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Does delaying ankle sprain rehab impact re-injury risk and medical costs?

Research reviewed: Delayed Rehabilitation Is Associated With Recurrence and Higher Medical Care Use After Ankle Sprain Injuries in the United States Military Health System; JOSPT 2021

Ankle sprains are one of the most prevalent injuries in all active populations – from athletes to weekend warriors to military personnel – and therefore contribute to one of the highest time-loss and medical cost of injuries.

Naturally, a pertinent question becomes can that time and cost be reduced through proper physiotherapy? In this paper, researchers examined that question by investigating military personnel who suffered an ankle sprain and had or hadn’t gone through physical therapy for it (in this case, physiotherapy was defined as exercise therapy which is the best-practice recommendation).

This is the sorting process researchers went through:

You can see that the total sample size of over 22000 is pretty significant which lends itself to a stronger conclusion.

The main takeaways were as follows:

  • The group that received physio (“yes”) had significantly less reinjury than those who didn’t. Nearly 50% of the no-physio group suffered a recurrence.
  • Amongst the “yes” group, recurrence rates increased for each day that physio wasn’t started during the first week
  • Amongst that “yes” group, those subjects receiving physio in the first four weeks after an ankle sprain led to a significantly reduced risk of injury recurrence compared to those who received it at 8 to 12 weeks.
  • The delayed care group also had much longer plans of care, nearly 10 more visits
  • Costs were over 10% higher for the delayed care group

Practically, the recommendation is crystal clear – get physiotherapy as soon as you can following an ankle sprain. Your risk of reinjury goes down, total visits go down, and overall cost goes down.

Dr. Rajpal Brar, DPT, (@3cbperformance) is a physiotherapistmovement expertstrength and conditioning/fitness coach, sports scientist and mindfulness coach. He runs the LA and online based physiotherapy and athletic performance clinic 3CB Performance and you can subscribe to his Youtube channel (which posts a variety of sports injury, performance, and fitness related content).

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