Is a tensor (elastic bandage) effective for treating a sprained ankle?

Tensor Bandages for Sprained Ankles: Evidence-Based Recommendations

A tensor (elastic bandage) may be considered for a sprained ankle primarily to promote comfort in the acute phase, but it does not significantly reduce swelling, improve function, or speed recovery compared to other treatment options. 1

Effectiveness of Tensor Bandages

• Tensor bandages (elastic compression wraps) may provide some comfort and pain relief in the acute phase of an ankle sprain, but should be applied without compromising circulation 1
• Systematic reviews have found that compression wraps do not significantly reduce swelling or pain during the recovery period 1
• Compression wraps do not improve ankle joint function, range of motion, or time to recovery compared to other interventions 1
• There is insufficient evidence to strongly recommend for or against the application of a compression bandage for acute ankle sprains 1

Recommended Treatment Approach for Ankle Sprains

Immediate Management (First 24-72 hours)

• Rest and avoid activities that cause pain 1
• Apply cold therapy (ice and water in a damp cloth) for 20-30 minutes, 3-4 times daily to decrease pain and swelling 1
• Consider a compression wrap primarily for comfort, ensuring it's not too tight 1
• Elevate the injured extremity 2
• Seek medical attention, especially if the injury limits use of the extremity 1

Follow-up Treatment

• Functional support with an ankle brace is preferred over elastic bandages and shows greater benefits 1, 3
• Begin early weight-bearing and functional rehabilitation as tolerated 1, 2
• Implement an exercise program including range of motion, strengthening, and proprioceptive exercises 1, 2
• Manual joint mobilization combined with exercise therapy provides better outcomes than exercise therapy alone 1, 4

Common Pitfalls to Avoid

• Overtightening the compression wrap, which can compromise circulation 1
• Prolonged immobilization (more than 10 days), which leads to poorer outcomes 1
• Relying solely on compression therapy without implementing other evidence-based treatments like exercise 1, 2
• Expecting significant reduction in swelling or faster recovery from compression wraps alone 1
• Neglecting proper rehabilitation, which increases the risk of recurrent sprains 1, 2

Treatment Hierarchy Based on Evidence

1. Strongest evidence supports:

   • Functional rehabilitation with exercise therapy 1, 2
   • Use of ankle braces rather than elastic bandages 1, 3
   • Cold application for pain and swelling 1

2. Moderate evidence supports:

   • Manual therapy combined with exercise 1, 4
   • Short-term use of compression for comfort 1

3. Limited or conflicting evidence for:

   • Compression wraps for reducing swelling or speeding recovery 1

In conclusion, while a tensor bandage may provide some comfort for a sprained ankle in the acute phase, it should be considered as just one component of a comprehensive treatment approach that emphasizes functional rehabilitation and appropriate support.