From the Guidelines
For an old partial thickness tear of the ATFL, functional support with a brace and exercise therapy should be the primary treatment approach, as it enhances recovery and reduces the risk of recurrent ankle sprains, according to the most recent evidence 1.
Treatment Approach
The treatment of an old partial thickness tear of the ATFL should focus on functional support and exercise therapy. This approach is supported by the British Journal of Sports Medicine guideline, which recommends functional support over immobilization, especially the use of a brace, and exercise therapy to recover joint functionality 1.
Key Components of Treatment
- Functional Support: The use of a brace is preferred over immobilization to provide support during the recovery process and return to activities, as advised in the guideline 1.
- Exercise Therapy: Exercise should be started as soon as possible to recover joint functionality, focusing on proprioception, strength, coordination, and function, which is crucial for preventing recurrent ankle sprains and chronic instability 1.
- Pain Management: NSAIDs may be used to reduce pain and swelling, as recommended in the guideline 1.
- Surgery: Surgery is only advised for patients who require quick recovery or whose complaints are not resolved by conservative treatment, which is typically not the case for partial thickness tears of the ATFL 1.
Additional Considerations
- Prognostic Factors: Assessment of prognostic factors during the rehabilitation process is important to address negative modifiable factors, which can influence the outcome of the treatment 1.
- Interprofessional Communication: A communication checklist should be used to ensure communication errors are minimized, which is essential for effective treatment and rehabilitation 1.
From the Research
Treatment Options for Old Partial Thickness Tear of ATFL
- Non-surgical treatment is the first choice for acute injury of the ATFL, and this approach can also be applied to old partial thickness tears 2
- The standard treatment strategy involves the "peace and love" principle, followed by personalized rehabilitation training programs, which may include:
- Proprioception training
- Muscle training
- Functional exercise to restore limb coordination and muscle strength
- Other techniques that can relieve pain, restore range of motion, and prevent joint stiffness include:
- Static stretching
- Acupuncture
- Moxibustion massage
- Other traditional medical treatments
- If non-surgical treatment is not ideal or fails, surgical treatment is feasible, and arthroscopic anatomical repair or anatomical reconstruction surgery is commonly used in clinical practice 2
- Conservative management approaches, such as early and effective initial treatment involving pain management, prompt resumption of weight-bearing activities, limited immobilisation, and targeted physical therapy, can yield favorable outcomes for minor-grade sprains and prevent recurrent injuries 3
Considerations for Treatment
- Treatment management and methods should be timely and reasonably arranged according to the specific injury scenario 2
- The efficiency and effectiveness of treatments depend on the specific nature of the injury and the unique traits of the individuals who sustain it 3
- Athletes who experience regular ankle sprains should consider prophylactic bracing or taping to lower the risk of re-injury while enhancing their functionality 3