ANKLE SPRAIN GRADES

                                                                   ANKLE SPRAIN GRADES 



Abstract 
Ankle ligament sprains are usually graded on the basis of difficulty or injury such as Grade I, II, and III and most common causes of musculoskeletal joint pain and disability encountered in daily physical life.

keywords 
Ankle sprain, Ligament, Ankle sprain grade,Ligament injury

Introduction 
Ankle sprain are the most common source of musculoskeletal joint pain and disability encountered in daily physical life. Ankle sprain create difficulty in the balance between joint mobility and joint stability. Ankle ligament sprains are usually graded on the basis of difficulty or injury such as Grade I, II, and III.1, 2

GRADES 
Ankle ligament sprains are usually graded on the basis of difficulty or injury.

Grade- I Partial tear of a ligament 
Grade I ankle sprains incorporates the mild stretching of the ligament (ligament is the fibrous connective tissue that attach one bone to another bones) complex without joint instability.
Grade I sprains is painful, mild swelling around the bone on the outside of the ankle but there is slight or no loss of function, mild tenderness and patient is able to bear weight. 
The generally accepted therapy of grade I is Rest, Ice, Compression and Elevation. Therapy will resolve the problem within 7–14 days.

Grade II 
Grade II ankle sprains incorporates the moderate ligament damage, mild to moderate ecchymosis, instability of the joint resulting from moderate pain, swelling and stiffness in the ankle joint, a little loss of motion and function. 


Grade III 
In this  sprains complete rupture of the ligament (medial and lateral ligaments) with gross instability of the joint resulting from severe swelling, ecchymosis, Loss of function and motion.3,4,5,6

Conclusion 
Ankle sprains are usually graded on the basis of difficulty or injury such as Grade I, II, and III.

References 
1.Hubbard Tricia J, Wikstrom Erik A. Ankle sprain: pathophysiology, predisposing factors, and management strategies, Open Access Journal of Sports Medicine 2010:1.
2.Petersen Wolf, Rembitzki Ingo Volker, Koppenburg Andreas Gösele, Ellermann Andre, Liebau Christian, Brüggemann Gerd Peter, Best Raymond. Treatment of acute ankle ligament injuries: a systematic review. Arch Orthop Trauma Surg (2013) 133:1129–1141.
3.Wolfe Michael W, UHL Tim L., Mattacola Carl G, Mccluskey Leland C, Management of Ankle Sprains. American Family Physician, January 1, 2001 / Volume 63, Number 1.
4.Whitmana J.M, Childsc J.D, Walker V. The use of manipulation in a patient with an ankle sprain injury not responding to conventional management: a case report. Manual Therapy 10 (2005) 224–231.
5.Seah Richard, and Mani-Babu Sivanadian. Managing ankle sprains in primary care: what is best practice? A systematic review of the last 10 years of evidence. British Medical Bulletin 2011; 97: 105–135.
6.Gino M Kerkhoffs et al. Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline. Br J Sports Med 2012; 46:854–860.

GRADE 2 ANKLE SPRAIN

                                                         GRADE 2 ANKLE SPRAIN


Abstract 
A grade 2 ankle sprain included the moderate ligament damage, mild to moderate ecchymosis, instability of the joint resulting from moderate pain, swelling, little loss of motion and function.

Keywords 
Ankle sprain, ligament, Cryotherapy, vasoconstriction

Introduction 
Ankle joint is surrounded by 3 groups of ligaments, such as lateral, posterior and medial ligaments complex. Lateral complex consisting of the Anterior Talofibular ligament (ATFL), Calcaneofibular ligament (CFL), posterior talofibular ligament (PTFL) and medial (deltoid) ligament complex, is divided into a superficial and deep part. A grade 2 ankle sprain involves moderate ligament damage (commonly with a complete tear of the Anterior Talofibular ligament and partial tear of the Calcaneofibular ligament).1

Sign and symptoms
A grade 2 ankle sprain symptoms may include moderate ligament damage, mild to moderate ecchymosis, instability of the joint resulting from moderate pain, bruising and localized swelling, due to tearing of the anterior joint capsule, ATFL, and adjoining soft tissue  and stiffness in the ankle joint, a little loss of motion and function.2

Treatment 
Short period of Immobilization and Rest 
Short period of Rest or immobilization is essential to decrease the blood flow and prevent the further tissue damage. Restrictive movement of the injured area at initial phase is helpful in short term recovery.3

Cryotherapy 
Crushed ice in a plastic bag may be applied to the affected area is dropping the temperature of the injured tissues, minimizing the metabolic demand and inducing the vasoconstriction (Narrowing of the blood vessels), and limiting the bleeding.4 

Compression  
Compression is applied to the injured area by the use of bandage to limit the amount of edema (swelling) and reduces the swelling and exudation of the fluid. 

