Giving Ankle Injury the Third Degree

Here’s a dilemma for sports medicine. Say an athlete sprains an ankle. Can the medical examiner tell the coach how soon the athlete can return to the sport? Right now, ligament sprains are divided into first, second, and third-degree sprains. The first-degree sprain is mildest and usually means a faster recovery. But how quickly can the athlete return to competition? And how does this compare to a second-degree or third-degree sprain?

A group of physical therapists wanted to classify ankle sprains based on prognosis, or expected treatment results. Such a method would help predict what will happen with each degree of ankle sprain. No test is known to predict the time required to return to play, so the therapists decided to see if a patient’s report of the injury could help predict how soon the athlete returned to sport. Number of days to return to sport may be one way to classify ankle injury. This could then be used to predict the outcome of other athletes’ injuries.

Twenty athletes who had sprained an ankle participated in this study. The athletes gave the therapists information right after the injury about their pain level and ability to walk or use the leg (compared to the uninjured leg). The therapists measured ankle motion and strength. Treatment was provided twice a day beginning the day after the sprain. Treatment continued until the athlete returned to sport.

The ability to walk and use the leg as reported by athletes was the best predictor of number of days to return to sport. There may be other ways to predict return to sport that are more accurate. Further research will help identify these for use by sports health professionals.