Ankle sprains cause lasting problems for some

NEW YORK (Reuters Health) - While many people who sprain an ankle get back on their feet quickly, some continue to have pain and other problems for months to years, a new study shows.

Ankle sprains occur when a ligament in the joint is over stretched or torn, often from a sudden twist or awkward landing of the foot. While ankle sprains are among the most common of sports injuries, surprisingly little has been known about how the recovery typically plays out.

For the new study, published in the American Journal of Medicine, researchers reviewed 31 previous studies that followed ankle-sprain sufferers who had received standard treatment, such as physical therapy and ankle bracing.

Overall, the review found, a majority of patients said their pain was substantially better within two weeks of the injury. But in several studies, up to one-third were still having pain one year later, while as many as one-quarter reported lingering pain at the three-year mark.

And while most patients eventually felt they'd recovered their normal ankle stability, up to half in certain studies reported lasting stability problems.

When it came to the risk of re-injuring the ankle, the studies came to wide-ranging conclusions -- with anywhere from 3 percent to 34 percent of patients suffering a repeat sprain during the study follow-up

Unfortunately, the factors that make certain people vulnerable to long-term problems are not clear, according to the researchers, led by Rogier M. van Rijn of Erasmus Medical Center in Rotterdam, the Netherlands.

Only one study in the review looked at such prognostic factors. Those researchers found that patients who were highly active in sports -- training at least three times per week -- were at heightened risk of a repeat sprain or incomplete recovery.

According to van Rijn and his colleagues, more studies should now investigate the risk factors for poor recovery from an ankle sprain. Doctors might then be able to target high-risk patients for more-intensive treatment.

SOURCE: American Journal of Medicine, April 2008.