Sprained Ankle? You Probably Don’t Need Physical Therapy

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Plenty of research has shown that physical therapy aids recovery from meniscus tears and other joint injuries. But for a sprained ankle? Save your money and rehab at home, suggests a new study published in the British Medical Journal.

Physical therapy is often recommended for lateral ankle sprains, the most common musculoskeletal injury among physically active folks. To find out if PT is really necessary, researchers from Queen’s University in Canada rounded up 503 patients who’d torn a lateral, or outer, ankle ligament and monitored their recovery. Over the next six months, everyone was instructed to rest, ice, elevate, apply compression, and restrict weight-bearing activities on their own. On top of that, half of the patients were assigned up to seven sessions of physical therapy.

At one, three, and six months, the researchers assessed both groups’ recovery. At no time were the participants receiving PT faring any better than the participants who did self-care. Everyone’s ankle functionality, on average, progressed about equally.

"Intuitively, you’d expect that if you were getting additional therapy, you’d see better results," says lead researcher Brenda Brouwer. "But we just didn’t see that in terms of functional benefits."

It's not clear why the groups made similar progress. Brouwer says it’s possible that physical therapists aren’t employing the most effective tactics or modalities. Or maybe the fault lies with the patients — perhaps people in physical therapy slack on self-care. Or, now that there’s so much readily available information on how to handle a sprain, she says maybe people are doing a better job of self-care and don’t necessarily need physical therapy.

This doesn’t mean PT is totally worthless for ankle sprains. It’s virtually harmless, and depending on the particulars of the injury, it could help you recover better than self-care. "To some extent, physical therapy is very much a personal choice," Brouwer says. "Some people like to be monitored regularly to make sure everything is OK, that they’re doing what they’re supposed to, that they’re recovering as the therapist might expect. It’s nice peace of mind, and I don’t mean that to belittle its potential physical benefits."

No matter which mode of recovery you choose, any time you hurt your ankle, Brouwer strongly advises having a doctor or physical therapist diagnose the issue. According to a companion paper on Brouwer's study, more than half of all people with lateral ankle sprains fail to get their joint checked out. That, and because they don’t fully commit to rehab, is a big reason why more than 40 percent don’t recover completely. They battle nagging pain and instability, sometimes for years, and often wind up reinjuring that ligament.

Don’t let this be you. See your doctor first, get a diagnosis, discuss your treatment options, and then decide whether or not to do PT.