A modified mobilization-with-movement to treat a lateral ankle sprain.

Authors: Mau H, Baker RT

Lateral ankle sprains (LAS) are common occurrences in sports and can result in a high rate of re-injury and chronic ankle instability (CAI). Recent evidence supports the use on mobilizations directed at the ankle in patients who have suffered a LAS. The Mulligan Concept of Mobilization-with-Movement (MWM) provides an intervention strategy for LAS’s, but requires pain-free mobilization application and little literature exists on modifications of these techniques. The purpose of this case study is to present the use of a modified MWM to treat LAS’s when the traditional MWM technique could not be performed due to patient reported pain and to assess outcomes of the treatment. The subject of this case report is a 23-year-old female collegiate basketball player who had failed to respond to initial conservative treatments after being diagnosed with a lateral ankle sprain. The initial management and subsequent interventions are presented. After re-examination, the addition of a modification of a MWM technique produced immediate and clinically significant changes in patient symptoms. The use of the modified-MWM resulted in full resolution of symptoms and a rapid return to full athletic participation. Recent evidence has been presented to support the use of mobilization techniques to treat patient limitations following ankle injury; however, the majority of evidence is associated with addressing the talar and dorsiflexion limitations. Currently, little evidence is available regarding the use of the MWM technique designed for LAS’s and the expected outcomes. This case adds to the emerging evidence supporting the use for MWMs to treat ankle pathology and introduces a modification that may be applied in cases where patient reported pain prevents traditional application.

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