Nonpharmacological management for acute ligament sprain

Initial management techniques for acute ligament sprains are detailed in Features of nonpharmacological management techniques for acute soft-tissue limb conditions.

In some cases, particularly grade 3 ligament injuries, short-term immobilisation and support with taping or a brace (eg knee brace) may be appropriate. These can provide stability and reduce the risk of early reinjury.

Consider referral to a physical therapist (eg physiotherapist) for acute ligament injuries, particularly more severe grades. Physical therapy may include:

• restoration of range of motion
• proprioception training
• local muscle strengthening
• functional exercises.

For acute lateral ankle ligament sprain, supportive taping is useful during the early stages of return to activity. Recent evidence supports the beneficial effect of exercise therapy for preventing recurrent lateral ankle sprains, reducing the risk of functional ankle instability, and increasing the rate of recovery of ankle-joint functionVuurberg, 2018. It is therefore recommended that exercise should be commenced after acute lateral ankle ligament sprain to optimise recovery of joint functionality. Evidence is conflicting and unclear as to whether exercise therapy should be supervised or not.

Complete ligament tear or rupture may require surgical repair.