HFHT's Practising Wisely Newsletter
For clinicians, by clinicians.
Issue 13: When There's a Sprain in the Game
February 21, 2017

DeMar DeRozan recently missed 4 basketball games due to an ankle sprain, but returned to score 31 points to lead the Toronto Raptors to a win over the LA Clippers.

The Raps look to be following the newly published Choosing Wisely advice from the The Academy of Sports and Exercise Medicine on treating ankle sprains:

"Don’t immobilize ankle inversion sprains with no evidence of bony or syndesmotic injury."

The Choosing Wisely recommendations go on to say that "Ankle sprains are among the most common injuries seen in the ER or physician clinics. Ankle sprains cause a high incidence of absenteeism in professional and physical activities with important economic consequences. There is good evidence to show that functional bracing of the ankle instead of rigid immobilization is associated with improved and earlier functional improvement and an overall shorter recovery period.

For ankle inversion sprains with no associated bony or syndesmotic injury, early mobilization using a functional ankle brace and physiotherapy/athletic therapy should be considered instead of rigid immobilization." (Visit our Quick Links section for more recommendations from sport and exercise medicine experts.)

Syndesmotic injury, the dreaded “high ankle sprain” is a disruption of the ligamentous structures between the distal fibula and tibia. It can be treated conservatively with immobilisation while clinically unstable injuries are usually treated surgically.

A recommendation on ankle braces from a local expert:

We asked Dr. Dave Robinson, sports medicine physician at McMaster’s David Braley Sports Medicine Centre about ankle braces and he recommends the ASO functional ankle brace, which is more supportive than taping and can fit into most shoes, athletic or otherwise.

Don't forget to tune in to monthly Choosing Wisely Talks! On March 2, Dr. Shawn Dowling & Ms. Heather Hair will focus on advancing patient engagement through information design. Visit our Quick Links section to find more details!

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