Elevation
Elevation of the affected part reduces the pressure in blood vessels of injured area and helps to limit the blood loss and swelling. 

Medications
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) are used in the treatment of ligament Injuries.

Exercises
Various exercises is used in the management of grade 2 sprains such as ABC’s Exercise, Towel Curls and stretching exercises (Towel and Standing Stretch).3,5,6

Conclusion 
A grade 2 ankle sprain included the moderate ligament damage, instability of the joint resulting from moderate pain, swelling, little loss of motion and function.

References 
1.Joshua C.et al. Lateral and syndesmotic ankle sprain injuries:a narrative literature review. Journal of Chiropractic Medicine (2011) 10, 204–219.
2.Chan Keith W, Ding Bryan C and Mroczek Kenneth J. Acute and Chronic Lateral Ankle Instability in the Athlete. Bulletin of the NYU Hospital for Joint Diseases 2011; 69(1):17-26.
3.Rensburg Christa Janse Van. Approach to and Management of Acute Ankle Ligamentous Injuries. CME March 2004 Vol.22 No.3.
4.Bekerom Michel P.J. van den, Struijs Peter A.A, Blankevoort Leendert, Welling Lieke, C. van Dijk Niek, Kerkhoffs Gino M.M.J. What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?. Journal of Athletic Training 2012; 47(4):435–443.
5.Gino M Kerkhoffs et al. Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline. Br J Sports Med 2012; 46:854–860.
6.Hauser R.A, Dolan E.E, Phillips H.J, Newlin A.C, Moore R.E. and Woldin B.A. Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics. The Open Rehabilitation Journal, 2013, 6, 1-20.

SEVERE ANKLE SPRAIN

                                                      SEVERE ANKLE SPRAIN


Abstract 
A severe ankle sprain is including the complete ligament damage, severe ecchymosis (bleeding in to the skin) instability of the joint and more severe ankle impairment can also include rupture of the bones or high ankle sprains. Treatment of severe ankle sprain is included the immobilization and rest, cryotherapy, compression, elevation, medications (NSAIDs), exercises and surgery.

Keywords 
Severe ankle sprain, Surgery, NSAIDs, Stretching
Introduction 
Severe ankle sprain identified as complete ruptured of anterior capsule, Anterior Talofibular ligament (ATFL), Calcaneofibular ligament (CFL) and posterior talofibular ligament (PTFL) with instability of the joint and more severe ankle impairment can also include rupture of the bones or high ankle sprains.1,2

Sign and Symptoms 
A severe ankle sprain symptoms may include complete ligament damage, severe ecchymosis (bleeding in to the skin) instability of the joint resulting from severe pain, diffuse inflammation both sides Achilles tendon, possible tenderness medially and laterally a complete loss of motion and function.3

Treatment 
Immobilization and Rest 
Rest or immobilization (restrict the movement of the ankle joint in bothflexion/extension and inversion/eversion) is essential to decrease the blood flow and prevent the further tissue damage. Restrictive movement of the injured area at initial phase is helpful in short term recovery.

Ice 
Crushed ice in a plastic bag may be applied to the injured area is falling the temperature of the affected part, minimizing the metabolic demand of the tissue and inducing the vasoconstriction (Narrowing of the blood vessels), and limiting the bleeding. 

Compression  
Compression is applied to the injured area by the use of bandage and taping to limit the amount of edema (swelling) and reduces the swelling and exudation of the fluid. 


Elevation
Elevation of the affected part reduces the pressure in local blood vessels of injured area and helps to limit the blood loss and improving the excretion of inflammatory exudate through the lymphatic system, reducing oedema (swelling). 

