Massage Therapy and Ankle Sprains

foot massage

Massage Therapy and Ankle Sprains

Following an initial ankle injury there is a risk of re-injury dependent on a combination of factors including, but not limited to: sensorimotor deficits and changes in ankle biomechanics. Massage therapists are uniquely suited to incorporate a number sensory-targeted rehabilitation strategies for patient with chronic ankle instability.

The most effective approach is a multi-modal rehabilitation strategy utilizing exercise (proprioceptive and strengthening) and manual therapy (plantar massage, joint mobilizations and neural mobilization) to enhance motor control in patients (Doherty et al. 2017Plaza-Manzano et al.  2016).

Why Does Massage Therapy Work for Ankle Sprains?

The biopsychosocial model provides a practical framework for investigating the complex interplay between massage therapy and clinical outcomes. Which helps put into context the interconnected and multidirectional interaction between: physiology, thoughts, behaviors, and beliefs.

An observed favorable outcome may be explained by a number of overlapping mechanism in the periphery, spinal cord, and brain represented in the image below.

A contemporary framework for investigating  the complex interplay between massage therapy and clinical outcomes .

Structures to be Aware of When Treating Ankle Sprains

nerves of the foot

A massage therapy treatment plan should be implemented based on patient-specific assessment findings and patient tolerance. Structures to keep in mind while assessing and treating patients suffering from ankle pain may include neurovascular structures and investing fascia of:

  • Plantar Fascia

  • Lumbricals

  • Adductor Hallucis

  • Flexor Hallucis Brevis

  • Tibialis Anterior

  • Metatarsals & Interossei

  • Peroneals

  • Tibialis Posterior

  • Triceps Surae

More to Explore

Cleland et al. (2013). Manual physical therapy and exercise versus supervised home exercise in the management of patients with inversion ankle sprain: a multicenter randomized clinical trial. JOSPT.

Doherty et al. (2017). Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. Br J Sports Med.

Delahunt et al. (2018). Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium. Br J Sports Med.

Eglitis et al. (2016). The Importance of the Saphenous Nerve in Ankle Surgery. Anesth Analg.

Fraser et al. (2016). Midfoot and forefoot involvement in lateral ankle sprains and chronic instability. Part 1: Anatomy and Biomechanics. Int J Sports Phys Ther.

Fraser et al. (2016). Clinical commentary on midfoot and forefoot involvement in lateral ankle sprains and chronic ankle instability. Part 2 Clinical Considerations. Int J Sports Phys Ther.

Kalichman et al. (2016). Long-term impact of ankle sprains on postural control and fascial densification. 

McKeon & Wikstrom (2018). The effect of sensory-targeted ankle rehabilitation strategies on single-leg center of pressure elements in those with chronic ankle instability: A randomized clinical trial. J Sci Med Sport.

McKeon & Fourchet. (2016). Freeing the foot: integrating the foot core system into rehabilitation for lower extremity injuries. Clin Sports Med.

McKeon & Wikstrom. (2016). Sensory-Targeted Ankle Rehabilitation Strategies for Chronic Ankle Instability. Med Sci Sports Exerc.

McKeon et al. (2015). The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med.

Miklovic et al. (2017). Acute lateral ankle sprain to chronic ankle instability: a pathway of dysfunction. Phys Sportsmed.

Paraskevas et al. (2014). Fascial entrapment of the sural nerve and its clinical relevance. Anatomy & Cell Biology.

Plaza-Manzano et al. (2016). Manual therapy in joint and nerve structures combined with exercises in the treatment of recurrent ankle sprains: A randomized, controlled trial. Man Ther.

Powden et al. (2017). Rehabilitation and Improvement of Health-Related Quality-of-Life Detriments in Individuals With Chronic Ankle Instability: A Meta-Analysis. J Athl Train.

Silva et al. (2017). Effects of Anteroposterior Talus Mobilization on Range of Motion, Pain, and Functional Capacity in Participants With Subacute and Chronic Ankle Injuries: A Controlled Trial. J Manipulative Physiol Ther.

Southerst et al. (2015). The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Chiropr Man Therap.

Terada et al. (2017). Altered postural control variability in older-aged individuals with a history of lateral ankle sprain. Gait Posture.

Terada et al. (2013). Therapeutic interventions for increasing ankle dorsiflexion after ankle sprain: a systematic review. J Athl Train.

Truyols-Domí Nguez et al. (2013). Efficacy of thrust and nonthrust manipulation and exercise with or without the addition of myofascial therapy for the management of acute inversion ankle sprain: a randomized clinical trial. JOSPT.

Vuurberg et al. (2018). Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med.

Weerasekara et al. (2017). Clinical benefits of joint mobilisation on ankle sprains: a systematic review and meta-analysis. Arch Phys Med Rehabil.

Wikstrom et al. (2017). Comparative Effectiveness of Plantar-Massage Techniques on Postural Control in Those With Chronic Ankle Instability. J Athl Train.

Wikstrom & McKeon. (2017). Predicting Manual Therapy Treatment Success in Patients With Chronic Ankle Instability: Improving Self-Reported Function. J AthlTrain. 

Zhao et al. (2018). Acupressure Therapy for Acute Ankle Sprains: A Randomized Clinical Trial. PM R.