT) has frequently been used to measure motor control and residual functional deficits at different stages of recovery from lateral ankle sprain (LAS) in various populations. However, the validity of the measure used to characterize performance—the maximal reach distance (MRD) measured by visual estimation—is still unknown.

Objectives:

To evaluate the concurrent validity of the MRD in the SEBT estimated visually vs the MRD measured with a 3D motion-capture system and evaluate and compare the discriminant validity of 2 MRD-normalization methods (by height or by lower-limb length) in participants with or without LAS (n = 10 per group).

Results:

There is a high concurrent validity and a good degree of accuracy between the visual estimation measurement and the MRD gold-standard measurement for both groups and under all conditions. The Cohen d ratios between groups and MANOVA products were higher when computed from MRD data normalized by height.

Conclusion:

The results support the concurrent validity of visual estimation of the MRD and the use of the SEBT to evaluate motor control. Moreover, normalization of MRD data by height appears to increase the discriminant validity of this test.