{"id":6501,"date":"2021-08-02T17:15:00","date_gmt":"2021-08-02T15:15:00","guid":{"rendered":"https:\/\/www.physiotutors.com\/?p=6501"},"modified":"2023-03-16T16:01:36","modified_gmt":"2023-03-16T15:01:36","slug":"return-to-sport-ankle-sprain","status":"publish","type":"post","link":"https:\/\/www.physiotutors.com\/return-to-sport-ankle-sprain\/","title":{"rendered":"Return to Sport Criteria After an Acute Lateral Ankle Sprain"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Introduction<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Lateral ankle sprains are among the most common musculoskeletal injuries in athletes and recurrence rates are high. Making decisions to clear an athlete to return to sport can be difficult and should be made based on relevant criteria. Unfortunately for return to sport after an acute lateral ankle sprain, up till now, no clear criteria have yet been established, which may explain the high recurrence and prevalence of ongoing symptoms, instability and\/or \u201cgiving way\u201d.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.physiotutors.com\/wp-content\/uploads\/2021\/07\/Blog-Featured-Images-3.png\" alt=\"Blog featured images 3\" class=\"wp-image-6304\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Return to sport<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">If you are interested in the diagnosis and treatment of acute lateral ankle sprains, be sure to check out the following blog article: <a href=\"https:\/\/www.physiotutors.com\/ankle-sprain-rehab-guideline\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.physiotutors.com\/ankle-sprain-rehab-guideline\/<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Items to be considered in the decision making process for return to sport after an acute lateral ankle sprain can be classified into five domains.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">1. Pain<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Pain severity during sport participation and over the last 24h should be considered as essential criteria prior to clearing an athlete to return to sport.&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">2. Ankle impairments<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">As for ankle impairments, range of motion and muscle strength, endurance and power have to be evaluated.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">3. Athlete perception<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">The perceived stability of the ankle and the confidence or reassurance the athlete feels, together with the psychological readiness for return to sport should be taken into account. The athlete should feel confident to load the ankle in both the rehabilitation environment and on field.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">4. Sensorimotor control<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">A good proprioception and dynamic postural control are necessary items belonging to the sensorimotor control domain. Prior to returning to sport, the athlete should demonstrate adequate control of the ankle joint on unstable surfaces, when jumping and landing and in unpredictable situations.&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">5. Sport\/functional performance<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Regarding the sport and functional performance criteria, hopping and jumping, agility and sport-specific activities should be well tolerated. The final criterium for clearing an athlete to RTS is the ability to complete a full training session.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.physiotutors.com\/wp-content\/uploads\/2021\/07\/Schermafbeelding-2021-06-29-om-20.07.54.png\" alt=\"Schermafbeelding 2021 06 29 om 20.07.54\" class=\"wp-image-6292\"\/><figcaption class=\"wp-element-caption\">From: Smith et al. 2021<\/figcaption><\/figure>\n\n\n<div class=\"cta\" style=\"\">\n    <div class=\"cta__in\">\n        <div class=\"left\">\n            <div class=\"cta__content text-color-light\">\n\t\t\t\t\t\t\t\t\t<h2 class=\"own-size\">ORTHOPEDIC PHYSIOTHERAPY OF THE UPPER AND LOWER EXTREMITIES<\/h2>\n\t\t\t\t\t                <p>Boost Your Knowledge about the 23 Most Common Orthopedic Pathologies in Just 40 Hours<\/p>\n                                        <div class=\"cta__button\">\n                                <a href=\"https:\/\/study.physiotutors.com\/course\/orthopedic-physical-assessment\/\" class=\"button button-five\" target=\"_self\">\n                                    Learn More                                <\/a>\n                            <\/div>\n                                    <\/div>\n        <\/div>\n                        <div class=\"right\">\n                    <img decoding=\"async\" src=\"https:\/\/www.physiotutors.com\/wp-content\/uploads\/2022\/10\/Extremity-course-mockup-full.png\" alt=\"\"\/>\n                <\/div>\n                <\/div>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Clinical application<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Unfortunately, no clear definition of cutoff values for these proposed measures has been defined, which makes it difficult to implement them straightaway in practice.\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The following measurements can be considered in clinical practice. For pain, this can be quite simple as the numeric rating scale and visual analog scale are widely known. Ankle range of motion can be evaluated through the active and passive range of motion assessment and joint play, for which we have made a couple of videos.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.youtube.com\/watch?v=ViRsbvnL6uQ\" target=\"_blank\" rel=\"noreferrer noopener\">Active Range of Motion (Ankle &amp; Foot)<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.youtube.com\/watch?v=VYH9HKSNxoA\" target=\"_blank\" rel=\"noreferrer noopener\">Ankle Passive Range of Motion (PROM)<\/a><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Joint Play: Ankle &amp; Foot\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/IwfUodlzIAc?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Measuring an athletes\u2019 perception is a little more complicated and is more subjective compared to the other criteria for return to sport. We recommend building a good therapeutic relationship and to facilitate open communication with the patient. Ideally, decisions in this return to sport process should be taken together with the athlete and team.<\/p>\n\n\n<div class=\"quote-with-background\" style=\"\">\n    <div class=\"quote-with-background__in\">\n\n        <svg width=\"30px\" height=\"25px\" viewBox=\"0 0 30 25\" version=\"1.1\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\">\n            <g id=\"Design\" stroke=\"none\" stroke-width=\"1\" fill=\"none\" fill-rule=\"evenodd\">\n                <g id=\"08-blog-redesign\" transform=\"translate(-191.000000, -2974.000000)\" fill=\"#7973FF\" fill-rule=\"nonzero\">\n                    <g id=\"Group-7\" transform=\"translate(80.000000, 2893.000000)\">\n                        <g id=\"\u201c\" transform=\"translate(111.000000, 81.000000)\">\n                            <path d=\"M6.4,25 C4.42666667,25 2.86666667,24.3743344 1.72,23.1230032 C0.573333333,21.871672 0,20.2609159 0,18.2907348 C0,17.2790202 0.173333333,16.2539936 0.52,15.215655 C0.866666667,14.1773163 1.49333333,12.513312 2.4,10.2236422 L6.48,0 L12.8,0 L10,12.5399361 C11.9733333,14.0841321 12.96,16.001065 12.96,18.2907348 C12.96,20.2076677 12.3466667,21.8051118 11.12,23.0830671 C9.89333333,24.3610224 8.32,25 6.4,25 Z M23.44,25 C21.4666667,25 19.9066667,24.3743344 18.76,23.1230032 C17.6133333,21.871672 17.04,20.2609159 17.04,18.2907348 C17.04,17.2790202 17.2133333,16.2539936 17.56,15.215655 C17.9066667,14.1773163 18.5333333,12.513312 19.44,10.2236422 L23.52,0 L29.84,0 L27.04,12.5399361 C29.0133333,14.0841321 30,16.001065 30,18.2907348 C30,20.2076677 29.3866667,21.8051118 28.16,23.0830671 C26.9333333,24.3610224 25.36,25 23.44,25 Z\" id=\"Shape\"><\/path>\n                        <\/g>\n                    <\/g>\n                <\/g>\n            <\/g>\n        <\/svg>\n       <div class=\"quote-with-background__content heading-three\">\n            <p>Measuring an athletes\u2019 perception is a little more complicated and is more subjective compared to the other criteria for return to sport. We recommend building a good therapeutic relationship and to facilitate open communication with the patient.<\/p>\n       <\/div>\n       <div class=\"quote-with-background__info\">\n                   <\/div>\n    <\/div>\n<!--    <div class=\"quote-with-background__background\">-->\n<!