The Influence of therapeutic exercise after ankle sprain on the incidence of subsequent knee, hip, and lumbar spine injury

Review written by Dr Chris Bleakley info

Key Points

  1. In a large retrospective audit, less than 33% of patients with ankle sprain were prescribed therapeutic exercises.
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Ankle sprains commonly occur in active populations, with 40% developing chronic ankle instability (CAI). CAI presents clinically as persistent subjective instability or recurrent injury, due to a combination of mechanical and sensorimotor impairments. Such changes in ankle neuromechanics can pervade proximally, to affect the entire kinetic chain, with increasing evidence that individuals with CAI also present with aberrant movements at the knee, hip and trunk (1). It is therefore likely that CAI also increases the risk of subsequent injury to joints proximal to the ankle, but this has not yet been confirmed empirically.

This was the first large study to quantify the burden of subsequent injury to the knee, hip and lumbar regions after an initial ankle sprain. The authors were also interested in determining if the risk of proximal injury was influenced by demographic variables and exercise prescription.

Ankle sprains commonly occur in active populations, with 40% developing chronic ankle instability.
Effective rehabilitation must progress beyond the local injury region, to target proximal joints and incorporate global movement patterns.


This study used a retrospective cohort design. All data were extracted from electronic medical records within the US Military Health Repository. Military personnel who had incurred an ankle sprain over a 2-year observation period were included. Their medical records were

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