Medications
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) are used in the treatment of ligament Injuries.4,5,6

Exercises
Various exercises are used in the management of severe sprains such as Joint Mobilization, Stretching (Achilles tendon, gastrocnemius, soleus) and stretching exercises.

Surgery
Diverse surgical methods are used in the treatment of severe lateral ankle instability.
The surgical methods may be denoted as anatomical or nonanatomical.7,8

Conclusion 
Severe ankle sprain treatment is included the immobilization and rest, cryotherapy, compression, elevation, medications (NSAIDs), exercises and surgery.

References 
1.Hertel Jay. Functional Anatomy, Pathomechanics, and Pathophysiology of Lateral Ankle Instability. Journal of Athletic Training, Volume 37, Number 4, December 2002.
2.Cooke MW et al. Treatment of severe ankle sprain: a pragmatic randomised controlled trial comparing the clinical effectiveness and cost-effectiveness of three types of mechanical ankle support with tubular bandage. The CAST trial. Health Technology Assessment 2009; Vol. 13: No. 13.
3.Joshua C.et al. Lateral and syndesmotic ankle sprain injuries:a narrative literature review. Journal of Chiropractic Medicine (2011) 10, 204–219.
4.Bekerom Michel P.J. van den, Struijs Peter A.A, Blankevoort Leendert, Welling Lieke, C. van Dijk Niek, Kerkhoffs Gino M.M.J. What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?. Journal of Athletic Training 2012; 47(4):435–443.
5.Gino M Kerkhoffs et al. Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline. Br J Sports Med 2012; 46:854–860.
6.Hauser R.A, Dolan E.E, Phillips H.J, Newlin A.C, Moore R.E. and Woldin B.A. Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics. The Open Rehabilitation Journal, 2013, 6, 1-20.
7.Dr Gaylene McKay and Dr Jill Cook. Evidence-based Clinical Statement Physiotherapy management of ankle injuries in sport. Australian Physiotherapy Association.
8.Standard of Care: Ankle Sprain. Brigham and Women’s Hospital Department of Rehabilitation Services.

TWISTED ANKLE TREATMENT

                                                         TWISTED ANKLE TREATMENT


Abstract
Ankle sprain is characterized as ankle injury and divided into two groups: complicated and uncomplicated. Uncomplicated ankle sprains are deal with without surgery. They include includes rest, ice (Cryotherapy), compression and elevation and medications. Complicated ankle sprains usually need surgical treatment.

Keywords 
Ankle sprain, Cryotherapy, Vasoconstriction, Edema

Introduction 
Ankle sprain is characterized as ankle injury that arises when a person stumbles and the foot bend, resulting in injury to the ligaments. Ankle ligament sprains are categorize on the basis of severity such as I, II and III.  Ankle injury is divided into two groups: complicated and uncomplicated. Uncomplicated ankle sprains are deal with without surgery. They include includes rest, ice (Cryotherapy), compression and elevation and medications. Complicated ankle sprains usually need surgical treatment.1, 2, 3

Twisted ankle sprain Management

Immobilization and Rest 
Rest or immobilization is essential to decrease the metabolic burden of the injured tissue and thus avoid increased blood circulation and prevent the further tissue damage in the joint by restrictive movement, and thereby, declining pain and swelling. It may help in improving recovery time, decreasing functional impairment, and in reducing pain.4

Crushed ice
Crushed ice in a plastic bag may be applied to the affected area is limit the injury-induced damage by dropping the temperature of the tissues and consequently minimizing the metabolic demand, inducing vasoconstriction (Narrowing of the blood vessels), and limiting the bleeding. Affected area should be cooled for nearly twenty minutes every 2 to 3 hours for the initial 48 hours.5 

Compression  
Compression is applied to the affected area by the use of bandage to limit the amount of edema (swelling) caused by the exudation of fluid from the damaged capillaries and retain into the tissue. Compression reduces the swelling and exudation of the fluid.

Elevation
Elevation of the affected part reduces the pressure in blood vessels of injured area and helps to limit the blood loss. Elevation of the affected part increases the drainage of the inflammatory exudates through the lymphatic system, reducing and limiting the swelling. 

Medications
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) are used in the treatment of ligament Injuries.3,6

Conclusion 
Ankle ligament injury and treatment included the rest, ice (Cryotherapy), compression and elevation, medications and surgery. 