--        <svg width=\"100%\" height=\"100%\" viewBox=\"0 0 849 447\" version=\"1.1\" preserveAspectRatio=none xmlns=\"http:\/\/www.w3.org\/2000\/svg\" xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\">-->\n<!--            <g id=\"Design\" stroke=\"none\" stroke-width=\"1\" fill=\"none\" fill-rule=\"evenodd\">-->\n<!--                <g id=\"08-blog-redesign\" transform=\"translate(-80.000000, -2893.000000)\" fill=\"#F1F5FD\">-->\n<!--                    <g id=\"Group-7\" transform=\"translate(80.000000, 2893.000000)\">-->\n<!--                        <polygon id=\"Rectangle\" transform=\"translate(424.500000, 223.500000) scale(-1, 1) translate(-424.500000, -223.500000) \" points=\"0 99.703192 849 -4.43831367e-13 849 347.296808 0 447\"><\/polygon>-->\n<!--                    <\/g>-->\n<!--                <\/g>-->\n<!--            <\/g>-->\n<!--        <\/svg>-->\n<!--    <\/div>-->\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">To evaluate the strength of the muscles surrounding the ankle joint we propose to watch the following video: <a href=\"https:\/\/www.youtube.com\/watch?v=apRDvOLqTrE\" target=\"_blank\" rel=\"noreferrer noopener\">How Good is Your Calf Function? What is the Norm &amp; Common Compensations<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Evaluating how the athlete executes functional movements both in predictable and unpredictable situations can be used to give a rough idea of the ankle joint proprioception and postural control. When well tolerated and executed, more sport-specific tasks like jumping and landing should become the focus.\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The final step of this return to sport process is to see how the athlete copes with a full training session. When well tolerated, the ultimate decision to clear an athlete to return to sport should not be feared.\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">We hope you enjoyed this read.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ellen<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Reference<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Smith MD, Vicenzino B, Bahr R, Bandholm T, Cooke R, Mendon\u00e7a LM, Fourchet F, Glasgow P, Gribble PA, Herrington L, Hiller CE, Lee SY, Macaluso A, Meeusen R, Owoeye OBA, Reid D, Tassignon B, Terada M, Thorborg K, Verhagen E, Verschueren J, Wang D, Whiteley R, Wikstrom EA, Delahunt E. Return to sport decisions after an acute lateral ankle sprain injury: introducing the PAASS framework-an international multidisciplinary consensus. Br J Sports Med. 2021 Nov;55(22):1270-1276. doi: 10.1136\/bjsports-2021-104087. Epub 2021 Jun 22. PMID: 34158354. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34158354\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/pubmed.ncbi.nlm.nih.gov\/34158354\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":45,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"9930,16504,5115,6444,13043,4968","_relevanssi_noindex_reason":"","footnotes":""},"categories":[189],"tags":[915,917,919,921],"tracking_tag":[],"class_list":["post-6501","post","type-post","status-publish","format-standard","hentry","category-ankle-foot","tag-ankle-sprain","tag-lateral-ankle-sprain","tag-rehabilitation","tag-return-to-sport"],"acf":{"sections":[{"acf_fc_layout":"featured-related","heading":"Related blog posts","subheading":"","content_editor":"","featured_or_related":"related","posts":null,"button_type":"internal_link","button_label":"","button_style":"button-one","button_internal_link":"","button_anchor":"","button_url":"","button_file":null}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Return to Sport after an Acute Lateral Ankle Sprain - Physiotutors<\/title>\n<meta name=\"description\" content=\"Clearing an athlete to return to sport can be difficult. What criteria to use for return to sport after an acute lateral ankle sprain? Read on\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.physiotutors.com\/return-to-sport-ankle-sprain\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Return to Sport after an Acute Lateral Ankle Sprain - Physiotutors\" \/>\n<meta property=\"og:description\" content=\"Clearing an athlete to return to sport can be difficult. What criteria to use for return to sport after an acute lateral ankle sprain? 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