To What Extent Should I Use Manipulative Therapies to Treat Ankle Sprains and Chronic Ankle Instability?

Decreases in ankle dorsiflexion range of motion are frequently identified in patients with a history of ankle sprain or chronic ankle instability. In these patients, dorsiflexion range-of-motion deficits have been linked to changes in motion and positioning of the talus and fibula relative to the ankle mortise or tibia. Specifically, individuals who have sustained an ankle sprain are more likely to exhibit restrictions in posterior talar glide, and individuals with chronic ankle instability are more likely to have an anterior positional fault of the talus or distal fibula. ^1-3 Cumulatively, these deficits suggest that the basis for decreased dorsiflexion following ankle injury is alterations in motion and position of the articulating surfaces within the joint. Dorsiflexion impairments often are accompanied by other deleterious symptoms and impairments following ankle injury, such as pain, diminished sensorimotor function, activity limitations, and participation restrictions. Therefore, dorsiflexion range-of-motion deficits are common in individuals with a history of ankle sprain and may have implications on recovery following an ankle sprain and the progression to chronic ankle instability.