References 
1.Wolfe Michael W, UHL Tim L., Mattacola Carl G, Mccluskey Leland C, Management of Ankle Sprains. American Family Physician, January 1, 2001 / Volume 63, Number 1.
2.Seah Richard, and Mani-Babu Sivanadian. Managing ankle sprains in primary care: what is best practice? A systematic review of the last 10 years of evidence. British Medical Bulletin 2011; 97: 105–135.
3.Hauser R.A, Dolan E.E, Phillips H.J, Newlin A.C, Moore R.E. and Woldin B.A. Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics. The Open Rehabilitation Journal, 2013, 6, 1-20.
4.Kerr KM, Daley L, Booth L, Stark J. PRICE guidelines: guidelines for the management of soft tissue (musculoskeletal) injury with protection, rest, ice, compression, elevation (PRICE) during the first 72 hours (ACPSM). ACPOM. 1998;6:10–11.
5.Bekerom Michel P.J. van den,  Struijs Peter A.A, Blankevoort Leendert, Welling Lieke, C. van Dijk Niek, Kerkhoffs Gino M.M.J. What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?. Journal of Athletic Training 2012;47(4):435–443.
6.Gino M Kerkhoffs et al. Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline. Br J Sports Med 2012; 46:854–860.

ANKLE SPRAIN EXERCISES

                                                          ANKLE SPRAIN EXERCISES


Abstract 
Ankle sprain exercises include controlling and regaining the full ankle range of motion, increasing the muscle strength and power, and improving proprioceptive abilities by the use of flexibility exercises, and progressive strength and balance-training exercises.

Keywords 
Ankle sprain exercises, Range of motion, Dorsiflexion, Inversion

Introduction 
Ankle sprain exercises include controlling and regaining the full ankle range of motion, increasing the muscle strength and power, and improving proprioceptive abilities by the use of flexibility exercises, and progressive strength and balance-training exercises. Early functional treatment of the ankle sprain should include range-of-motion exercises, isometric, isotonic strength-training exercises and Resistance Exercises. 1,2

Range of Motion Exercises (ROM)
The Ranges of motion exercises are maintain the flexibility and mobility of the joints, these exercises decrease the stiffness and prevent or slow down the freezing of the joints as the ankle sprain develop and lack of motion. Various range of motion exercise is use in the treatment of ankle sprain such as Dorsiflexion (Pull leg upward), Plantar flexion (Push leg downward), Inversion:Push leg inward (toward the midline of the body), Eversion:Push leg outward (away from the midline of the body), Alphabet.

Isometric Exercises 
Isometric exercises allow building strength around injured ankle joint without moving joint against resistance. Resistance can be provided by an immovable item such as wall or floor. Isometric exercises included the eversion isometrics and inversion isometrics.

Resistance Exercises 
Resistance exercises are carrying out by moving the joint against a force in the opposite direction that you are moving. These exercises work to strengthen the muscles around your ankle to provide additional support to the joint. 
Partial and Full Weight-Bearing Exercises
Weight-Bearing Exercises will help set more weight on the injured foot as well as strengthen it. This type of exercises included following process such as Seated Calf Raise, Single Leg Stand, Lateral Stepping, and Lateral Jump. 


Balance Activities
Decreased balance ability is found in the Patients with ankle sprain, Single Leg Stance on a Towel exercise is used in the treatment of ankle sprains.3,4,5

Conclusion 
Early functional treatment of the ankle sprain should include range-of-motion exercises, isometric, isotonic strength-training exercises and Resistance Exercises.

References 
1.Mattacola Carl G, Dwyer Maureen K. Rehabilitation of the Ankle after Acute Sprain or Chronic Instability. Journal of Athletic Training 2002; 37(4):413–429.
2.Terada Masafumi, Pietrosimone Brian G, Gribble Phillip A., Therapeutic Interventions for Increasing AnkleDorsiflexion After Ankle Sprain: A Systematic Review. Journal of Athletic Training 2013; 48(5):696–709. 
3.Whitmana J.M, Childsc J.D, Walker V. The use of manipulation in a patient with an ankle sprain injury not responding to conventional management: a case report. Manual Therapy 10 (2005) 224–231.
4.Wolfe Michael W, UHL Tim L, Mattacola Carl G, Mccluskey Leland C, Management of Ankle Sprains. American Family Physician, January 1, 2001 / Volume 63, Number 1.
5.Dubin Joshua C, Comeau Doug, McClelland Rebecca I, Dubin PT Rachel A., Ernest Ferrel. Lateral and syndesmotic ankle sprain injuries:a narrative literature review. Journal of Chiropractic Medicine (2011) 10, 204–219.

