Wednesday, November 8, 2017

The Application of Mechanical Diagnosis and Therapy to an Ankle Sprain: a case report

Background: A sprained ankle is a common musculoskeletal condition that causes pain and dysfunction. Current physical therapy treatment for a sprained ankle has limited efficacy as compared to unsupervised management. Mechanical Diagnosis and Therapy [MDT] is an orthopedic classification and treatment system based on mechanical and symptomatic response to repeated and sustained movement. There has been no investigation of the association between MDT and patients diagnosed with ankle sprain.

Case description: This report presents a 49-year-old female with intermittent right, lateral ankle pain for 14 days after landing incorrectly during an exercise movement. The patient was self referred through direct access receiving classification and treatment solely by a Diplomat of MDT utilizing MDT principles.

Outcomes: Short- and long-term (6 month) outcomes were excellent, demonstrating rapid abolishment of symptoms and return to prior levels of function in 4 visits over 14 days without the use of modalities, manual therapy, strength, or proprioceptive training. The patient demonstrated the ability to prevent and manage re-occurrence of symptoms independently without seeking further healthcare at 6–month and follow-up.

Discussion: The rapid speed of recovery and return to high level athletics demonstrated in this case report, raises questions about whether the pathologies traditionally associated with the etiology of lateral ankle sprains are actually at fault or understood. Moreover, it demonstrates that specific movements can rapidly worsen or improve symptoms challenging the current generalized rehabilitation protocols. The series provides preliminary evidence that MDT may be capable of providing more effective short- and long-term outcomes in the management of ankle sprains.

Level of Evidence: 5

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