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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