SPRAINED ANKLE RECOVERY

 SPRAINED ANKLE RECOVERY

Abstract 
The severity of the sprain determines the speed of recovery. There are three goals to aim for in recovery such as Restore motion and flexibility, restore strength and restore balance. Recovery for a sprained ankle starts with the RICE theory (Rest, Ice, Compression, and Elevation).

Keywords 
Sprained Ankle Recovery, RICE theory, Ranges of motion exercises (ROM)

Introduction 
Ankle sprain create difficulty in the balance between joint mobility and joint stability. Recovery for a sprained ankle starts with the RICE theory (Rest, Ice, Compression, and Elevation). The severity of the sprain determines the speed of recovery. There are three goals to aim for in recovery such as Restore motion and flexibility, restore strength and restore balance.

Initial therapy (0-3 days)
Recovery for an ankle sprain starts with the RICE theory (Rest, Ice, Compression, and Elevation). The main aim of initial therapy is reduce the pain and swelling, improve blood circulation, and help in the partial to full weight bearing.

Restore motion and flexibility (4-10 days)
The Ranges of motion exercises (ROM) are maintain the flexibility and mobility of the joints. Various range of motion exercise is use in the management of ankle sprain such as Dorsiflexion (Pull foot upward), Plantar flexion (Push foot downward), Inversion (Push foot inward (toward the midline of the body), Eversion (Push foot outward (away from the midline of the body), Alphabet.

Restore strength (11-21 days)
After the ankle’s normal motion has restore, patients can begin strengthening exercises using a various type of strengthening exercises such as isometric exercises, resistance exercises. 

Isometric Exercises 
Isometric exercises allow building strength around injured ankle joint without moving joint against resistance. Resistance can be provided by an immovable item such as wall or floor. Isometric exercises included the eversion isometrics and inversion isometrics.

Resistance Exercises 
Resistance exercises are carrying out by moving the joint against a force in the opposite direction that you are moving. These exercises work to strengthen the muscles around your ankle to provide additional support to the joint. 

Restore balance (3-6 weeks)
Decreased balance ability is found in the Patients with ankle sprain, as the ankle recovers and strength returns, balance is restored by using exercise like the Single Leg Stance on a Towel.

Conclusion 
There are three goals to aim for in recovery such as Restore motion and flexibility, restore strength and restore balance.

References 
1.Hubbard Tricia J, Wikstrom Erik A. Ankle sprain: pathophysiology, predisposing factors, and management strategies, Open Access Journal of Sports Medicine 2010:1.
2.Cosgarea Andrew J.. Ankle Sprains: How to Speed Your Recovery. American Orthopaedic Society for Sports Medicine. www.sportsmed.org.
3.Whitmana J.M, Childsc J.D, Walker V. The use of manipulation in a patient with an ankle sprain injury not responding to conventional management: a case report. Manual Therapy 10 (2005) 224–231.
4.Wolfe Michael W, UHL Tim L, Mattacola Carl G, Mccluskey Leland C, Management of Ankle Sprains. American Family Physician, January 1, 2001/Volume 63, Number 1.
5.Dubin Joshua C, Comeau Doug, McClelland Rebecca I, Dubin PT Rachel A., Ernest Ferrel. Lateral and syndesmotic ankle sprain injuries:a narrative literature review. Journal of Chiropractic Medicine (2011) 10, 204–219.

TREATING A SPRAINED ANKLE

                                                            TREATING A SPRAINED ANKLE
Abstract 
Treatment of ankle sprains is based on the severity such as grade I, II and III. Ankle sprain is an overstretching or tearing of one or more ankle ligaments when a person stumbles and the foot bend, resulting in injury to the ligaments.

