Table 8

Final recommendations per intervention modality

ModalityRecommendationLevel of evidence
Predisposing factorsIn the treatment of patients with LAS, modifiable risk factors should be identified and, if possible, addressed.2–3
Prognostic factorsAssessed of prognostic factors during the rehabilitation process in order to address negative modifiable factors.3
DiagnosticsLate physical examination is advised to come to conclusions on the severity of the ligament damage.2
RICERICE is not advised as treatment modality after a LAS.2
NSAIDsNSAIDs may be used to reduce pain and swelling.2
ImmobilisationImmobilisation should not be used in the treatment of a LAS.2
Functional supportFunctional 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
ExerciseExercise 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 mobilisationManual mobilisation is only advised in combination with other treatment modalities to enhance the treatment effect.3
SurgerySurgery 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 therapiesBased on current evidence, other modalities than the once mentioned above are not advised.2
Interprofessional communicationA communication checklist should be used to ensure communication errors.1
FootwearNo recommendations can be made concerning footwear due to inconclusiveness of evidence.1
Work resumptionImmediate functional treatment and a return to work schedule are advised to minimise work absenteeism.3
Sport resumptionSupervised 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.