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A case of effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain.

A case of effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain. A case of effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain.
A case of effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain. A case of effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain.

A 21-year-old woman complained of lateral left ankle pain after experiencing a grade 2 ankle inversion sprain during walking one week prior to treatment. She had been diagnosed with left ankle inversion sprain 2 years prior, for which she had received manual physical therapy for 3 weeks. However, she continued to experience occasional ankle sprain. She complained of painful ankle inversion and instability when descending stairs, ascending an oblique surface, and standing on unstable ground and severe pain during running, jumping, and squatting. Full weight bearing on the sprained leg was especially difficult.

 The most likely diagnosis of this presentation is

  • Ankle inversion sprain
  • Ankle instability
  • Ankle pain

Ankle inversion sprain often occurs during sports-related activity, landing on an inverted and plantar flexed foot after jumping, and running on uneven surfaces. Approximately 85% of ankle sprain injuries are related to the lateral ligament. It involves pain, lateral ligamentous injury, excessive ankle inversion, swelling, and limitations in ankle range of motion. Some patients with ankle inversion sprain experience continuous pain and ankle instability at long-term follow-up. Additionally, the re-injury rate of ankle inversion sprain may be as high as 80 per cent. Therefore, utilizing the most effective intervention for ankle inversion sprain is important. Here, we report the effects of repeated application of ankle eversion taping (AET) using kinesiology tape in a patient with ankle inversion sprain.

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Key take away

A young lady with grade 2 ankle inversion sprain had significant improvement in functional dynamic balance, ankle instability and pain after using ankle eversion taping for four weeks.

Medical history

She had a history of left ankle inversion sprain two years prior, for which she had received manual physical therapy for three weeks.

Examination & lab investigations

In the initial assessment, the Numeric Pain Rating Scale (NPRS) score of the lateral ankle at rest was 4 and that on application of 3 kg pressure on the most tender area of the lateral ankle using an algometer was 7. Her left ankle score on the Cumberland Ankle Instability Tool (CAIT) questionnaire was 2/30. The Y-Balance test was used to assess functional dynamic balance with ankle instability. The maximal reach distances of the opposite leg in 3 directions (anterior, posteromedial, and posterolateral) while in a sprained left leg stance were 35 cm, 55 cm, and 54 cm, respectively. The lunge test was used to assess ankle flexibility. The initial distance of the left toe was 5 cm.

Management

Followed by detailed diagnosis, patient was treated with ankle eversion taping (AET) using kinesiology tape daily to the left ankle for 4 weeks (average, 15 h/day). Firstly, an I-shaped tape was applied from the talus to the calcaneus in a mild dorsiflexion position for posterior talar glide. Secondly, an I-shaped tape was applied from 5 cm above the lateral malleolus, over the medial calcaneus, to the inside of the instep of the foot in an eversion position to prevent painful inversion. Thirdly, an I-shaped tape was applied using the same method as that used for the second tape to reinforce prevention of painful inversion and allow ankle eversion. Fourthly, an I-shaped tape was applied using the same method as that used for the first tape to reinforce posterior talar glide and provide ankle support. We applied AET to the sprained left ankle daily after removal of the AET applied the previous day, even though the patient did not complain of itchiness. Additionally, the start and end points of the tape (approximately 2–3 cm) were applied without stretching to prevent skin problems. No other treatment intervention for ankle inversion sprain was used.

Discussion

This case study showed that repeated AET application for 4 weeks reduced lateral ankle pain and improved ankle flexibility and functional dynamic balance. Painful plantar flexion and inversion of the sprained ankle were prevented through a more everted ankle with AET application. In addition, the sprained ankle was protected from re-injury through the mechanical effects of AET application. Previous studies have reported that kinesiology tape application to an ankle with instability and eversion sprain reduced pain and improved stability. Therefore, healing of ankle inversion sprain was possible.

Learning

Repeated ankle eversion taping is an effective treatment intervention for ankle inversion sprain as in this case. Ankle instability and pain were reduced and functional dynamic balance was improved after ankle eversion taping for 4 weeks. Kinesiology tape may provide support to the joint structure and improve joint position sense. However, future studies on the clinical effects of AET in a larger number of patients with ankle inversion sprain are required.

References

    1. Hockenbury RT, Sammarco GJ.: Evaluation and treatment of ankle sprains: clinical recommendations for a positive outcome. Phys Sports med, 2001, 29: 57–64.
    2. Beynnon BD, Murphy DF, Alosa DM.: Predictive factors for lateral ankle sprains: a literature review. J Athl Train, 2002, 37: 376–380.
    3. Krueger B, Becker L, Leemkuil G, et al.: Does talocrural joint-thrust manipulation improve outcomes after inversion ankle sprain? J Sport Rehabil, 2015, 24: 315–321.
    4. Gerber JP, Williams GN, Scoville CR, et al.: Persistent disability associated with ankle sprains: a prospective examination of an athletic population. Foot Ankle Int, 1998,19: 653–660.
    5. Smith RW, Reischl SF.: Treatment of ankle sprains in young athletes. Am J Sports Med, 1986, 14: 465–471.
    6. Kim BJ, Lee JH.: Effects of scapula-upward taping using kinesiology tape in a patient with shoulder pain caused by scapular downward rotation. J Phys Ther Sci, 2015, 27: 547–548.
    7. Hiller CE, Refshauge KM, Bundy AC, et al.: The Cumberland ankle instability tool: a report of validity and reliability testing. Arch Phys Med Rehabil, 2006, 87: 1235–1241.
    8. Lee DK, Kim GM, Ha SM, et al.: Correlation of the Y-balance test with lower-limb strength of adult women. J Phys Ther Sci, 2014, 26: 641–643.

Source:

J Phys Ther Sci. 2016 Feb; 28(2): 708–710.

Article:

A case of effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain.

Authors:

Sun-Min Lee et al.

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