The effectiveness of mobilisation with movement for chronic medial ankle pain: a case study

M Penso

doi:10.4102/sajp.v64i1.94

Abstract

Introduction and Purpose: It has been shown that approximatelythirty percent of those sustaining an ankle sprain are likely to develop chronicfunctional limitations. Mulligan has developed mobilisation with movement (MWM)for treatment of joint dysfunction and suggests that it is a positional fault of the jointthat causes pain and movement restriction. Method: This single case reports on the effects of a MWM technique on chronicmedial ankle pain. The patient was a 25-year-old female runner who had experiencedpain since an initial ankle sprain at 8 years of age. The main findings of the subjective and physical examinations were decrease in active and passive dorsiflexion and eversion range of motion (ROM), shortening of gastrocnemiusand soleus muscles and the functional limitation of pain when running. The patient was treated twice with the MWMtechnique.Results: Outcomes of immediate reduction in pain, restoration of full dorsiflexion and eversion ROM, increase in calfmuscle length and pain free running were observed. This was maintained over a four-month follow up period.Conclusion: This case concurs with previous studies detailing increases in range of motion and restoration of painfree movement as well as adding new support for the resolution of chronic pain with MWM.

Highlights

Introduction and PurposeIt has been shown that approximately thirty percent of those sustaining an ankle sprain are likely to develop chronic functional limitations
Outcomes of immediate reduction in pain, restoration of full dorsiflexion and eversion ROM, increase in calf muscle length and pain free running were observed. This was maintained over a four-month follow up period. This case concurs with previous studies detailing increases in range of motion and restoration of pain free movement as well as adding new support for the resolution of chronic pain with mobilisation with movement (MWM)
This study has shown the beneficial effects of applying a MWM technique to manage chronic medial ankle pain

Summary

Introduction

It has been shown that approximately thirty percent of those sustaining an ankle sprain are likely to develop chronic functional limitations. The subject of this case study presented with chronic medial ankle pain with a history of a serious ankle sprain as a child. Especially of the lateral ankle ligaments, are extremely common injuries in both the athletic and the general population (Brukner and Khan 2001, Kirchner et al 2005). Thirty percent of those sustaining an ankle sprain are likely to develop chronic functional limitations post injury regardless of whether treatment was previously received (Kavanagh 1999, Kirchner et al 2005). Accurate history taking and examination of the ankle will guide in the appropriate management (Brukner and Khan 2001, Kirchner et al 2005). The decreased dorsiflexion ROM predisposing to recurring ankle injuries (Vicenzino et al 2006)

Objectives

Discussion

Conclusion