Modality | Recommendation | Level of evidence |
Predisposing factors | In the treatment of patients with LAS, modifiable risk factors should be identified and, if possible, addressed. | 2–3 |
Prognostic factors | Assessed of prognostic factors during the rehabilitation process in order to address negative modifiable factors. | 3 |
Diagnostics | Late physical examination is advised to come to conclusions on the severity of the ligament damage. | 2 |
RICE | RICE is not advised as treatment modality after a LAS. | 2 |
NSAIDs | NSAIDs may be used to reduce pain and swelling. | 2 |
Immobilisation | Immobilisation should not be used in the treatment of a LAS. | 2 |
Functional support | Functional support is preferred over immobilisation, especially the use of a brace. | 2 |
For prevention, both tape and brace may be used. Choice of modality should always be based on patient preferences. | 1 | |
Exercise | Exercise therapy should be started as soon as possible to recover joint functionality. | 1 |
For recurrent ankle sprains, exercise should be included in regular training activities as much as possible. | 1 | |
Manual mobilisation | Manual mobilisation is only advised in combination with other treatment modalities to enhance the treatment effect. | 3 |
Surgery | Surgery is only advised for patients that require quick recovery, such as professional athletes, or whose complaints are not resolved by conservative treatment to avoid unnecessary invasive treatment on patients that would just as well recover from conservative treatment. | 1 |
Other therapies | Based on current evidence, other modalities than the once mentioned above are not advised. | 2 |
Interprofessional communication | A communication checklist should be used to ensure communication errors. | 1 |
Footwear | No recommendations can be made concerning footwear due to inconclusiveness of evidence. | 1 |
Work resumption | Immediate functional treatment and a return to work schedule are advised to minimise work absenteeism. | 3 |
Sport resumption | Supervised exercises are advised with the focus on proprioception, strength, coordination and function. | 1 |
LAS, lateral ankle sprain; NSAIDs, non-steroidal anti-inflammatory drugs; RICE, Rest Ice Compression Elevation.