The effect of three degrees of elevation on swelling in acute inversion ankle sprains

Abstract

The use of elevation is a central tenant in the treatment of acute soft tissue injuries, the most appropriate degree of elevation for swelling reduction is yet to be established The aim of this study was to determine the acute effect different degrees of limb elevation on the amount of swelling present in patients with acute first and second degree anterior Talo-fibular ligament sprains. Thirty patients with a diagnosed grade 1 or 2 anterior Talo-fibular ligament (ATFL) sprains (injuries 24 to a maximum 72 h old) participated in the study. Subjects were randomly allocated to one of three groups, either 0°, 20° or 60° elevation. Each subject was elevated to the group angle for 30 min, following 30 min elevation the patients undertook two sets of 20 repetitions full (available) range dorsi to plantar flexion at 0° elevation. Volumetric measurement of the foot and ankle (water displacement method) and girth measurement of ankle (using a tape measure) were made pre-elevation, post-elevation and post-exercise. MANCOVA analysis revealed a significant effect for treatment on post elevation girth and volume measurements ( p < 0.0001 ) and post exercise girth and volume measurements ( p < 0.0001 ). Post-hoc stepwise comparisons revealed post-elevation and post-exercise volume and girth measurements to show a significantly greater reduction in 60° vs. 20° ( p < 0.0001 ), 60° vs. 0° ( p < 0.0001 ) and 20° vs. 0° ( p < 0.003 ). The results of this study would indicate that in acute ATFL sprains 60° of limb elevation provides the most effective acute means of swelling reduction.