Keywords 
Ankle sprain, Anterior Talofibular ligament, Edema, RICE

Introduction 
Ankle sprain is an overstretching or tearing of one or more ankle ligaments when a person stumbles and the foot bend, resulting in injury to the ligaments. Ankle joint is surrounded by 3 groups of ligaments, such as lateral (Anterior Talofibular ligament (ATFL),Calcaneofibular ligament (CFL)), posterior (posterior talofibular ligament (PTFL)) and medial (deltoid) ligament complex) complex. Treatment of ankle sprains is based on the severity such as grade I, II and III.1,2

Treatment of Ankle Injury

Treatment of Grade I Ankle Injury
Treatment of Grade I Ankle Injury is includes the rest, ice (Cryotherapy), compression and elevation and medications.

Immobilization and Rest 
Rest or immobilization is important to reduce the metabolic burden of the injured tissue and thus avoid increased blood circulation and prevent the further tissue damage in the joint by restrictive movement, and thereby, declining pain and swelling. It may help in improving recovery time, decreasing functional impairment, and in reducing pain.

Crushed ice (Cryotherapy)
Crushed ice in a plastic bag may be applied to the affected area is limit the injury-induced damage by dropping the temperature of the tissues and inducing vasoconstriction (Narrowing of the blood vessels), and limiting the bleeding. Affected area should be cooled for nearly twenty minutes every 2 to 3 hours for the initial 48 hours. 


Compression  
Compression is applied to the affected area by the use of bandage or tapping to limit the amount of edema (swelling) caused by the exudation of fluid from the damaged capillaries and retain into the tissue. Compression reduces the swelling and exudation of the fluid.

Elevation
Elevation of the affected part reduces the pressure in blood vessels of injured area and helps to limit the blood loss. Elevation of the affected part increases the drainage of the inflammatory exudates through the lymphatic system, reducing and limiting the swelling.3,4,5 

Medications
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) are used in the treatment of ligament Injuries.

Treatment of Grade II Ankle Injury
They include includes rest, ice (Cryotherapy), compression and elevation and medications same as grade I and exercise.

Exercises
Various exercises is used in the management of grade 2 sprains such as ABC’s Exercise, Towel Curls and stretching exercises (Towel and Standing Stretch).

Treatment of Grade III Ankle Injury
Treatment of grade III Ankle Injury is including the rest, ice (Cryotherapy), compression, elevation, medications, exercise and surgery.

Surgery
Various surgical methods are used in the treatment of severe lateral ankle instability.The surgical methods may be denoted as anatomical or nonanatomical.6,7,8

Conclusion 
Treatment of ankle sprains is based on the severity of injury and their grade such as I, II and III.

References 
1.Joshua C.et al. Lateral and syndesmotic ankle sprain injuries:a narrative literature review. Journal of Chiropractic Medicine (2011) 10, 204–219.
2.Wolfe Michael W, UHL Tim L., Mattacola Carl G, Mccluskey Leland C, Management of Ankle Sprains. American Family Physician, January 1, 2001 / Volume 63, Number 1.
3.Seah Richard, and Mani-Babu Sivanadian. Managing ankle sprains in primary care: what is best practice? A systematic review of the last 10 years of evidence. British Medical Bulletin 2011; 97: 105–135.
4.Hauser R.A, Dolan E.E, Phillips H.J, Newlin A.C, Moore R.E. and Woldin B.A. Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics. The Open Rehabilitation Journal, 2013, 6, 1-20.
5.Kerr KM, Daley L, Booth L, Stark J. PRICE guidelines: guidelines for the management of soft tissue (musculoskeletal) injury with protection, rest, ice, compression, elevation (PRICE) during the first 72 hours (ACPSM). ACPOM. 1998;6:10–11.
6.Bekerom Michel P.J. van den,  Struijs Peter A.A, Blankevoort Leendert, Welling Lieke, C. van Dijk Niek, Kerkhoffs Gino M.M.J. What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?. Journal of Athletic Training 2012;47(4):435–443.
7.Gino M Kerkhoffs et al. Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline. Br J Sports Med 2012; 46:854–860.
8.Rensburg Christa Janse Van. Approach to and Management of Acute Ankle Ligamentous Injuries. CME March 2004 Vol.22 No.3.
9.Standard of Care: Ankle Sprain. Brigham and Women’s Hospital Department of Rehabilitation Services.